Technical supervision
The Supervisory Authority of Insurance and Social Welfare (ACAPS) oversees the financial situation, 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 their compliance with Law No. 65-00 and its implementing regulations.
This supervision is carried out through document verification and on-site inspections.
The managing organizations are required to submit all statements, reports, tables, and documents necessary for monitoring :
- Financial standing
- Contribution collection and recovery
- 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 the President of ACAPS’s circular on AMO’s financial organization and the required reporting by its managing organizations.
Did you know ?
The Social Welfare Directorate ensures the supervision and monitoring of social welfare bodies and ensures compliance with the rules of protection of affiliates, policyholders and members.
