Circular 60 of 2022: Administrators and Managed Care Organisations accredited by the CMS
The Council for Medical Schemes (CMS) hereby confirms that the Executive Committee (EXCO) of Council considered and resolved to approve the following new and renewal of accreditation / compliance certificate applications of the organisations listed below, at its meeting held on 21 October 2022 (via MS Teams).
Managed Care Organisation:
Renewal Application
- Bestmed Medical Scheme (self-administered): Renewal of the compliance certificate was granted for a period of three years from 22 November 2022 with no conditions, in respect of the following services:
1) Hospital Benefit Management
- Pre-Authorisation.
- Case Management.
- Clinical Audit
2) Pharmacy Benefit Management
3) Active Disease Risk Management Services.
- Oncology
- Chronic Renal Disease
- Muscular-skeletal program
4) Managed Care Network Management Services and Risk Management
- General Practitioner
- Specialist Network
- Hospital Network
- Pharmacy Network
- Dental Network
- Auxiliary Network
Administrators:
Renewal applications
- National Health Group (Pty) Ltd: Renewal of accreditation was granted for a period of two years from 23 October 2022, subject to compliance with the condition stipulated on the CMS website
- De Beers Benefit Society (Self-administered): Renewal of the compliance certificate was granted for a period of three years from 9 December 2022 with no conditions.
- Rand Water Medical Scheme (Self-administered): Renewal of the compliance certificate was granted for a period of three years from 29 October 2022, subject to compliance with the condition stipulated on the CMS website.
The above-mentioned Managed Care Organisation and Administrators’ conditions and status are available here.
Download the Circular here.