CMS receives 46 Bonitas complaints, investigates two urgent cases
The regulator says it is monitoring the situation and sees signs of improvement, but some members continue to report difficulties accessing healthcare and resolving claims.
#CouncilforMedicalSchemes
CMS rejects GEMS bid to cut 2026 contribution increase as unions demand answers
The regulator has rejected the scheme’s proposal to reduce its weighted average contribution adjustment to 7.5%, leaving the existing 9.5% increase in place.
Was it really just Covid?
A review of five years of Medihelp’s annual reports traces the events behind the scheme’s fall below and its rise back above the statutory minimum.
Medihelp’s turnaround: How the scheme rebuilt its business before its balance sheet
Twelve months after reporting a solvency ratio of just 20.99%, Medihelp returned above the statutory threshold while almost nine-folding its operating surplus.
High Court upholds medical schemes’ recovery powers
The ruling preserves a key anti-fraud tool that industry bodies say protects member funds and helps contain healthcare costs.
Bigger, older, and more concentrated: 7 facts reshaping medical schemes
Twenty years of industry data show that medical schemes have become increasingly dependent on scale, investment returns, and strong reserves to remain sustainable.
Medscheme rejects Bonitas’s explanation for post-transition disruptions
Medscheme says it repeatedly warned Bonitas against a ‘clean-cut’ transition and disputes the scheme’s claim that unresolved legacy issues were behind the service disruptions experienced by members after the administration switch.
Bonitas members caught in service disruption after administration switch
The medical scheme says legacy issues contributed to post-transition challenges as members report delays with hospital authorisations and medication approvals.
Bonitas: administrator change is part of a wider repositioning
The scheme says continuity of care remains the priority as it moves administration to Momentum Health and managed care to PHA on 1 June.
3Sixty wins lifeline in accreditation dispute with CMS
The High Court finds the Council must disclose the material it relies on before taking a decision that affects the provider’s ability to operate.
Medscheme secures Sisonke administration mandate
The appointment strengthens Medscheme’s foothold in the employer-based healthcare sector.
Parliament flags slow progress on Health Market Inquiry reforms
The CMS cites statutory constraints, while the Portfolio Committee on Health calls for a clear roadmap to implement the Inquiry’s recommendations.
CMS moves to rein in how medical schemes investigate fraud
Circular 10 introduces interim rules to standardise audits, investigations, and clawbacks as broader reforms are developed.
Bonitas-Medscheme court battle stalls as application removed from urgent roll
Medscheme’s bid to halt Bonitas’ administration transition has been delayed after procedural lapses and unresolved interlocutory issues forced the matter off the urgent roll.
Tensions rise as Bonitas and Medscheme clash ahead of court showdown
Bonitas, Medscheme, and PHA trade accusations as court papers, whistleblower claims, and a CMS probe intensify the battle over medical scheme contracts.
Sizwe Hosmed: High Court blocks board comeback, new curator installed
The CMS frames the judgment as necessary to protect members, emphasising the scheme is compliant, operational and under close oversight.
Bonitas-Medscheme split: what the CMS probe means for members
The scheme and the regulator say a narrowly focused investigation will not halt the transition – but members should brace for some operational changes.
