Commed un­der pro­vi­sional cu­ra­tor­ship

Weekend Argus (Saturday Edition) - - FRONT PAGE - STAFF RE­PORTER

The Gaut­eng High Court has placed Com­mu­nity Med­i­cal Aid Scheme (Commed) un­der pro­vi­sional cu­ra­tor­ship fol­low­ing a suc­cess­ful ap­pli­ca­tion by the Regis­trar of Med­i­cal Schemes in terms of the Med­i­cal Schemes Act, ac­cord­ing to a re­lease by the Coun­cil for Med­i­cal Schemes (CMS), the reg­u­la­tor of the med­i­cal schemes in­dus­try.

Judge Bill Prinsloo or­dered that Ad­vo­cate Deon van Wyk be ap­pointed as pro­vi­sional cu­ra­tor of Commed.

Among the points made by the court in rul­ing in favour of a cu­ra­tor­ship were:

• The his­tory of the regis­trar and the scheme be­ing at loggerheads, in­clud­ing at­tempts by the regis­trar to un­der­take in­spec­tions of the scheme;

• Ir­reg­u­lar ad­vance pay­ments made to All­care, the scheme’s ad­min­is­tra­tor;

• Vex­a­tious al­le­ga­tions made in court that were deroga­tory of the regis­trar; and

• The pay­ment of bonuses to the scheme’s prin­ci­pal of­fi­cer out­side her em­ploy­ment con­tract.

The court also found that All­care’s chief ex­ec­u­tive had at­tended board meet­ings of the scheme, suc­ceed­ing in per­suad­ing the board to grant con­tracts to All­care.

Ac­cord­ing to the CMS, the regis­trar has no rea­son to be­lieve that the scheme is not able to meet its fi­nan­cial obli­ga­tions to its mem­bers and ser­vice providers. There is there­fore no need for any con­cern on the part of mem­bers and ser­vice providers re­gard­ing the dayto-day op­er­a­tions of the scheme.

STRATA NOT AC­CRED­ITED

The CMS has with­drawn the ac­cred­i­ta­tion of Strata Health­care Man­age­ment as a man­aged-care or­gan­i­sa­tion with ef­fect from May 31, ac­cord­ing to a re­cent re­lease by the CMS. This fol­lows Strata’s fail­ure to meet the “fit and proper” cri­te­ria for ren­der­ing med­i­cal scheme ad­min­is­tra­tion ser­vices, as set out in Med­i­cal Schemes Act.

The de­ci­sion, taken by the CMS at a meet­ing on May 31, was pre­ceded by a coun­cil ex­ec­u­tive com­mit­tee de­ci­sion not to re­new Strata’s ac­cred­i­ta­tion as a med­i­cal scheme ad­min­is­tra­tor in De­cem­ber 2015, due to its fail­ure to meet statu­tory re­quire­ments to ren­der ad­min­is­tra­tion ser­vices to med­i­cal schemes.

Strata pre­vi­ously ren­dered ad­min­is­tra­tion and man­aged­care ser­vices to Medi­help med­i­cal scheme. These ser­vices are now vested in Medi­help.

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