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Medical Schemes Act, 1998 (Act No. 131 of 1998)

Chapter 12 : General

67. Regulations

 

(1) The Minister may, after consultation with the Council, make regulations relating to—
(a) the provision by medical schemes to their members of written proof of membership, and the particulars such proof shall or may contain;
(b) the conditions subject to which any person who has terminated his or her membership of a medical scheme shall be enrolled as a beneficiary of any other medical scheme,
(c) the assets to be held by a medical scheme in the Republic including the limiting of the amount which or the extent to which such a medical scheme may invest in particular assets or in particular kinds or categories of assets;
(d) the manner in which any payment due by a medical scheme shall be made;
(e) the administration of the affairs of medical schemes, including the regulating, controlling, restricting or prohibiting of any act relating to such administration;
(f) the fees to be paid to the Council in respect of—
(i) an application for the registration of a medical scheme;
(ii) the registration of a medical scheme;
(iii) the change of the name of a medical scheme in terms of section 23;
(iv) the registration of an amendment or rescission of a rule, or an addition to the rules of a medical scheme, in terms of section 31;
(v) the fees payable by an appellant in terms of section 50(3); and
(vi) the fees payable by an intermediary in terms of section 58(4);
(g) the prescribed scope and level of minimum benefits to which members and their registered dependants shall be entitled to under the rules of a medical scheme;
(h) the minimum membership required for registration of a medical scheme;
(i) the conditions under which a medical scheme may provide benefits in terms of a personal savings account;
(j) the conditions under which a person may act as an administrator of a medical scheme;
(k) the nett assets to be held by a medical scheme;
(l) open enrolment periods, premium penalties within defined bands for persons joining only late in life and such other measures against adverse selection as may be appropriate;
(m) provisions associated with the manner of providing managed health care to beneficiaries and requirements for managed health care contracts;
(n) the conditions under which a broker may provide advice and other services to or on behalf of a medical scheme beneficiary or any other person,
(o) penalties to be applied to a Medical Scheme or an Administrator in respect of the late payments of benefits owing to a member or a supplier of service, in contravention of section 59(2),
(p) reporting of acts or omissions of any person in contravention of the provisions of this Act; and
(q) all other matters which he or she considers necessary or expedient to prescribe in order that the purposes of this Act may be achieved.

 

(2) The Minister shall, not less than three months before any regulation is made under subsection (1), cause a copy of the proposed regulation to be published in the Gazette together with a notice declaring his or her intention to make that regulation and inviting interested persons to furnish him or her with their comments thereon or any representations they may wish to make in regard thereto.

 

(3) The provisions of subsection (2) shall not apply in respect of—
(a) any regulation made by the Minister which, after the provisions of that subsection have been complied with, has been amended by the Minister in consequence of comments or representations received by him or her in pursuance of a notice issued thereunder; or
(b) any regulation in respect of which the Minister, after consultation with the Council, is of the opinion that the public interest requires it to be made without delay.

 

 


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