On 4 September 2017, the Council for Medical Schemes (CMS) published the Prescribed Minimum Benefit Definition Guideline regarding Early Stage Colon and Rectal Cancer. The purpose of the guideline is to improve clarity in respect of funding decisions by medical schemes.
The Regulations enacted under the Medical Schemes Act governs the provisions of the prescribed minimum benefits (PMB). The CMS has noted that in some cases medical scheme beneficiaries find it difficult to know their entitlements in advance. Medical schemes may also interpret these benefits differently. The benefit definition project which is coordinated by the CMS, aims to define the PMB package and to provide guidance on the interpretation of these provisions.