Supervised AMO entities
The Supervisory Authority of Insurance and Social Welfare (ACAPS) oversees financial management, contribution collection and recovery, claims processing, reserve constitution and representation, and compliance with agreements signed with healthcare providers. ACAPS also ensures that the managing organizations of Mandatory Health Insurance (AMO) comply with the provisions of Law No. 65-00 governing AMO.
The management of AMO is entrusted to the National Social Security Fund (CNSS) and the National Fund of Social Welfare Organizations (CNOPS).
These organizations are subject to technical supervision by ACAPS, whose mission is to ensure that they comply with the provisions of Law No. 65-00 and its implementing regulations.
This supervision is conducted both through document verification and on-site inspections.
The managing organizations must provide all statements, reports, tables, and documents necessary to monitor :
- Financial standing
- Collection and recovery of contributions
- Claims processing
- Reserve constitution and representation
- Implementation of agreements with healthcare providers
The content, format, and submission deadlines for these statements, reports, tables, and documents are set by Circular No. PS/9/21 of September 26, 2021, issued by the President of ACAPS, which regulates AMO’s financial organization and the required reporting by its managing organizations.
