Health Funders Association seeks clarity from panel after medical schemesâ racial profiling findings
By Zelda Venter
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Pretoria â The Health Funders Association (HFA) â a representative body for medical schemes â welcomed the interim findings by the Section 59 Investigation panel that there is no evidence of explicit or intentional racial bias in the algorithms and methods that medical schemes use to identify fraud, waste and abuse (FWA).
The preliminary report issued on Tuesday, despite futile attempts by the Government Employee Pension Funds (Gems) to block it being made public, found that some medical schemes racially profiled doctors.
The panel serving on the Council for Medical Schemes, which investigated claims that black medical practitioners were discriminated against by some medical schemes, said while they found that there were racial discrimination, they could not find that it was intentional.
HFA happy there is no evidence of explicit racial bias by medical schemes 20 January 2021 - 13:25 The Health Funders Association says it will provide detailed input to the panel appointed by the Council for Medical Schemes, which found there is unfair racial discrimination against black practitioners by three medical schemes. Stock photo. Image: 123RF/Samsonovs
The Health Funders Association (HFA) has welcomed an interim report which investigated claims of unfair discrimination by medical schemes and administrators against black health practitioners.
The panel appointed by the Council for Medical Schemes (CMS) has found black practitioners were more likely to be found to have committed fraud, waste and abuse (FWA) than their white counterparts by Discovery, Medscheme and the Government Employees Medical Scheme (Gems).
Sipho Mabena According to the applicants, the report makes scathing allegations and findings in relation to Gems [and others] . Picture: iStock.
Adding weight to this prospect is the fact that the independent panel’s findings into allegations of medical aid schemes and administrators withholding payments to black and Indian doctors on perception of fraudulent claims have twice been blocked on the eve of being made public.
The report was initially scheduled to be released on 16 December but Health Minister Dr Zweli Mkhize instructed it could not be released without him being appraised of its contents, sentiments echoed by the CMS.
Medical scheme members not likely to pay arm and a leg for Covid vaccine
By Edward West
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CAPE TOWN - The inclusion of Covid-19 vaccine to medical scheme benefits is not likely to substantially increase medical aid payments by members, Council for Medical Schemes (CMS) acting GM for Stakeholder Relations Mmatsie Mpshane said Wednesday.
The CMS has been coordinating public-private sector collaboration aimed at ensuring universal access to vaccines when it is available in South Africa, in line with the country’s priorities and individual health needs.
Covid-19 vaccine has been included in the Prescribed Minimum Benefits of medical schemes, amendments that had also recently been approved by Health Minister Zweli Mkhize, Mpshane said in a statement.
COVID-19: What will your medical aid cover? Updated
Lifestyle Reporter
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While benefits may differ slightly depending on the medical scheme plan you are on, here are the ones which are covered by all schemes, regardless of your plan.
Coronavirus medication/ iStock
Many South Africans breathed a sigh of relief when the country seemed to be over the peak of the first wave of the COVID-19 pandemic. However, the alarming recent resurgence in cases is a stark reminder that we cannot afford to become complacent.
With the festive season around the corner, many of us will be attending family gatherings which could act as super-spreader events if we don’t stringently observe the now commonplace essential precautionary protocols like meticulous hand-washing, social distancing, wearing of masks, and adequate ventilation. Where possible, outdoor family gatherings and other activities are much safer than indoor meetings.