41725

National Health Insurance Bill, 2018: for Broader Public
Comment

GOVERNMENT NOTICES
    
    DEPARTMENT OF HEALTH
    
    NO. 635
    
    21 JUNE 2018
    
    NATIONAL HEALTH INSURANCE BILL, 2018
    
    I, Dr Aaron Motsoaledi, Minister of Health, having obtained Cabinet
approval, hereby publish the draft National Health Insurance Bill, 2018
for broader public comment.
    
    Interested persons are invited to submit any substantiated comments
or representation on the proposed Bill to the Director-General of Health,
Private Bag X 828, Pretoria, 0001 (for the attention of Deputy Director-
General: National Health Insurance, Dr Anban Pillay or e-mail:
Anban.Pillay@health.gov.za, within three months of the publication of
this Notice.
    
    (Signed)
    DR A MOTSOALEDI, MP
    MINISTER OF HEALTH
    DATE: 18/6/2018
    
    REPUBLIC OF SOUTH AFRICA
    
    NATIONAL HEALTH INSURANCE BILL
    
    (As introduced in the National Assembly (proposed section 76);
explanatory summary of Bill published in Government Gazette No. 41725 of
21 June 2018) (The English text is the official text of the Bill)
    
    (MINISTER OF HEALTH)
    
    [B -2018]
    
    BILL
    
    To provide mandatory prepayment health care services in the Republic
in pursuance of section 27 of the Constitution; to establish a National
Health Insurance Fund and to set out its powers, functions and governance
structures; to provide a framework for the active purchasing of health
care services by the Fund on behalf of users; to create mechanisms for
the equitable, effective and efficient utilisation of the resources of
the Fund to meet the health needs of users; to preclude or limit
undesirable, unethical and unlawful practices in relation to the Fund and
its users; and to provide for matters connected herewith.
    
    PREAMBLE
    
    RECOGNISING the socio-economic injustices, imbalances and inequities
of the past, the need to heal the divisions of the past and to establish
a society based on democratic values, social justice and fundamental
human rights and the need to improve the life expectancy and the quality
of life of all citizens;
    
    BEARING IN MIND THAT-
    
    • Article 12 of the United Nations Covenant on Economic, Social
and Cultural Rights, 1966, provides for the right of everyone to the
enjoyment of the highest attainable standard of physical and mental
health;
    
    • Article 16 of the African Charter on Human and People's
Rights, 1981, provides for the right to enjoy the best attainable state
of physical and mental health, and requires States Parties to take the
necessary measures to protect the health of their people and to ensure
that they receive medical attention when they are sick;
    
    • the right to equality and human dignity are enshrined in
sections 9 and 10 of the Constitution, respectively and the right to
bodily and psychological integrity is entrenched in section 12(2) of the
Constitution;
    
    • the right to have access to health care services, including
reproductive health care, is provided for in section 27(1)(a) of the
Constitution and in terms of section 27(2) of the Constitution, the state
must take reasonable legislative and other measures, within its available
resources, to achieve the progressive realisation of the right of access
to health care services;
    
    • section 27(3) of the Constitution provides that no one may be
refused emergency medical treatment; and
    
    • section 28(1)(c)of the Constitution provides that every child
has the right to basic nutrition, shelter, health care services and
social services;
    
    AND IN ORDER TO-
    
    • achieve the progressive realisation of the right of access to
good quality personal health care services by South African citizens and
permanent residents;
    
    • ensure financial protection from the costs of health care and
provide access to health care services by consolidating public revenue in
order to actively and strategically purchase health care services based
on the principles of universality and social solidarity;
    
    • create a single framework throughout the Republic for the
public funding and public purchasing of health care services, medicines,
health goods and health related products, and to eliminate as far as is
reasonably possible the fragmentation of health care funding in South
Africa;
    
    • promote sustainable, equitable, appropriate, efficient and
effective public funding for the purchasing of health care services and
the procurement of medicines, health goods and health related products
from service providers within the context of the national health system;
and
    
    • ensure continuity and portability of financing and services
throughout the Republic,
    
    BE IT THEREFORE ENACTED by the Parliament of the Republic of South
Africa, as follows:-
    
