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Recently announced changes to medical cover provider rules should ultimately benefit consumers – GTC Healthcare

31 January 2017 | Medical Schemes

Changes to the rules regulating medical cover providers have caused concern among consumers over the continuity of their products. However, very little attention has been paid to the fact that the Minister of Health has requested the Council for Medical Schemes to grant an exemption for a period of two years for the changes in product structures to take effect.

CMS clarifies facts re beneficiary registry

26 January 2017 | General

The Council for Medical Schemes (CMS) noted with great concern the recent press statements and subsequent radio and television interviews regarding the beneficiary registry (BR). The CMS would like to clarify the position and any misconceptions created by these statements concerning the BR. Current press releases and billboards are misleading in that they wrongly suggest that the CMS will be collecting medical data. It is not the CMS’ intention to collect any medical data and the directive received from the Minister of Health is clear in this regard.

CMS CE & registrar of medical schemes passed away

23 January 2017 | Medical Schemes

The Chief Executive & Registrar of the Council for Medical Schemes (CMS), Dr Humphrey Zokufa has passed away on Sunday, 22 January 2017, after a short period of being ill.

Appeal Board ruling clarifies application of section 59(2) of the Medical Schemes Act

09 December 2016 | Medical Schemes

The ruling by the Appeal Board to dismiss a claim lodged by a medical doctor against the South African Police Service Medical Scheme (POLMED) (appellant) has helped to provide clarity on the application of section 59(2) of the Medical Schemes Act, 131 of 1998 (MSA). The section states that when there is a benefit owing to a member, the scheme has the right to pay either the member or the service provider directly within 30 days after the claim was received by the scheme. This interpretation had been confirmed by the High Court previously, but a recent judgment concerning claims submitted to a liquidated scheme created confusion in the industry as to whether the scheme has a discretion to elect who to pay, following a claim.

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