BHF to engage panel over report on racial profiling by medical schemes

The Board of Healthcare Funders (BHF) has said that efforts are being made to address fraud and corruption, following the report into racial profiling by medical schemes

BHF to engage panel over report on racial profiling by medical schemes

The Board of Healthcare Funders (BHF) has responded to a scathing report – which highlighted racial profiling by medical schemes against black practitioners.

The board said it will review the findings in the report and also engage the panel – which was established to look into the claims.

According to BHF Managing Director Dr Katlego Mothudi, efforts are being made to root out fraud, waste and corruption.

“We are of the view that our members have and had no agenda to intentionally discriminate against any of the medical professionals as we have zero-tolerance for any forms of discrimination,” he said.

The panel, appointed by the council for medical schemes, found that a number of health-care professionals were being treated unfairly by medical aid schemes, particularly because of their race and ethnicity.

The board, which represents the majority of the country’s medical schemes – said members have no agenda to intentionally discriminate.

Discovery, Medscheme and the Government Employees Medical Scheme (Gems) were singled out as the guilty parties in this regard.

Advocate Thembeka Ngcukaitobi, who chaired the panel, said however that the level of racial discrimination varied.

“For Discovery, we found that they were 35 percent more likely to identify black providers as having committed fraud, waste and abuse,” he said.

“This is the lowest rate of the three schemes and administrators that we looked at. Discovery had the lowest rate of the likelihood of unfair racial discrimination.”

While Medscheme, which has the highest likelihood, was 330 percent more likely to identify black providers as having committed fraud, waste and abuse.

For Gems, the panel found that it was 80% likely to single out black providers.  

Medscheme to review contents of report into racial profiling

Medscheme, the largest medical health risk management services provider, has rejected the findings of racial profiling but also said it would review the matter being making a formal response.

“We shall now review the contents of the Interim Report and make a formal submission in response thereto. The company maintains that its duty will always be towards its beneficiaries to validate and verify healthcare claims, and the company does not take this duty lightly,” said executive director, Dr Lungi Nyathi.

“Our fiduciary duty to safeguard funds entrusted to us remains to ensure that members and their dependents continue to receive access to healthcare treatment that is affordable and of the highest quality. This function has become even more critical in current depressing economic times, a function without which private healthcare would be substantially more expensive for everyone,” he added.

Source : The South African More