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Circular 40 of 2023: Request for stakeholders’ consideration to form part of the PMB Advisory Committee

  1. Purpose
    • The Council for Medical Schemes (CMS) will reestablish the Prescribed Minimum Benefits (PMBs) Advisory Committee (BAC). The purpose of this circular is to request representation from various stakeholders within the medical schemes industry to form part of the BAC.
  1. Background
    • According to the Medical Schemes Act 131 of 1998, the PMBs should be reviewed at least every two years.
    • As communicated in Circular 15 of 2023, which provided a progress update on the PMB Review Project, the current PMB review is focused on establishing a primary health care benefit package of services, as depicted in Table 1 below.
    • The BAC will consist of a multidisciplinary team comprising individuals from professional bodies,

patient groups, funders, and those likely to be involved in the provision of services that are under review. BAC members will be required to meet at least once monthly, review PMB-related documentation, provide expert opinion, actively engage in discussions and undertake tasks as assigned by the Chairperson of the BAC based on their expertise.

  • Duties of the BAC will be outlined in a separate terms of reference document.
  • The newly formed BAC will comprise selected old BAC members, as established previously, and newly elected stakeholders based on their expertise and the entity they represent.
  • Members of the BAC shall be selected by the CMS Secretariat based on their qualifications,

relevant experience, and technical skills. There will be a deliberate attempt to ensure that there is wide representation in the Committee. Individuals working in or with knowledge of the medical schemes industry, with expertise in the following areas, will be considered:

  • Health economists
  • Health actuaries
  • Clinical or public health experts with experience in costing primary health care packages and conducting prioritisation methodologies.
  • Academic researchers with experience and expertise in health policy relating to National Health Policy
    • BAC members are chosen as volunteers to represent their respective entities as stakeholders in the medical schemes industry.
    • The CMS looks forward to receiving representation from various stakeholders for the PMB Review Project focus areas.
    • Kindly submit CVs detailing the necessary expertise to pmbreview@medicalschemes.co.za by the 17th of November 2023 for consideration.

Download the Circular here.