
Bonitas, Medscheme clash over scope of CMS investigation
Medscheme says the CMS has broadened its investigation into Bonitas’s procurement processes, but Bonitas disputes that interpretation.

Medscheme says the CMS has broadened its investigation into Bonitas’s procurement processes, but Bonitas disputes that interpretation.

The regulator says it is monitoring the situation and sees signs of improvement, but some members continue to report difficulties accessing healthcare and resolving claims.

Medscheme says it repeatedly warned Bonitas against a ‘clean-cut’ transition and disputes the scheme’s claim that unresolved legacy issues were behind the service disruptions experienced by members after the administration switch.

The scheme says continuity of care remains the priority as it moves administration to Momentum Health and managed care to PHA on 1 June.

From broker commissions to digital channels and claims processing, Momentum Health has set out what stakeholders can expect when Bonitas changes administrators.

Private Health Administrators outlines how provider contracts, managed-care operations, and service commitments will work from 1 June.

The appointment strengthens Medscheme’s foothold in the employer-based healthcare sector.

Sanlam and Momentum outline how they are managing workforce, operations, and risk as the Bonitas transition proceeds despite an unresolved court challenge.

Medscheme’s bid to halt Bonitas’ administration transition has been delayed after procedural lapses and unresolved interlocutory issues forced the matter off the urgent roll.

Bonitas, Medscheme, and PHA trade accusations as court papers, whistleblower claims, and a CMS probe intensify the battle over medical scheme contracts.

The scheme and the regulator say a narrowly focused investigation will not halt the transition – but members should brace for some operational changes.

Bonitas’ decision to change administrators comes amid a CMS investigation and High Court proceedings involving its former service provider.

After concluding its section 43 inquiry into Bonitas, the CMS has determined that the allegations merit a further forensic investigation.

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

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.