Medical expenses | Court grants leave to appeal in member’s dispute with RAF
The outcome of Discovery Health’s appeal before the SCA will affect the outcome of the member’s claim for R1.4 million.
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Court orders RAF to pay medical scheme members’ claims
Another attempt by the Road Accident Fund to contest liability based on the ‘majority decision’ against Discovery Health has fallen through.
Majority judgment ‘does not alter’ RAF’s liability for medical scheme members’ claims
The High Court in Cape Town rejects the Road Accident Fund’s contention that the Mlambo judgment has altered the legal landscape.
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.
Discovery to appeal ‘far-reaching’ judgment in favour of RAF
The High Court says Discovery Health misconstrued the scope of the judgment that set aside the RAF’s first directive on the payment of medical scheme members’ claims.
How the dispute between the RAF and Discovery unfolded
Discovery Health’s quest for reimbursement from the RAF for medical expenses incurred by road accident victims has faced multiple legal hurdles, with new RAF directives complicating the situation.
Rising demand for weight-loss drugs: balancing health, cost, and supply
The demand for GLP-1 medications as a weight-loss solution raises critical questions about accessibility, affordability, and the long-term sustainability of their use for managing obesity and diabetes.
Rising costs prompt members to weigh medical scheme options
Downgrading to a lower plan may appear to be a cost-saving strategy, but it frequently results in increased out-of-pocket expenses.
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.
RAF makes noise while silence reigns on draft Road Accident Amendment Bill
Judgment is ‘forthcoming’ in the contempt of court case against the Road Accident Fund and its CEO, as Discovery Health seeks the enforcement of court rulings regarding unpaid claims.
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.
Discovery Health says Road Accident Fund is in breach of court order
In 2022, the High Court ruled that the fund could not withhold payments for past medical expenses covered by medical schemes.
Hypertension surging among young medical scheme members
Chronic high blood pressure, a leading cause of heart attacks and strokes, is driving up healthcare costs significantly, according to recent claims data from Discovery Health.
RAF claims ‘out of ICU’, but hundreds of millions still owed to medical scheme clients
Despite Parliament’s commitment to prioritise the Road Accident Amendment Bill, there has been no further communication about the comments submitted on the draft legislation.
Medical schemes regulator flags ‘extravagant’ AGM expenses
Council for Medical Schemes urges investigation into ‘worrisome’ AGM costs as new research report reveals disparities within the medical scheme landscape.
