New chief executive and Registrar appointed for the Council for Medical Schemes
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.
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Bestmed defends 12.75% 2025 contribution hike as industry faces cost pressures
Bestmed states pending rules for low-cost benefit options have further complicated efforts to reduce costs for members.
CMS aims to release long-awaited report into racial profiling by year-end
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.
ConCourt clarifies when medical schemes can cancel membership for non-disclosure
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.
Rise in complaints about medical schemes clawing back losses allegedly linked to fraud and waste
Schemes and healthcare professionals are at odds over whether these recoveries are justified, says the Council for Medical Schemes.
As medical schemes announce hikes, members brace for tough choices amid rising costs
With major medical schemes reporting average contribution hikes exceeding 9%, members face tough choices in an increasingly unaffordable healthcare landscape.
Discovery announces 2025 contribution increases: average hike of 9.3%
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.
Will medical schemes adhere to an inflation-linked tariff hike?
The Council for Medical Schemes has advised medical schemes to limit their contribution increases for 2025 to 4.4% plus ‘reasonable’ utilisation estimates.
Medical scheme placed under statutory management as reserves plummet
The deterioration in Sizwe Hosmed’s reserves is attributed to ‘benefit under-pricing and historically unreliable budgetary and forecasting processes’.
CMS webinars for brokers, trustees, and medical scheme employees
The Council will provide a CPD-accredited training session for newly appointed healthcare brokers in August.
Final report on racial profiling allegations ‘to be released soon’
Nearly four years since the investigation into allegations of racial profiling began, the Council for Medical Schemes has indicated that the final report is almost complete.
Another setback for CMS in legal battle over LCBO documents
The signing of the NHI Act does not mean the BHF is letting up in its fight for regulations on low-cost benefit options.
CMS invites BHF to collaborate, criticises ‘forum-shopping’ tactics
The BHF’s canvassing of key policy issues in the public domain via a ‘deliberately leaked’ lawyer’s letter indicates the organisation ‘has run out of creative ideas’.
Council mulls outsourcing appeal adjudication amid BHF accusations
The CMS asserts that medical schemes have frequently disregarded the existing appeals procedures, exploiting them to the detriment of members’ interests.
CMS denies it is sabotaging medical schemes to boost NHI
The regulator comes out swinging in its response to the Board of Healthcare Funders’ claims of bullying and curatorship abuse.
Primary health insurance policies can be sold for another year
The exemption will remain in force for 12 months unless a decision is made on low-cost benefit options before 31 March 2025.
Board of Healthcare Funders takes Council for Medical Schemes to task in lawyer’s letter
The BHF raises 10 issues, including the ‘misuse’ of curatorships, whether NHI is informing policy prematurely, and the absence of low-cost benefit options.
