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.
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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 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.
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.
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.
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’.
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.
Regulator finds ‘comprehensive chronic cover’ advert misleading
The former chief executive of Massmart and Edcon filed a complaint with the Advertising Regulatory Board against Discovery Health Medical Scheme.
