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The Council for Medical Schemes provides a downloadable document titled 'Circular 62 of 2017: Standard Guidelines' that outlines regulatory standards for medical schemes. It is available for anyone to access and download at any time.
- Who it is for:
- registered medical schemes, administrators, compliance officers, healthcare providers, and other regulated entities in the medical aid sector
- How to act on it:
- Visit the Council for Medical Schemes website and navigate to the document listing; click on the download link for Circular 62 of 2017
The Council for Medical Schemes invites financial reporting tool users and medical scheme administrators to submit suggestions for topics to be covered in an upcoming administrator workshop.
- Who it is for:
- users of financial reporting tools, medical scheme administrators
- How to act on it:
- Submit topic suggestions via email to information@medicalschemes.co.za or by calling +27 86 112 3267
A workshop on managed care that was originally scheduled for March 2018 has been postponed. The new date has not been specified, and no further details are provided in this document.
- Who it is for:
- medical schemes, managed care providers, industry stakeholders
- How to act on it:
- No specific access route is described; interested parties should contact the Council for Medical Schemes for updates.
The Council for Medical Schemes invites stakeholders to submit suggestions for topics to be discussed at the Managed Care Workshop scheduled for March 2018. This is an opportunity for industry participants to influence the agenda of a key professional event.
- Who it is for:
- medical schemes, managed care providers, healthcare professionals, and other industry stakeholders
- How to act on it:
- Submit topic suggestions via email to information@medicalschemes.co.za or by calling +27 86 112 3267
The Council for Medical Schemes provides access to the SAICA Accounting Guide as part of its regulatory documentation. This guide offers accounting standards and practices for medical schemes and their auditors.
- Who it is for:
- medical schemes, auditors, accountants, regulated entities in the medical schemes sector
- How to act on it:
- Visit the Council for Medical Schemes website and download the file from the circular page
The Council for Medical Schemes has made available prescribed auditor report templates based on ISAE 3000 (Revised) standards for use by auditors of medical schemes. These templates are intended to ensure consistency and compliance in audit reporting across the industry.
- Who it is for:
- auditors of medical schemes, medical scheme administrators
- How to act on it:
- Download the document from the official portal or website of the Council for Medical Schemes
The Council for Medical Schemes has made available the proposed 2018 IRBA Medical Schemes Auditing Guide for public review. This document outlines auditing standards and procedures for medical schemes in South Africa.
- Who it is for:
- medical schemes, auditors, regulated entities, stakeholders in the medical schemes industry
- How to act on it:
- Download the document from the official portal using the provided link
The Council for Medical Schemes has issued minimum data specifications for reporting on Diabetes Insipidus and Addison's Disease. These specifications must be followed by medical schemes and healthcare providers when handling claims or data related to these conditions.
- Who it is for:
- medical schemes, healthcare providers, regulated entities in the medical scheme industry
- How to act on it:
- Download the document from the official portal of the Council for Medical Schemes
Medical schemes are required to provide data on HIV, tuberculosis, and sexually transmitted infections to the South African National AIDS Council (SANAC) as part of national health monitoring and reporting obligations.
- Who it is for:
- registered medical schemes in South Africa
- How to act on it:
- Submit data directly to SANAC through the requested reporting mechanism as specified in the circular
The Council for Medical Schemes has approved the accreditation of administrators and managed care organisations, allowing them to operate under regulated conditions within the medical schemes sector.
- Who it is for:
- medical scheme administrators and managed care organisations
- How to act on it:
- No application process is described; the document states that the Executive Committee has already approved the accreditation.
The Council for Medical Schemes has officially confirmed the merger between Spectramed Medical Scheme and Resolution Health Medical Scheme. This means the two schemes are now legally combined under one entity, and members of both schemes should expect changes to their coverage, benefits, and administrative processes as a result.
- Who it is for:
- members of Spectramed Medical Scheme and members of Resolution Health Medical Scheme
- How to act on it:
- No action required; members will be informed by the merged scheme through official communication channels.
The Council for Medical Schemes makes available the IRBA Medical Schemes Auditing Guide, which provides guidance for auditors and medical schemes on auditing requirements and standards. This document is intended to ensure compliance with financial reporting obligations under the Medical Schemes Act.
- Who it is for:
- auditors of medical schemes, medical scheme administrators, financial reporting officers, IRBA-registered auditors
- How to act on it:
- Download the document from the official website portal