Circular 21 of 2022: Revised Healthcare Utilisation Annual Statutory Return
The Council for Medical Schemes (CMS) hereby publishes version 10 of the updated technical guideline document for completing the Utilisation section of the 2020/2021 Annual Statutory Return (ASR).
The system is live, and schemes are encouraged to familiarise themselves with it well before the deadline for submission. No extension on deadlines will be granted. Schemes should note the following important data submission dates aimed at giving schemes enough time to work through changes, ensuring accurate and complete submissions.
| Deadlines | Description | Due date |
| Electronic data submission | The deadline for electronic submission of schemes data | 20 May 2022 |
| Feedback reports | Feedback to schemes on data submission and possible resubmission of data | 24 May 2022 |
| Resubmission of data | Resubmission of data due to errors identified in feedback reports | 31 May 2022 |
| Final signed off report | Final report signed off by PO and Trustees | 10 June 2022 |
The following updates and changes have been made in the technical guideline document:
| Part | Field |
Amendment |
| B6 and B13 | · Discipline category | A new field has been added to filter providers. |
| B14 | · Financial Month
· Discipline Code · Subdiscipline Code |
Additional fields included |
| B15 | · New Table | New part |
| All | · Year of Submission | “YearOfSubmission” changed to “YearOfSpec” |
| Updated Table and document | ||
| CdRef 28 Discipline Category (New) and CdRef 29 Tariff Code (New)
A10BK01 – Dapagliflozin was added for Asthma. Changes are specified on pages 5 and 6 of Entry and Verification Criteria Version 15.1. |
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This latest version of the technical guideline document should be read in conjunction with the following updated documents.
- ASR Data Specification v10.0: This workbook contains the layout and field type definitions for the data tables.
- ASR Valid Codes v10.0: The reference workbook containing tables with valid values for certain key columns specified in the ASR Data Specification v10.0.
- Guidelines for the Identification of Beneficiaries with Risk Factors in Accordance with the Entry and Verification Criteria Version 15.1.
- ASR Data Specification Appendix A v10.0: The Appendix should be used only as a guideline for identifying utilisation statistics and is not necessarily a complete list of codes used in the industry. Please inform the CMS in case you become aware of any missing codes (excluding “in-house” codes) by sending a list of such codes to lion@medicalschemes.co.za
- List of Validation rules V1.0
Data officers will receive notification of the schemes that must resubmit the 2020 data submission for part C.5 as data errors were identified on this section.
The final signoff report can be electronically signed, if the scheme has the option available, however, schemes may submit the scanned signed document to the CMS by 10 June 2022 to b.khuzwayo@medicalschemes.co.za.
Officials from the CMS will be at hand to address all technical queries relating to the updated Healthcare Utilisation Data specification document.
Your cooperation will be highly appreciated.
Download the full circular here.