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Tag Archives | Prescribed Minimum Benefits

Will PMB changes mean compromised care?

The National Department of Health recently gazetted proposed changes to regulations governing the payment of Prescribed Minimum Benefits (PMBs) by medical schemes, prompting a national debate. While the need for changes is acknowledged, it is important that this change does not compromise quality of care for medical scheme members. (more…)

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Mixed reactions to PMB draft amendments

While medical schemes have welcomed the draft amendments to Regulations 5 and 8 of the Medical Schemes Act (MSA), pertaining to prescribed minimum benefits (PMBs), both the SA Private Practitioners Forum (SAPPF) and the SA Medical Association (SAMA) have voiced concerns about the proposed changes. The two bodies represent the majority of healthcare professionals in the […]

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SASA concerned about draft amendments to PMBs

The South African Society of Anaesthesiologists (SASA) notes with concern a move that may result in loss of patient benefits and multiple additional burdens placed on medical practitioners as a result of the new draft amendments to Regulations 5 and 8 of the Medical Schemes Act as it pertains to reporting requirements and Prescribed Minimum […]

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Motsoaledi doggedly determined to drive down prices

Just as sustained pressure from the government brought down the cost of antiretroviral (ARVs) and TB medicines, private healthcare providers should brace themselves for unrelenting pressure to drive down their prices too. GPs can expect a brighter future under NHI and details on the White Paper remain vague. Medical Chronicle tries to learn more details […]

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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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Doctor’s Voice: Private Medicine: The Battle Continues

Dr AM Levin   Private medicine is facing an ongoing battle on two fronts. The first is the question of the cost of private medicine. Government persistently blames private medicine for the overall cost increase of national healthcare. The reason for, and the correlation of this financial manipulation, has as yet not been fully explained, nor […]

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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 […]

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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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The Doctor’s Voice: Political Ideology has No Place in Quality Healthcare

Dr AM Levin  With the impending National Health Insurance system, it has become imperative that the private healthcare sector adopts a common and uniform policy. Firstly, in terms of the structure of private medical care particularly pertaining to its freedom from government interference, and secondly, the financing of this private healthcare, which must be market-related and […]

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