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Calls for action on medical aid fraud

News that corrupt doctors and other healthcare practitioners are defrauding medical aid schemes of as much as R22 billion a year has met calls for action - from the DA to Cosatu.

Trade union federation Cosatu said it was "disturbed and shocked" at the report and demanded action against the culprits, while the DA said it would write to the Health Professions Council of SA (HPCSA) to ask it to investigate. This comes after a report last week that the Board of Healthcare Funders had convened a two-day conference to discuss the crisis of soaring medical aid fraud.

An analysis of two-and-a-half years' worth of data had been done to arrive at the estimated R22bn in fraud. Each member of a medical scheme in South Africa was estimated to be paying between R2 500 and R2 800 a year to cover fraudulent and irregular expenditure. Cosatu spokesman Patrick Craven said that in line with its policy of zero tolerance of corruption, the federation demanded "tough action against all those proved to have been guilty of such fraud". DA health spokeswoman Patricia Kopane said the HPCSA must investigate the reports and "immediately institute disciplinary proceedings".

It should also work with law enforcement to ensure criminal charges were laid and followed through. Bertha Peters-Scheepers of the HPCSA said the council was already investigating. She said the council worked closely with the Board of Healthcare Funders and medical schemes when they were investigating matters of fraud.

Craig Dodds: The Cape Argus