MEDICAL SCHEMES ACT 131 OF 1998

The purpose of the Medical Schemes Act is to consolidate the laws relating to registered medical schemes; to provide for the establishment of the Council for Medical Schemes as a juristic person; to provide for the appointment of the Registrar of Medical Schemes; to make provision for the registration and control of certain activities of medical schemes; to protect the interests of members of medical schemes; to provide for measures for the coordination of medical schemes; and to provide for incidental matters.

Establishment of Council for Medical Schemes

(1) There is hereby established a juristic person called the Council for Medical Schemes.
(2) The Council shall be entitled to sue and be sued, to acquire, possess and alienate moveable and immovable property and to acquire rights and incur liabilities.
(3) The registered office of the Council shall be situated in Pretoria or such other address as the Council may from time to time determine.
(4) The Council shall, at all times, function in a transparent, responsive and efficient manner.

Functions of Council

The functions of the Council shall be to -
(a) protect the interests of the beneficiaries at all times;
(b) control and coordinate the functioning of medical schemes in a manner that is complementary with the national health policy;
(c) make recommendations to the Minister on criteria for the measurement of quality and outcomes of the relevant health services provided for by medical schemes, and such other services as the Council may from time to time determine;
(d) investigate complaints and settle disputes in relation to the affairs of medical schemes as provided for in this Act;
(e) collect and disseminate information about private health care;
(f) make rules, not inconsistent with the provisions of this Act for the purpose of the performance of its functions and the exercise of its powers;
(g) advise the Minister on any matter concerning medical schemes; and
(h) perform any other functions conferred on the Council by the Minister or by this Act.

Source: SABINET