Health Funders Association seeks clarity from panel after medical schemesâ racial profiling findings
By Zelda Venter
Share
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.
The Government Employees’ Medical Scheme (Gems) and the Board of Healthcare Funders (BHF) went to court on Sunday to block the public release of an interim report about racial discrimination against doctors by local medical schemes.
It was due to be released at midday on Sunday at a press conference, but, according to the court documents, the applicants claim “scathing allegations and findings in relation to Gems (and others)”.
And the facts that the state-owned medical aid has not seen the interim report or the investigation’s terms of reference, nor has it been given an opportunity to comment on it, make the public release a contravention of the Medical Schemes Act, the applicants claim.
Damning allegations of racism by medical schemes released Siyanda Ndlovu
Photo for illustration: iStock In the period between 2012 and 2019, black practitioners were more likely to be found to have committed fraud, waste and abuse than their white counterparts.
A much-anticipated Section 59 investigation into racial discrimination from medical schemes has been made public.
The Council for Medical Schemes back in 2019 appointed advocates Tembeka Ngcukaitobi, Adilla Hassim and Kerry Williams to probe allegations of unfair treatment and discrimination.
The report released on Tuesday cited that there was no deliberate unfair treatment nor evidence of that by the schemes but the outcomes of the schemes’ actions showed clear evidence of discrimination.