Prescribed Minimum Benefit Review - Call for Comments in response to the Council for Medical Scheme's proposed new PMB framework

Dear SAMA Doctor ,

The Council for Medical Schemes and various stakeholder groups have been involved in a process to review the existing Prescribed Minimum Benefits from mid-2017. The Council has proposed a new service-based PMB framework and is taking comments on the new structure. (See CMS Circular 6 of 2018 - Attached).

This is an important process which could well completely redefine the mandatory benefits available to medical scheme members. What is proposed in the review is a SERVICE-based package rather than a diagnosis / disease based package.

SAMA and other doctor representatives have been involved in the initial discussions as part of the PMB Advisory Committee, which met in November 2017 and January 2018.

Currently General Practitioners are represented on the PMB Review Advisory Committee by:
Dr Mukesh Govind (IPAF)
Dr Riaz Fadal (Life healthcare - rehabilitation, mental health and oncology centres)
Johann Serfontein (Healthman)

Currently Medical Specialists are represented on the PMB Review Advisory Committee by:
Dr Adri Kok (FCPSA)
Dr Chris Archer (SAPPF)
Dr Selaelo Mametja (SAMA)
Dr Mike Klipin (Surgicom)
Ms Natalie Zimmelman (SASA)

SAMA is performing secretariat functions to the health professional groups on the committee.

To ensure a representative submission in response to the proposed PMB Framework, SAMA will be taking comments directly from the membership in this regard.

Please share any comments, concerns, remarks regarding the proposed framework with us by 26 February so we can complete comments ahead of the 2 March deadline. Please send to joleneh@samedical.org