Circular 54 of 2022: Final updated Accredited Managed Health Care Services document

The Council for Medical Schemes (CMS) wishes to thank stakeholders for their submissions on the draft updated managed care services document published with Circular 38 of 2022. Industry comments were incorporated into the final document where appropriate.

The final, updated document, which includes some additional managed care services and further clarification on existing service categorisations, can be accessed here.

The effective date for implementation

Medical schemes and managed care organisations must implement the updated managed care services with effect from 1 January 2023. New managed care agreements should be prepared in accordance with the accredited managed care services categories as per the updated document and existing agreements should be amended by way of an addendum to correctly reflect the appropriate service categories and naming conventions.

The Financial Supervision Unit of the CMS will likewise affect the necessary updates to the statutory returns with effect from 1 January 2023.

Download the Circular here.