Release of report on probe into Medical Aid Scheme racial prejudice postponed

SABC News Doctor R 1 1 - Release of report on probe into Medical Aid Scheme racial prejudice postponed

The release of a report on a probe into racial prejudice by medical aid schemes has been postponed to Friday. The cash-strapped medical schemes regulator spent more than R11 million in unbudgeted funds on the high-profile probe last year.

The investigations by the Council for Medical Schemes (CMS) followed allegations of racial profiling against Black and Indian medical practitioners.

The CMS said the medical practitioners who were members of the National Health Care Professionals’ Association alleged that they were being unfairly treated and their claims were being withheld based on the colour of their skin and their ethnicity.

The Inquiry was chaired by advocate Tembeka Ngcukaitobi.

More evidence against medical aid schemes

Last year the Solutionist Thinkers Group, representing 200 doctors, gave evidence.

Chairperson of the Group, Nomaefese Gatsheni, argued that Black and Indian doctors are excessively audited by medical aid schemes and are then accused of claiming fraudulently.

They are also allegedly expected to provide confidential information to prove the claim is real.

Gatsheni says white doctors are not audited as frequently: “It happens to be that most of the Black and Indian doctors are the ones that are requested to provide clinical notes or confidential information of the patients – whereas when you compare with your colleagues that are white, they will come back and say we were never asked that, what do you mean you were asked to submit that information? I was only requested a diary and that’s it.”

Medical aids respond to racism allegations:

The South African Optometrists Association (SAOA) also said last year that they noted that they were unfairly treated and their claims were being withheld by medical aid schemes based on their race and ethnicity.

SAOA says unreasonable practices, lack of cooperation, and intimidation by medical aid schemes, prompted them to make submissions at the Investigations Inquiry.

SAOA President Dolah Seboloka says there are many issues that need to be brought up for resolution.

“Intimidation of members by schemes, the guilty until you prove yourself innocent approach as part of under section 59. That’s what the schemes do to our members. The non-accreditation of these networks, that means they are police, they are judges, they are prosecutors. They do everything. You are always at their mercy.” Additional reporting by Liela Magnus and Maluti Obuseng


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