    ARRANGEMENT OF SECTIONS
    
    Section
    
    1. Definitions
    
    2. Application of Act
    
    Part 1
    
    National Health Insurance Fund
    
    3. Establishment
    
    4. Objective of Act
    
    5. Duties of Fund
    
    6. Functions of Fund
    
    Part 2
    
    Right to health care
    
    7. Eligibility as beneficiaries of Fund
    
    8. Registration of users
    
    9. Rights of users
    
    10. Reimbursement for services rendered
    
    11. Health service benefits coverage
    
    12. Cost coverage
    
    Part 3
    
    Board of Fund
    
    13. Establishment
    
    14. Constitution and composition
    
    15. Chairperson and Deputy Chairperson
    
    16. Functions of Board
    
    17. Committees
    
    18. Conduct and disclosure of interests
    
    19. Procedures
    
    20. Remuneration and reimbursement
    
    Part 4
    
    Chief Executive Officer
    
    21. Appointment
    
    22. Responsibilities
    
    23. Relationship of Board with Minister, Director-General and Office
of Health Standards Compliance
    
    24. Staff at executive management level
    
    Part 5
    
    Ministerial Committees
    
    25. Benefits Advisory Committee
    
    26. Health Benefits Pricing Committee
    
    27. Stakeholder Advisory Committee
    
    28. Technical Committees
    
    29. Disclosure of interests
    
    30. Procedure and remuneration
    
    31. Vacation of office
    
    Part 6
    
    General provisions applicable to operation of Fund
    
    32. Role of Minister
    
    33. Role of Department
    
    34. National Health Information Repository and Data System
    
    35. Purchasing of health care services
    
    36. Role of District Health Management Offices
    
    37. Contracting Unit for Primary Health Care
    
    38. Accreditation of service providers
    
    39. Payment of service providers
    
    Part 7
    
    Complaints and appeals
    
    40. Complaints
    
    41. Lodging of Appeals
    
    42. Appeal Tribunal
    
    43. Powers of Appeal Tribunal
    
    44. Secretariat
    
    45. Procedure and remuneration
    
    Part 8
    
    Financial matters
    
    46. Sources of income
    
    47. Auditing
    
    48. Annual report
    
    Part 9
    
    Miscellaneous
    
    49. Assignment of duties and delegation of powers
    
    50. Protection of confidential information
    
    51. Offences
    
    52. Regulations
    
    53. Repeal and amendment of laws
    
    54. Transitional arrangements
    
    55. Short title and commencement
    
    Definitions
    
    1. In this Act, unless the context indicates otherwise-
    
    "accreditation" means the process contemplated in section 38;
    
    "Benefits Advisory Committee" means a committee appointed by the
Minister in terms of section 25;
    
    "Board "means the Board of the Fund established in terms of section
13;
    
    "certified" means that a health establishment or health agency must
be in possession of a valid certificate of need as provided for
inspection 36 of the National Health Act;
    
    "Chief Executive Officer" means the person appointed in terms of
section 21;
    
    "child" means a person under the age of 18 years as defined in
section 28(3) of the Constitution;
    
    "Constitution "means the Constitution of the Republic of South
Africa, 1996;
    
    "Contracting Unit for Primary Health Care" means the Contracting Unit
for Primary Health Care referred to in section 37(1);
    
    "Correctional Services Act" means the Correctional Services Act, 1998
(Act No. 111 of 1998);
    
    "Department" means the national department of health;
    
    "dependant "means-
    
    (a) a spouse;
    
    (b) a child; or
    
    (c) any other person who is legally entitled to support from a person
        who is eligible to become a beneficiary of the Fund and who is
        registered as a user;
    
    "District Health Management Office" means the District Health
Management Office referred to in section 36(1);
    
    "emergency medical services" means services provided by any private
or public entity dedicated, staffed and equipped to offer pre-hospital
medical treatment and transport of the ill or injured;
    
    "financial year" means a financial year as defined in section 1 of
the Public Finance Management Act;
    
    "Fund" means the National Health Insurance Fund established by
section 3; "health care provider "has the meaning ascribed to it in
section 1 of the National Health Act;
    
    "health establishment "has the meaning ascribed to it in section 1 of
the National Health Act;
    
    "health goods" means goods for delivering health care services which
include medical equipment, medical devices and supplies, health
technology or health research in

National Health Insurance Bill, 2018: for Broader Public Comment