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.
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.
The signing of the NHI Act does not mean the BHF is letting up in its fight for regulations on low-cost benefit options.
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’.
The CMS asserts that medical schemes have frequently disregarded the existing appeals procedures, exploiting them to the detriment of members’ interests.
The regulator comes out swinging in its response to the Board of Healthcare Funders’ claims of bullying and curatorship abuse.
The exemption will remain in force for 12 months unless a decision is made on low-cost benefit options before 31 March 2025.
The BHF raises 10 issues, including the ‘misuse’ of curatorships, whether NHI is informing policy prematurely, and the absence of low-cost benefit options.
The induction programme takes place online over two days in February.
According to the circular, the regulator has approved the launch of only one new option next year.
