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Medical Scheme Issues

SAMA has noted with concern the latest communique from Fedhealth (dated 27 March 2011) to doctors regarding payment of PMB's.  We wish to remind all doctors that the current legal position regarding the interpretation of Regulation 8 is that PMB benefits are payable at cost or invoice price and that beneficiaries may not incur or be held liable for co-payments in relation to such treatment.

Circular 13 of 2011: Compliance by medical scheme administrators and self-administered medical schemes with Prescribed Minimum Benefit (PMB) requirements.
Click to download Circular 13 of 2011