
Coalition: government’s ‘piecemeal’ healthcare reforms fall short
The Universal Healthcare Access Coalition says the proposed tariff-setting measures for private healthcare side-step essential reforms.

The Universal Healthcare Access Coalition says the proposed tariff-setting measures for private healthcare side-step essential reforms.

But the government cannot afford to set up an independent supply-side regulator as recommended by the Health Market Inquiry.

After months of speculation, Sanlam has officially partnered with Fedhealth as its exclusive open medical scheme provider.

In its long-awaited report, the Council for Medical Schemes says its preferred recommendation is not to introduce LCBOs.

The Board of Health Funders has ‘serious reservations’ about giving the Department of Health the power to manage the block exemption negotiation process.

A regulatory expert believes the judgment misinterpreted key legal principles in its ruling on the RAF’s obligation to reimburse medical schemes.

The case raises questions about whether LCBOs will expand access to affordable private healthcare or threaten the rollout of NHI.

Dr Musa Gumede steps into the role of Registrar of the CMS, succeeding Dr Sipho Kabane, whose tenure was marked by significant challenges and critical industry reforms.

Bestmed states pending rules for low-cost benefit options have further complicated efforts to reduce costs for members.

Launched in 2019, the inquiry sought to investigate allegations of racial profiling by medical schemes. As 2024 draws to a close, the CMS is still battling objections and technical reviews to finalise the report.

Medical schemes cannot cancel membership based solely on the non-disclosure of a diagnostic procedure that does not lead to the diagnosis of a serious medical condition.

Schemes and healthcare professionals are at odds over whether these recoveries are justified, says the Council for Medical Schemes.

With major medical schemes reporting average contribution hikes exceeding 9%, members face tough choices in an increasingly unaffordable healthcare landscape.

Discovery Health Medical Scheme’s contribution adjustments will be more evenly distributed across its members, highlighting the widespread effects of increasing medical inflation on contribution rates.

The Council for Medical Schemes has advised medical schemes to limit their contribution increases for 2025 to 4.4% plus ‘reasonable’ utilisation estimates.

The deterioration in Sizwe Hosmed’s reserves is attributed to ‘benefit under-pricing and historically unreliable budgetary and forecasting processes’.

The Council will provide a CPD-accredited training session for newly appointed healthcare brokers in August.