LEGAL

1.1 Medical Schemes Amendments Bill

At a Press Conference on Thursday 21 June 2018, Dr Aaron Motsoaledi, Minister of Health, released the Medical Schemes Amendment Bill together with the National Health Insurance Bill for public comment.

Motsoaledi stated that the “reason for the amendment is to align the medical scheme environment to that which will exist under NHI so that there is a smooth, harmonious transition that does not unduly disrupt access to health care.”

Briefly, he outlined a few amendments which would;

• Abolish co-payments, use of brokers & practice of PMBs
• Ban “health plans” & “cash plans” not registered with CMS
• Create a central beneficiary & provider registry
• Introduce income cross-subsidisation model (solidarity)
• Compel schemes to pass on savings to members (DSPs)
• Review cancellation of membership & waiting periods
• Require minimum educational qualifications & expertise to be a Scheme Trustee

Click here for the Medical Schemes Amendment Bill
Click here for the Press Conference Release

1.2 The National Health Insurance (NHI) Bill

Preamble:
“RECOGNISING the socio-economic injustices, imbalances
and inequities of the past, the need to heal the divisions of the past and to establish a society based on democratic values, social justice and fundamental human rights and the need to improve the life expectancy and the quality of life of all citizens”;

In summary, the Bill sets out to;

• provide mandatory prepayment health care services
• establish a National Health Insurance Fund & to set out its powers, functions & governance structures;
• provide a framework for the active purchasing of health care services by the Fund on behalf of users;
• create mechanisms for the equitable, effective and efficient utilisation of the resources of the Fund to meet the health needs of users;
• preclude or limit undesirable, unethical and unlawful practices in relation to the Fund and its users; and
• provide for matters connected herewith.

Click here for the National Health Insurance Bill.

ICPA will be providing substantiated comment on both Bills and request members to forward their concerns & comments to info@icpa.co.za for incorporation into the documents.

1.3 Competitions Commission Health Marker Inquiry

The Competitions Commission conducted a market inquiry into the private healthcare sector. The market inquiry was a general investigation into the state, nature and form of competition in a market. The Commission had initiated an inquiry into the private healthcare sector because it had reason to believe that there are features of the sector that prevent, distort or restrict competition.

After several delays and challenges, the Commission finally released the report of the inquiry. Interested parties have 3 months to comment on the findings in the report. ICPA will study and interrogate the report in depth and will submit comments to the Competition Commission.

Click the links to read the Executive Summary of the Health Market Inquiry and their recommendations. The full report will be shared with you in a future Info Flash. You are invited to send your comments to ICPA for inclusion in a consolidated submission to the Competition Commission.

Date: July 17, 2018