Pre-NHI forum to take on medical aid graft
Fraud, waste and abuse in healthcare remain challenges in the well-funded private healthcare sector
The Special Investigations Unit (SIU) has partnered with the private healthcare industry to create a forum to help detect and prevent corruption and abuse in preparation for National Health Insurance (NHI). Fraud, waste and abuse in healthcare remain challenges in the well-funded private healthcare sector, which faces risks from both patients and healthcare providers, with the industry losing billions every year. The Board of Healthcare Funders’ (BHF’s) 18th annual conference is under way in Cape Town and these risks formed part of the discussions on Tuesday. The event has been addressed by both local and international experts. SIU head Andy Mothibi said the unit had been in talks with various associations in private healthcare about the creation of a joint forum that would result in law enforcement agencies and funders collaborating to prevent criminal activity. Data generated by the BHF suggest that about 7% of all medical aid claims are fraudulent. It is estimated fraud costs the...