Explore the Category

Bonitas ups the ante in the fight against healthcare fraud

23 November 2015 | General

Medical aids lose between R9 billion to R19 billion every year to fraud, abuse and waste (FAW).

SCA confirms liability of scheme to fund PMBs in private sector

18 November 2015 | Medical Schemes

The Supreme Court of Appeal (SCA) in Bloemfontein yesterday upheld an appeal by the Council for Medical Schemes (CMS) concerning prescribed minimum benefits (PMBs). The Court per Mr. Justice Leach overturned a judgment of the Western Cape High Court and awarded legal costs to the CMS. The matter concerned the liability of a medical scheme to pay for PMBs obtained from a private hospital as prescribed by the Medical Schemes Act 131 of 1998 (the Act). The contention of the scheme was that in terms of its rules, only services obtained from the state had to be funded under the PMB legislation.

Cost of the top 10 Hospital Plans in South Africa in 2016

16 November 2015 | General

Hospital plans are designed to provide cover for private healthcare funding for the unknown or perhaps unexpected and expensive mishaps in life, such as a big accident, illness or disease. In order to keep contributions affordable, day-to-day or out of hospital expenses are mostly funded by members, as and when needed. This also enables members to exercise direct control over such expenditure.

Tackling healthcare issues in South Africa

16 November 2015 | General

In South Africa, private and public health systems exist side by side. The public system serves the vast majority of the population, but is underfunded and understaffed. The wealthiest of the population use the private system and are better served than the poor.

quick poll

Question

The strongest deterrent against FSP compliance missteps is or should be:

Answer

A criminal conviction Debarment Fine or penalty Any of the above can work

View the Results