PMBs here to stay, court rules
Legalbrief reports that the North Gauteng High Court has thrown out, on technical grounds, a bid to clarify what medical aid funds are required to pay for the treatment of a basic set of conditions, ranging from tuberculosis to malaria.
The effect of the judgment is that the current legal position stands: where certain illnesses are concerned, medical aid funds must pay as per the doctor's invoice no matter what 'the funds' rules say.
However, according to Legalbrief, because the case was decided on technical grounds, it might be a short-lived victory as a court is yet to make a definitive finding on the disputed issue. The case was brought by the Board of Healthcare Funders (BHF) - a Section 21 company - which sought a 'declaratory order' on what 'pay in full' meant with regard to - prescribed minimum benefits (PMBs). But Judge Cynthia Pretorius said it had no direct and substantial interest in the order because it would not be affected by it one way or another. 'A court does not give legal advice,' she said.
For more:
- Legalbrief: PMBs remain in place - ruling
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