The Council for Medical Schemes recently published the Demarcation Exemption Appeal Outcome. In March 2017 the Council in consultation with other stakeholders approved the Exemption Framework, which permits the exemption of Providers of indemnity products that are conducting the business of a medical scheme from certain provisions of the Medical Schemes Act for a period of two years (1 April 2017 to 3 March 2019). Two entities that applied to the Council for an exemption were declined and their appeals later dismissed. The affected entities have a right to take the decision on review if they are advised to do so.
Following from this decision, the Council cautions members of the public and contractors of health products from the affected entities, Discovery Health (Pty) Ltd and Agility Insurance Administrators (Pty) Ltd that these products are unregulated and are prohibited. Discovery Health has been directed to move affected members to a regulated product by 28 February 2019.
The Council for Medical Schemes has urged clients who have purchased Discovery Comprehensive Primary Care or Discovery Essential Primary Care products from Discovery Health to contact Discovery Health to make alternative arrangements. We recommend that FSPs that have clients who are affected by this ruling, make contact with their clients to ensure that they are not left without cover.
Click here to read the full Notice published by the Council for Medical Schemes – Circular 50 of 2018: Demarcation Exemption Appeal Outcome