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Tag Archives | Council for Medical Schemes

IPASA reacts to Dr Zokufa’s passing

The Innovative Pharmaceutical Association of South Africa and its members, are deeply shocked and mourns the sudden passing of recently appointed of Council for Medical Schemes (CMS) Chief Executive and Registrar Dr Humphrey Zokufa. (more…)

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HPCSA warns about DSPs

The HPCSA has added its voice to a growing sense of dissatisfaction among preferred service providers to medical schemes, over the limitations placed on their ability to provide what they see as being in the best interests of the patient. In a media statement, the Council commented on ‘the practice of enticing practitioners to enter […]

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Doctors, you Have Rights … Use them!

Elsabé Klinck Through doing what we call ‘doctor talks’, I have come to the deep realisation that doctors feel extremely under siege. This is not only as a result of the sheer volume of health-sector changes currently taking place (many in abbreviation form – DCST, HDACC, DHIMS, OHSC – to name but a few), but […]

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Third Time Lucky for BHF?

The Board of Healthcare Funders (BHF) is to appeal the High Court ruling of 11 May, which upheld a previous ruling in November 2011, that it did not have the locus standi (legal standing) to bring an application for a declaratory order on Prescribed Minimum Benefits (PMBs). In both cases, the BHF was ordered to pay […]

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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 […]

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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 […]

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PMBs: Status Quo Remains for Now

The Council for Medical Schemes (CMS) has expressed delight at the Prescribed Minimum Benefits (PMB) ruling made by Judge Cynthia Pretorius in the Gauteng High Court in November last year, while the Board of Healthcare Funders (BHF) expressed disappointment that the merits of Regulation 8 of the Medical Schemes Act were not taken into consideration […]

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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 […]

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NHI: Don’t Panic – Read Between the Lines

The success of the National Health Insurance (NHI) scheme will depend on the effective implementation of four key interventions. According to health minister, Dr Aaron Motsoaledi, these include the complete transformation of healthcare service provision and delivery, the total overhaul of the entire healthcare system, the radical change of administration and management, and the provision of […]

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Private Pricing: Round and Round the Mulberry Bush

In a scenario reminiscent of the era of the late health minister, Dr Manto Tshabalala-Msimang, the private health sector and the Department of Health (DoH) are embroiled in yet another vicious fight over healthcare costs with price regulation again mooted as the only solution to reign in escalating expenditure. Instigated by health minister Dr Aaron […]

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