Picture: THE TIMES
Picture: THE TIMES

SA’s medical scheme regulator has suspended its head of investigations, Stephen Mmatli, pending the outcome of a probe into allegations of corruption.

The move by the Council for Medical Schemes (CMS) has potentially fa r-reaching implications for the medical schemes industry, as it raises questions about the legitimacy of inspections currently under way, and whether the regulator may have turned a blind eye to issues that warranted scrutiny. 

The CMS is the watchdog agency for the medical schemes industry, charged with safeguarding the interests of consumers and ensuring medical schemes and administrators comply with the Medical Schemes Act.

At least four inspections are currently in play, including probes into SA’s two biggest medical schemes, Discovery Health Medical Scheme and the Government Employees Medical Scheme (Gems), as well as smaller schemes Resolution Health and Bonitas.

In a circular issued late on Friday afternoon, the CMS said it had served its GM for compliance and investigations, Mmatli, with a letter of precautionary suspension, pending the outcome of investigations into “serious acts of misconduct”.

“We received anonymous tip-offs alleging, among others, that Mr Mmatli has been involved in corrupt relationships with organisations regulated by the CMS. Secondly, that he has deliberately misled the council to take decisions in favour of those organisations and benefited financially in return,” the CMS said in the circular.

Acting CMS registrar Sipho Kabane said the organisation had received anonymous allegations against Mmatli in December, and was alerted by the SIU in January that it had received similar complaints.

He declined to name the organisations Mmatli was alleged to have had a corrupt relationship with or provide any further details of the allegations made against him. No other employees had been suspended, and the CMS planned to appoint an independent party to conduct the investigation into Mmatli’s conduct, he said. Inspections that were currently under way would continue, he said. “We cannot suspend our work, or any of our regulatory activities,” he said.

The SIU’s spokesperson,Nazreen Pandor, could not immediately respond to Business Day’s questions, but said she would do so by Wednesday.

Mmatli, who has worked for the CMS since March 2002, directed queries to his lawyer, Hope Chaane, who said his client would oppose his suspension. “We will be going to court,” he said.

Chaane said Kabane had failed to provide Mmatli with sufficient detail in his notice of intention to suspend his client for him to be able to defend himself and offer reasons he should not be suspended. Kabane subsequently informed Mmatli that he had decided to suspend him, in a letter seen by Business Day. Kabane said the allegations against Mmatli were of a serious nature and there was a possibility that he would interfere with the investigation if he remained at work.

Discovery and GEMS declined to comment on Mmatli’s suspension and the status of their inspections by the CMS.

CMS spokesperson Grace Khoza said the inspections into Discovery, Gems and Resolution Health were close to finalisation, while the inspection into Bonitas was at an earlier stage.

Kabane was appointed acting registrar of the CMS two years ago, following the sudden death of former registrar Humphrey Zokufa in January 2017. Khoza said a shortlist of three potential candidates for the job had recently been submitted by the CMS to health minister Aaron Motsoaledi, who had yet to make a decision on the matter.