
Major setback for medical schemes in legal battle over low-cost options
The Board of Healthcare Funders says it will appeal after the High Court dismissed its application on procedural and substantive grounds.
The Board of Healthcare Funders says it will appeal after the High Court dismissed its application on procedural and substantive grounds.
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.
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 BHF raises 10 issues, including the ‘misuse’ of curatorships, whether NHI is informing policy prematurely, and the absence of low-cost benefit options.