Netcare, Discovery appeal CMS directive to stop selling prepaid vouchers

Discovery Health and NetcarePlus have decided to appeal the directive from the Council for Medical Schemes (CMS) that ordered them to stop conducting the business of a medical scheme after they launched a new digital health innovation enabling people to buy vouchers for primary healthcare services in the private healthcare sector.

The directive instructed Discovery Health and NetcarePlus to provide the CMS with confirmation and evidence that their prepaid healthcare voucher schemes had ceased by close of business on 18 December 2020. The CMS said it would take further action should Discovery Health and NetcarePlus fail to comply with the directive.

ALSO READ: CMS to Discovery Health: Stop selling prepaid vouchers today or else

When the products were still available on the Discovery and Netcare websites on Monday morning, we asked the CMS about the steps it would take. The CMS replied that it had received an appeal from Discovery on Friday afternoon in terms of Section 49 (1) of the Medical Schemes Act.

This section gives everyone who is aggrieved by any decision of the medical scheme registrar the right to appeal to the CMS within 30 days after a decision. Section 49 (2) of the Act then suspends the directive until the appeal is heard.

ALSO READ: CMS tells Discovery Health and NetcarePlus to stop selling prepaid vouchers 

“We believe there is a real need to increase accessibility and affordability of healthcare. At NetcarePlus, we aim to help more South Africans get private healthcare,” says Teshlin Akaloo, managing director of Netcare’s innovative products division.

He said Netcare was aware of the registrar of medical schemes’ objection to its vouchers and was in the process of appealing this in terms of the Medical Schemes Act.

“NetcarePlus does not conduct the business of a medical scheme and the salient features of the products bear this out through an innovative solution, which falls outside of the Medical Schemes Act.”

Akaloo explained that the GP Vouchers were not an insurance-based product. “We carefully developed the product taking the relevant South African legislation into consideration in addition to obtaining external legal opinions before the launch of NetcarePlus.”

The directive was issued in terms of the Medical Schemes Act for “conducting the business of a medical scheme”. The Act describes the “business of a medical scheme” as the business of undertaking the liability associated with providing health services, as well as paying for it and rendering a relevant health service.

ALSO READ: Buy a voucher, visit the doctor

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