Bonitas commits to co-operating with CMS investigation
After concluding its section 43 inquiry into Bonitas, the CMS has determined that the allegations merit a further forensic investigation.
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Medihelp to appeal contempt judgment in Elaprase case
Medihelp says it will challenge the judgment while the cost of Elaprase awaits a final decision by the CMS Appeal Board.
CMS: No complaints about brokers’ conduct in 2024/25
The Council for Medical Schemes’ latest annual report shows a decline in registered complaints – continuing a three-year downward trajectory.
Consumer Goods Medical Scheme launches new options as it opens to entire sector
The Council for Medical Schemes has approved two savings plans that will be marketed from 1 November.
CMS research points to urgent need for chronic disease and cost-of-care reforms
Two new CMS studies highlight the growing strain of chronic diseases and soaring out-of-pocket healthcare costs.
High Court confirms curatorship of medical scheme
The Court ordered Sizwe Hosmed’s principal officer to personally pay legal costs after dismissing the scheme’s attempt to overturn the provisional curatorship.
Discovery delays 2026 contribution increase to April
Leading open medical schemes have announced increases above the CMS’s guidance, underscoring the tension between regulator calls for restraint and schemes’ funding needs.
Provisional curator to advise on future of medical scheme
The curator will assess Sizwe Hosmed’s finances and recommend whether it should merge, be liquidated, or continue.
Medical scheme hikes: CMS calls for restraint, but will schemes listen?
The Council for Medical Schemes recommends capping 2026 contribution increases at 3.3% plus “reasonable utilisation estimates”, yet past trends show schemes often push far higher.
Panel upholds findings of racial bias in medical scheme fraud investigations
Statistical analysis found that black healthcare professionals were multiple times more likely than their white peers to be investigated and found guilty of FWA.
BHF and Discovery challenge section 59 report’s conclusions
The Board of Healthcare Funders and Discovery Health say the panel’s final report on FWA investigations rests on flawed methodology and the misinterpretation of data.
Medihelp’s solvency dips again, but scheme says recovery plan is working
Medihelp says its recovery plan is on track, with strong cost controls, younger members, and CMS-approved funding measures set to restore financial stability by 2026.
CMS will issue a new circular on appointment of healthcare brokers
A significant ruling by the Appeal Board rendered the processes outlined in the circulars published in 2022 invalid.
Pandemic pricing pains catch up with medical schemes – higher contributions ahead
Three medical schemes fell below the 25% solvency threshold in 2023.
Major setback for medical schemes in legal battle over low-cost options
The Board of Healthcare Funders says it will appeal after the High Court dismissed its application on procedural and substantive grounds.
CMS extends exemption for primary healthcare policies
Insurers are allowed to offer primary healthcare policies for an additional two years pending the finalisation of a framework for low-cost benefit options.
Medical schemes push ahead with case over Covid test pricing
The Competition Tribunal has dismissed key objections from major pathology laboratories, moving the medical schemes closer to having their damages claim heard in the High Court.
