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.
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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.
Medical scheme placed under statutory management as reserves plummet
The deterioration in Sizwe Hosmed’s reserves is attributed to ‘benefit under-pricing and historically unreliable budgetary and forecasting processes’.
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.
Medical schemes get costlier as reform takes a back seat to NHI
Members of medical schemes are paying up to 30% more because the regulatory system broke down after the government’s focus shifted to NHI.
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’.
Council mulls outsourcing appeal adjudication amid BHF accusations
The CMS asserts that medical schemes have frequently disregarded the existing appeals procedures, exploiting them to the detriment of members’ interests.
CMS denies it is sabotaging medical schemes to boost NHI
The regulator comes out swinging in its response to the Board of Healthcare Funders’ claims of bullying and curatorship abuse.
Primary health insurance policies can be sold for another year
The exemption will remain in force for 12 months unless a decision is made on low-cost benefit options before 31 March 2025.
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.
Cap on healthcare broker fees increases by 5%
The new limit applies to contributions received from 1 January.
CMS seeks reconsideration after court dismisses appeal on LCBO documents
The Supreme Court of Appeal’s dismissal of the Council for Medical Schemes’ appeal against providing documents to the Board of Healthcare Funders on low-cost benefit options marks the latest development in the ongoing legal dispute.
