Johannesburg — THE Pretoria High Court has ruled that the registrar of medical schemes, Patrick Masobe, may not appeal against a decision by the Council for Medical Schemes, the regulatory body of which he is the executive officer.

Masobe has gained a reputation for challenging decisions by the council when it has approved schemes he has rejected, so the case has been keenly watched by medical aid schemes. Last year he refused to register 90 of 220 changes to proposed schemes.

Genesis Medical Scheme applied to the Pretoria High Court early this year to force Masobe to register the scheme's 2006 rules and benefits.

Judge Ferdi Preller, in a judgment delivered late last month, said the Medical Schemes Act did not give Masobe the right to appeal against his own tribunal.

He said: "It would simply make no sense if he was entitled to override decisions of the council, whose members have been appointed by the minister for their expertise in various fields."

The judge said the registrar "did not have power that could be exercised independently from, and contrary to the wishes of, the council".

Masobe intends to appeal against the judgment.

He is know for his perseverance. He took on Discovery Health over its controversial reinsurance agreements in 2000 and won.

His legal team, led by Craig Burton-Durham, the Council for Medical Schemes' head of legal services, said Preller's ruling allowed Masobe to object during an appeal process but gave him no grounds to lodge an appeal if he believed the appeal ruling was flawed. This would be in contravention of his duties as registrar and give greater rights to medical aid schemes, they said.

In December last year, Genesis won an appeal by the council's appeal body against Masobe's decision to reject the scheme's 2006 rules.

Masobe was ordered by the Council for Medical Schemes to approve Genesis's rules and benefit options "immediately".

Masobe said he was not happy with the appeal committee's decision and planned to take it on appeal.

The dispute between Genesis and Masobe revolved around Genesis's bid to register three scheme options for last year which offered private hospital cover and, in one option, allowed members to contribute to a medical savings account to cover the costs of out-of-hospital expenses.

Masobe objected to the schemes, saying the self-managed fund was an extension of the medical savings account and together exceeded the 25% contribution limit, that the options were in essence identical and that they discriminated against the elderly who were likely to pay a lot for out-of-hospital expenses.

The council's appeals committee rejected Masobe's concerns. It found that while the scheme might favour the young and healthy, this was not severe enough to be considered unfair. The elderly were free to choose another medical aid scheme.

The 30000-member medical scheme argued that it would suffer financial losses from further delays to the implementation of its rules and benefits, the result of which would "inevitably be the liquidation of the medical scheme, to the great detriment of its members".

Masobe had said that he would not approve the scheme's 2006 or 2007 options for the same reasons.

He told the high court the ruling in favour of Genesis by the council's appeals committee was "incorrect and unjustifiable".