Press Release 4 of 2022: Procurement of GEMS Vitamins
The Council for Medical Schemes (CMS) has taken note of news articles regarding the allegations that the Government Employees Medical Scheme (GEMS) awarded a vitamin contract to Activo Health, a subsidiary of AfroCentric. The CMS only became aware of the allegations after reading these news articles
Research Note 1/2022: Funding of healthcare services by medical schemes
This study presents the various funding models medical schemes employ for various healthcare services. It outlines the unique count of claiming providers and quantify the PMB expenditure paid by members who have PMSA on their benefit option. DATA SOURCES Data was sourced from the Annual Statutory
Press Release 3 of 2022: KeyHealth Medical Scheme curatorship lifted
The Council for Medical Schemes (CMS) hereby announces that the curatorship placed on KeyHealth Medical Scheme has been uplifted. Justice Collis agreed to lift the curatorship on KeyHealth Medical Scheme on 5 April 2022, in terms of section 5(9) of the Financial Institutions Protection of
Press Release 2 of 2022: CMS suspension of Glopin appealed
Glopin Health Consultants (Pty) Ltd has appealed its suspension of accreditation as a healthcare brokerage. The Council for Medical Schemes’ (CMS) had suspended Glopin’s accreditation on 15 March 2022, in terms of regulation 28c(1) of the Medical Schemes Act (131 of 1998) (MSA). “Glopin lodged an
Press Release 1 of 2022: CMS suspends the accreditation of Glopin Health Consultants
The Council for Medical Schemes (CMS) has suspended the accreditation of Glopin Health Consultants (Pty) Ltd (ORG726) as a healthcare brokerage in terms of regulation 28c (1) of the Medical Schemes Act (131 of 1998) (MSA) from rendering broker services to potential and current members
CMScript 5 of 2022: Focus on breathing difficulties in children
Breathing difficulties in children can range from a mild chest tightness or discomfort when breathing in or out to respiratory distress, which is a medical emergency. Children are not always able to explain what they are experiencing, therefore it is essential to know what to look
CMScript 4 of 2022: Focus on AMD
Age-related macular degeneration (AMD) is a common eye condition affecting the middle part of the vision, primarily in people older than 50 years. The condition causes damage to the macula resulting in progressive visual loss.. Age-Related Macular Degeneration (the formal diagnosis is H35.3 - Degeneration of
CMScript 3 of 2022: Focus on Hyperlipidaemia
Hyperlipidemia, also known as hypercholesterolemia or high cholesterol, is one of the 26 chronic diseases included in the PMB regulations. Hypercholesterolaemia qualifies as a PMB condition if the total fasting cholesterol level is >5mmol/L. The treatment of hypercholesterolaemia is specified in the algorithm in the Regulations. The algorithm
CMScript 2 of 2022: Focus on DSPs & Emergencies
Designated Service Providers (DSPs) are healthcare providers that have agreements with medical schemes to diagnose, treat and care for their members for PMB conditions. DSPs are also called network providers in some cases. When a member uses a DSP for a PMB condition, the account
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