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National Health Act, 2003 (Act No. 61 of 2003)


Regulations relating to the obtainance of information and processes of determination and publication of reference price lists

8. Determination of the Reference Price Lists


(1) The Director-General shall, after verification of information as contemplated in regulation 7(2), determine draft reference price lists.


(2) In determining a reference price list, the Director-General shall take the following into account:
(a) The recommendations of a committee contemplated in regulation 7(2);
(b) the need for private health establishments to have a reasonable return on investment;
(c) the need for health care providers to earn a reasonable income;
(d) the need for certainty, sustainability and stability within the medical schemes environment;
(e) the need to improve and maintain efficiency and quality in the delivery of health care services as well as to increase and ensure access to such services for medical scheme beneficiaries;
(f) the need to eliminate perverse incentives, unethical business practices and unprofessional conduct from the private health care industry;
(g) the legal obligations of medical schemes in terms of the Medical Schemes Act, 1998 (Act No. 1312 of 1998) in general and particularly with regard to the obligation to submit their rules, including benefit tables, to the Registrar of Medical Schemes for approval;
(h) the need to promote competition within the private health care industry;
(i) the need to promote and ensure access to membership of medical schemes for employed persons and their dependants.