Topnav

Tag Archives | Board of Healthcare Funders

Docs will benefit if funders stand together to fight fraud

While most medical schemes go to great pains to emphasise that it is only the few ‘bad eggs’ among service providers that commit fraud against funders, the public image of medical professionals continues to bear the brunt of this scourge. And medical schemes may be contributing to the problem by adopting a ‘lone-rider’ approach to […]

Continue Reading · 0

Medical Schemes Question New PMSA Requirements

Despite several issues raised by the Board of Healthcare Funders (BHF) on behalf of its members and the South African Institute of Chartered Accountants (SAICA), the Council for Medical Schemes (CMS) seems to be forging ahead with the implementation of Circular 38 of 2011. This circular compels medical schemes to ringfence and pay interest on […]

Continue Reading · 0

PMBs: Focus on Price Misses the Main Issue

Barry Childs, Lighthouse Actuarial Consulting and CareGauge The recent ruling regarding what schemes are liable to pay for Prescribed Minimum Benefits (PMBs) claims has left many asking ‘so now what?’. The Board of Healthcare Funders (BHF) was hoping the court would find that schemes are only liable up to their benefits stated in their rules for […]

Continue Reading · 0

Psychologists up in Arms over New Scope of Practice Requirements

The recent announcement by the HPCSA of an amended scope of practice for psychologists has been met with disappointment in some quarters. The regulations, published in the Government Gazette on 2 September, define nine categories of which neuro- and forensic psychologies are new subspecialty groups. Other practitioner groups, such as counselling and educational psychologists, some […]

Continue Reading · 0

Patients Expected to be the Winners in PMB Court Battle

The Board of Healthcare Funders’ (BHF) urgent­ application for a declaratory order as to the ­meaning of the words ‘payment in full’ for Prescribed Minimum Benefits (PMBs) as contained in Regulation 8 (1) of the Medical Schemes Act (MSA), was heard in the North Gauteng High Court in Pretoria on 22 and 23 September. A […]

Continue Reading · 0

Law in Practice: Fee Regulation and Price Setting: Legal and Policy Considerations

Elsabé Klinck  Following the statements by health minister Dr Aaron Motsoaledi at both the Cosatu and the Board of Healthcare Funders (BHF) conferences, it appears that some form of price regulation, or even price-setting is on the cards. On 27 July 2011, Parliament’s health portfolio committee heard presentations from the Council for Medical Schemes (CMS), the […]

Continue Reading · 0

BHF Court Application: SAPPF Joins the Fray

Cost studies undertaken by the SA Private Practitioners Forum (SAPPF) in terms of the Reference Price List (RPL) process revealed that the benefits that medical schemes currently pay for Prescribed Minimum Benefits (PMB) conditions are a fraction of what they should be. If the Board of Healthcare Funders (BHF) gets its way and schemes are […]

Continue Reading · 1

BHF Slated for ‘Sneaky’ PMB Court Action

Private health care providers have lambasted the Board of Healthcare Funders (BHF) for trying to sneak through an urgent court interdict against the Council for Medical Schemes (CMS) to prevent the council from acting against medical schemes not complying with the ‘payment in full’ requirement of Regulation 8 of the Medical Schemes Act, relating to […]

Continue Reading · 0