CMScript 1 of 2022: Focus on Ovarian Cancer
Treatable ovarian cancer is a Prescribed Minimum Benefit (PMB) condition under Diagnosis and Treatment Pair (DTP) code 952M - Cancer of ovary - treatable. According to the PMB regulation, treatable cancers are defined as follows: they involve only the organ of origin and have not
Press Release 13 of 2021: CMS welcomes reduced COVID-19 PCR test cost
The Council for Medical Schemes (CMS) delightfully welcomes the consent agreement concluded by the Competition Commission with Lancet and Ampath Laboratories to reduce the price of COVID-19 PCR tests from R850 to R500, including VAT, reflecting a 40% difference. The agreement follows a complaint lodged by
World Aids Day
Observed on the 1st of December each year, World AIDS Day provides an opportunity for every community to show their commitment to the fight against HIV. It allows us to give support to those living with HIV and remember those who have died from it. HIV
CMScript 13 of 2021: Hepatocellular carcinoma
As part of PMB level of care, medical schemes must fund the diagnosis and treatment of treatable Hepatocellular carcinoma HCC, which falls under DTP code 950G. For those patients who are diagnosed with HCC that is not treatable according to the PMB Regulations, DTP code 260S
Medical Aid Schemes vs Health Insurance
What is the difference, and which one is right for me? The choice between a medical aid scheme or a health insurance policy depends on your lifestyle, your needs, and your budget. The costs between the two differ because the products offer different services and benefits.
CMScript 12 of 2021: Lung Cancer
“Cancer of lung, bronchus, pleura, trachea, mediastinum & other respiratory organs – treatable” are included in the Prescribed Minimum Benefit conditions under Diagnosis and Treatment Pair (DTP) code 950D. Lung cancer develops when lung cells grow uncontrollable and abnormal. These cells then grow into a mass
CMS Annual Report 2020/21
The CMS Annual Report 2020/21 has been tabled in Parliament. The overall performance achievement for CMS in 2020/21 was 90.83% - 80% is the benchmark set by the AGSA. Other performance achievements include: Unqualified audit report by the Auditor General ICT systems up-time were maintained 99% of
Press Release 12 of 2021: CMS settles with SAMA on Modifier 0019(b)/0005
The CMS has concluded a settlement agreement with SAMA on the use of modifier 0019(b) and 0005 in the interest of protecting medical scheme members. The Council for Medical Schemes (CMS) has concluded a settlement agreement with the South African Medical Association (SAMA) in respect of
CMScript 11 of 2021: COVID-19 & vaccines
All medical schemes are required by law to pay for the diagnosis, treatment, care and vaccination costs for COVID-19 as a PMB irrespective of the plan type or option. Details about what constitutes PMB level of care for COVID-19 can be obtained from the PMB
Press Release 11 of 2021: CMS approves Medipos settlement order
The Council for Medical Schemes (CMS) has today approved the Court Settlement Order, in the matter between the trade union Solidarity, the South African Post Office (SAPO) and Medipos Medical Scheme. “The court settlement and the approval by CMS will allow Medipos to pay all its