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Compliance & Investigations

Stephen MmatliCompliance and Investigations serves members of medical schemes and the public in general by analysing, reviewing and investigating information on possible transgressions of the Medical Schemes Act and taking appropriate actions to enforce compliance with the Act.

By doing this we help the Council for Medical Schemes foster compliance with the Medical Schemes Act and take proportionate actions to promote a culture of compliance with legislation.

The Compliance & Investigations unit is headed by Mr. Stephen Mmatli.

The Compliance & Investigations unit ensures that schemes, administrators and brokers comply with the Medical Schemes Act and regulations, specifically in respect of the areas designated by the office as priority areas namely, non-healthcare expenditure, governance, general non-compliance, the risk assessment framework, enforcement of rulings made by the Registrar and the demarcation between medical schemes and insurers.


The Compliance & Investigations unit does that by:
  • Communicating with schemes, administrators and brokers on an ongoing basis;
  • Engaging the above in dialogue and discussions in respect of contentious/priority areas;
  • Training of Boards of Trustees; and Information sessions for Health Providers.
  • Specific enforcement actions.

 

Created: 2010/09/17 10:24:40 AM - Last Modified: 2015/01/27 02:05:14 PM
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