Health minister backs suspensions of officials at medical schemes regulator

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Health Minister Zweli Mkhize supports suspensions of five executives of the Council of Medical Schemes.

According to a statement issued by the CMS on Sunday, the minister was briefed by the regulator's chairperson Dr Clarence Mini and CEO Dr Sipho Kabane on the status of probes into allegations of irregularities by the officials.

The CMS regulates 75 medical schemes, covering eight million beneficiaries.

Earlier this week the CMS announced that two executives and three senior managers had been placed on precautionary suspension with full pay, following allegations of wrongdoing via the regulator's anonymous tip-off hotline.

Among the allegations include collusion in the appointment of service providers, the irregular placement of schemes under curatorship, irregular spending on service providers, lifestyles not matching salaries and close and corrupt relationships with entities that the council regulates.

The CMS said that the minister supported the suspensions as a move towards "ethical and good governance".

Probing matters

According to the CMS, the minister supports another investigation – known as the section 59 investigation – into racial profiling by medical schemes.

The investigation panel, announced in June, is chaired by Advocate Tembeka Ngcukaitobi

It follows allegations made by members of the National Health Care Professionals Association, who said they had been unfairly treated and their claims withheld by medical aid schemes based on the colour of their skin and ethnicity, according to the CMS.

"The Minister fully supports the Section 59 Investigation chaired by Advocate Tembeka Ngcukaitobi. He reaffirmed his full confidence in the process and believes that the outcomes of the report will assist in ensuring due process and dealing with issues of fraud, waste and abuse in the private medical sector," said Kabane.

"The minister also believes that this process will lay a good foundation to ensure proper process in the engagement between the schemes and healthcare providers towards the National Health Insurance that will still utilise the much-needed services of healthcare providers," he added.

The CMS also updated the minister on another investigation by the Special Investigating Unit led by Advocate Andy Mothibi. This is an industry-wide probe into allegations of fraud and corruption. This follows a previous investigation into the council's General Manager of Compliance, Stephen Mmatli – who had later been suspended over "corrupt relationships" with industry stakeholders, Fin24 previously reported.

The CMS said the minister was confident the different initiatives would help the regulator deal with issues at hand.

"I am happy with the CMS initiatives. They demonstrate strong leadership and good governance in regulating the medical schemes for the benefit of their members and the industry as a whole. Good leadership means you tackle all challenges head on," Mkhize said.

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