Medical Schemes Act, 1998 (Act No. 131 of 1998)RegulationsRegulations in terms of the Medical Schemes ActChapter 5 : Provision of managed health care15F. Capitation agreements |
A medical scheme shall not enter into a capitation agreement, unless –
| a) | the agreement is in the interests of the members of the medical scheme; |
| b) | the agreement embodies a genuine transfer of risk from the medical scheme to the managed health care organisation; |
| c) | the capitated payment is reasonably commensurate with the extent of the risk transfer. |