Negotiating forum is a ‘critical step’ in addressing the cost of healthcare
But the government cannot afford to set up an independent supply-side regulator as recommended by the Health Market Inquiry.
#CouncilforMedicalSchemes
Sanlam’s split with Bonitas paves the way for exclusive Fedhealth partnership
After months of speculation, Sanlam has officially partnered with Fedhealth as its exclusive open medical scheme provider.
Health Minister signals opposition to low-cost benefit options for medical schemes
In its long-awaited report, the Council for Medical Schemes says its preferred recommendation is not to introduce LCBOs.
Minister proposes interim framework for collective healthcare tariff-setting
The Board of Health Funders has ‘serious reservations’ about giving the Department of Health the power to manage the block exemption negotiation process.
Discovery vs RAF: CMS executive says High Court got it wrong
A regulatory expert believes the judgment misinterpreted key legal principles in its ruling on the RAF’s obligation to reimburse medical schemes.
Court hears case on low-cost benefit options for medical schemes
The case raises questions about whether LCBOs will expand access to affordable private healthcare or threaten the rollout of NHI.
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.
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.
