Medical schemes accuse CMS of not responding to proposals

29 Jul 2020

According to Dr Katlego Mothudi, managing director of the BHF, the CMS was asked to grant collective exemptions to allow schemes to extend relief such as financially distressed members a contribution holiday during Covid-19 period.

The fact that some schemes did not apply for the exemption does not mean that they did not offer assistance, it means they were able to identify areas within the scheme rules to support members without going through the individual exemption application process, said Mothudi. Medical aid schemes are compromised as they cannot collectively negotiate for effective pricing for hospital admissions or anything related to Covid-19, to increase affordability for members, because the proposed negotiation chamber has not been established.

The BHF further raised concerns on the delay in finalising the low-cost benefit options (LCBO) framework, which would have allowed the schemes to register these options as part of their service offering.