Council For Medical Schemes' Annual Performance Plan

The CMS, is the national medical schemes regulatory authority and a public entity responsible for regulating the medical schemes industry to protect the interests of members, promoting fair and equitable access to private health financing.

The vision of the CMS is to be "a fair custodian of equitable access to medical schemes in order to support the improvement of universal access to healthcare." The Council's mission is to regulate the medical schemes industry in a fair and transparent manner.

1. CMS Strategic Goals

. Access to good quality medical scheme cover is maximized; . To make sure that medical schemes are properly governed, are responsive to the environment, and beneficiaries are informed and protected; . CMS should be responsive to the needs of the environment by being an effective and efficient organization; . CMS provides influential strategic advice and support for the development and implementation of strategic health policy, including support to the National Health Insurance development process.

The Council noted that membership has grown faster than the employment growth. The difference in scheme risk has worsened over the past two years, leaving more than a million beneficiaries vulnerable. Some schemes have challenged the "payment in full provisions" in the regulations. Discovery has refused to accept Transmed members, in spite of a ruling by the Registrar and Council. The matter will be heard by the appeal board soon. GEMS have appealed the decisions by the Registrar, Council and the appeal board, and have taken the decision to the High court for revision.

2. Budget

The CMS' budget increased by approximately 11.8% from R98.4 million in 2012/13 to R110.1 million in 2013/14. Income from levies increased by approximately 11.4% from R92.6 million to R103.2 million.

The levy amount increased by 9.85% from R24.39 (2012/13) to R26.79 (2013/14). Current expenses increase by approximately 6.7% from R92.6 million to R103.2 million.

The CMS expenses are as follows:

1 Expenses

. Council Members Fees increased 61.1% from R930 986 to R1.5 million; . Research and Monitoring increase by 165.6% from R288 890 to R767 297; . Legal services increased 38.4% from R4.8 million to R6.7 million, whilst Legal Fees increased by 42.9% from R4.2 million to R6 million; . Financial Supervision increases 37.1% from R498 197 to R683 302; . Stakeholder relations increased by 29.9% from R2.1 million to R2.8 million; . Complaints and adjudication decreased by 29.8% from R184 500 to