
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.
The High Court in Cape Town rejects the Road Accident Fund’s contention that the Mlambo judgment has altered the legal landscape.
A regulatory expert believes the judgment misinterpreted key legal principles in its ruling on the RAF’s obligation to reimburse medical schemes.
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.
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.
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.
Downgrading to a lower plan may appear to be a cost-saving strategy, but it frequently results in increased out-of-pocket expenses.
Bestmed states pending rules for low-cost benefit options have further complicated efforts to reduce costs for members.
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.
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 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.
In 2022, the High Court ruled that the fund could not withhold payments for past medical expenses covered by medical schemes.
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.
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.
Council for Medical Schemes urges investigation into ‘worrisome’ AGM costs as new research report reveals disparities within the medical scheme landscape.
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