nmp sovereign health about us new user contact us sitemap epages


What is the Medical Advisory Committee?

What is the medical advisory committee?

Medical Advisory Committee 


  • To identify procedures and treatments that are unique, high cost, and/or life threatening and which require the establishments of Managed Care guidelines and protocols
  • To formulate Managed Care guidelines and protocols dealing with the granting of benefit to such events
  • Ensuring Managed Care guidelines and protocols are both medically appropriate and comply with scheme rules
  • To make decisions based on such guidelines and protocols and communicate these to affected parties
  • To ensure that wherever possible all stakeholders are involved in the development of guidelines and protocols including specialists from their respective fields

What is Ex-gratia

Exgratia Commitee


  • To consider requests for extensions of benefit in exceptional cases
  • To grant benefit in such cases according to medical appropriateness and scheme rules
  • To grant benefit in a consistent manner for all requests from members
  • To communicate decisions promptly and efficiently to affected parties