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Medical Schemes
CMS seeks to place Netcare scheme under curatorship
In yet another clash with the healthcare industry, and following recent accusations of hostility and harassment, the Council for Medical Schemes (CMS) has applied...
Regulator abusing power and hostile towards medical schemes – BHF
In an unprecedented move, the Board of Healthcare Funders (BHF) has sent a legal letter to the Council for Medical Schemes and the Health...
Drastic surge in medical gap cover
The medical aid industry is struggling to contain inflation, say experts, with insurance underwriters describing regular individual gap payouts to cover medical aid shortfalls...
Report on cheap medical aid options handed to Minister, finally
The Council for Medical Schemes has submitted its report on affordable medical scheme options to Health Minister Dr Joe Phaahla – although the Board...
Fraud and waste costs medical aids billions every year
An eye-popping R30bn – or 15% of total revenue – is being lost by medical aids to fraud, waste and system abuse every year,...
Discovery's 'chronic cover’ ad misleading, regulator finds
The Advertising Regulatory Board (ARB) has ordered Discovery Health to qualify its claim to offer “comprehensive” chronic cover after a complaint by leading business...
Only 15% of South Africans on medical aid
Countless working-class South Africans can no longer afford medical aid, according to general secretary of the Public Service Co-ordinating Bargaining Council Frikkie de Bruin,...
Shrinking proportion of South Africans on medical aid
The number of South Africans belonging to medical schemes overshot the 9m mark for the first time in 2022, but rapid population growth means...
Capping medical aid hikes won’t solve healthcare woes
The stark reality is that the South African private healthcare sector, in its current format, is unsustainable, writes Gary Feldman in Business Day, but...
Mediclinic's alleged irregular billing sparks forensic probes
A whistle-blower’s allegations – that six Mediclinic hospitals are guilty of irregular billing practices – have opened a can of worms, with forensic investigations...
How medical aid premiums are calculated and spent
The Council of Medical Schemes (CMS) recently announced that 2024 monthly premium increases should be capped at 5%, but with permission, this could rocket up...
Consumers shoulder burden of medical aid schemes fraud
Fraud and abuse are being practised by medical schemes that are failing to pay out prescribed minimum benefits (PMB) to members, forcing consumers to...
Special medicines fund proposal as medical aids under pressure
Against the backdrop of a stagnant medical-scheme growth environment, escalating costs of care and government dragging its feet on low cost medical aid options,...
Medical aid schemes shrink, but member numbers grow
Although the number of registered medical schemes continued to decrease over the past year, the number of principal members had increased by the end...
CMS reversal on low-cost benefits amounts to 'Let them eat cake' — Agility CEO
The Council for Medical Schemes' abrupt prohibition of low-cost benefit options will have "far-reaching and harmful effects, not least on the poor which these...
CMS move to scrap low-cost plans is 'catastrophic and unconstitutional'
The Council for Medical Schemes has stunned the private health care sector with its decision to scrap by March 2021 the pared-down schemes and...