Doctors bust in rehab ‘rip-off’

2012-04-28 15:48

- This article has been updated to reflect that the charges were later withdrawn.

Two Durban doctors who run an alcohol and drug rehabilitation centre landed in court this week, charged with defrauding medical aid schemes out of R3.5 million.

Doctors Mahendra Pramchand (42) and his ex-wife Anez Awath-Behari (37) are facing 266 charges of fraud and theft in Durban’s Commercial Crimes Court.

If found guilty, they could be struck off the roll.

Awath-Behari and Pramchand own Prydon Clinic in Phoenix, which treats alcoholics and drug addicts. They are alleged to have claimed money from medical aids for lengthy stays by patients when, in fact, the patients spent only a few days there.

In some cases, the patients were at work on the days they were said to have been “hospitalised”.

And, according to the charge sheet, other patients were allegedly paid for their role in the scam.

The prominent couple looked downcast and spoke little while waiting to be called to the dock for their first court appearance on Monday. They had arranged to hand themselves over to police.

According to the charge sheet, the two are alleged to have defrauded medical schemes including Bonitas and Polmed between June 2007 and January 2008.

On the charge sheet, investigators said the alleged scam was uncovered in March 2009 after a fraud hotline received a tip-off from an anonymous caller.

That tip-off centred around a member of police medical scheme Polmed, who had allegedly submitted fraudulent claims saying she was at Prydon Clinic when she was, in fact, at work.

The charge sheet also says that a random validation of claims by some Polmed members revealed a discrepancy in claims submitted by Prydon.

The case was handed to the police Commercial Crimes Unit in 2009 and Prydon Clinic’s business files were seized.

Awath-Behari and Pramchand, who met at medical school, are divorced but live together with their 14-year-old twin boys in the luxurious Pearls of Umhlanga complex in the resort town, where apartments sell for upward of R10 million.

On her Facebook page, Awath-Behari is seen posing alongside the couple’s yellow Lamborghini. The couple also owns a string of properties and the St James Clinic, a rehabilitation centre in Umhlanga.

Awath-Behari also owns the 19-room Inhle boutique hotel in Umhlanga which caters for international tourists.

The court granted the couple permission to go ahead with their planned three-week holiday, a tour of Europe, with their children but ruled that they had to provide investigators with a copy of their itinerary and hand over their passports as soon as they returned.

In court on Monday, officials spent about an hour counting the couple’s bail – R120 000 in cash.

A badly shaken Awath-Behari tried to dodge City Press’s cameras, covering her head with a burgundy scarf, and weeping on the way to her car. Pramchand tried to convince City Press not to publish the story.

Dr Kgosi Letlape, acting registrar and chief executive of the Health Professions Council of SA, confirmed that his organisation had laid complaints against the two.

He said the increasing number of fraud complaints the council received was a “serious concern”.

“There is a definite trend on matters such as fraudulent submission of accounts, overcharging and charging for services not rendered. One case is one too many,” he said.

The council, which has more than 200 000 members, received about 2 500 complaints a year.

- On October 19, 2015, Drs Behari and Pramchand pointed out through their legal representative that the charges reflected in this article were withdrawn later in 2012 as the prosecution was “unable to provide proper evidence of the alleged crimes”.

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