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BusinessLive reports that the SA Private Practitioners Forum (SAPPF) says it has no evidence medical schemes are using racial profiling to determine which of its members to investigate for fraud.
The Council for Medical Schemes (CMS) is conducting an investigation into allegations from the National Healthcare Practitioners Association (NHCPA) that medical schemes and administrators are targeting black and Indian doctors for fraud investigations and unfairly withholding payments. The CMS regulates the medical schemes industry, and is conducting its second round of public hearings into the matter this week. In its submission on Tuesday, the SAPPF, which represents specialists, raised concerns about the methods used by medical schemes to flag potentially crooked doctors among its membership base, but was adamant there was no racial dimension to it. “We’ve not picked up that there’s one race group [targeted] more than another,” SAPPF president Adri Kok told the investigating panel. She said many doctors, particularly the more junior ones, billed incorrectly out of ignorance rather than because they intended to commit fraud. But she conceded there were doctors who deliberately sought to defraud medical schemes. Yet, the Independent Community Pharmacy Association (ICPA) told the inquiry that there was evidence of racial profiling.
- Read the full original of the above report by Tamar Kahn at BusinessLive
- Read too, Inquiry medical aid race scandal hears about 'focused investigation on Africans', at The Star
Get other news reports at the SA Labour News home page