Medical Schemes

The medical schemes industry is rapidly changing and increasing in its complexity. The industry continues to be transformed by the effects of mergers and amalgamations, solvency measures, accounting standards developments, advancing technology and enhanced risk management and compliance requirements. We have a dedicated medical schemes industry group with extensive experience in providing services to both medical schemes and administrators. These services include audit, internal audit, and consulting services. Here in South Africa we have established a considerable skills base, with an in-depth knowledge of the functions and operations within the Medical Schemes Industry.

PwC serves on the South African Institute of Chartered Accountants (SAICA) Medical Scheme Interest Group and formed part of the working committee responsible for drafting the Audit and Accounting Guide on Medical Schemes. Our national Medical Scheme’s industry group, of which Ilse French is currently the National Leader, is situated in our Gauteng practice. This group, in addition to the normal structured audit, provides the following value added services to clients in the Medical Schemes Industry:

• Assistance with the interpretation of the Medical Schemes Act and Regulations;
• Assistance to Medical Schemes to comply with applicable laws;
• Identification of control weaknesses and high risk areas and recommendations to address these risks and control weaknesses;
• Guidance on the methods to be applied when interpreting the work of an actuary and evaluating provisions relevant to medical schemes;
• Assistance with disclosure requirements as required by International Financial Reporting Standards (IFRS) and the Audit and Accounting Guide on Medical Schemes issued by SAICA;
• Technical assistance on the accounting treatment for specific Medical Schemes products and transactions;
• Liaison with the Registrar of Medical Schemes; and
• Audit of statutory returns.