The increase in medical aid fraud in the healthcare sector poses problems for the future of the newly adopted National Health Insurance.
Healthcare experts from across Southern Africa and as far afield as the United States, have gathered at the 19th annual conference of the Board of Healthcare Funders of Southern Africa at Sun City near Rustenburg in the North West.
Amongst others, they are discussing strategies to combat the impact of medical aid fraud, heeding the call to uproot fraud and corruption at all levels.
Local and international healthcare experts are discussing ways to eradicate wastage that could potentially cripple the healthcare sector.
Principal Officer of Gems, Guni Goolab says:”The size and scale of the problem is significant. The board of healthcare funders has indicated that on annual bases almost R22 billion is wasted on fraud waste and abuse.”
USA special investigator David Popik says:”We are losing 3% of 3.3 trillion dollars. It’s a lot of money and that’s just for the United States so I can only imagine what your GDP is. By having universal healthcare you might as well have universal healthcare fraud so you got to be able to squash it out from the get go.”
With the advent of universal healthcare upon us, law enforcement institutions face a challenge to prevent such fraud, to keep it from contaminating the national healthcare insurance.
SIU Head Andy Mothibi says: “If we don’t deal effectively with corruption and fraud it’s going to deplete the capital adequacy and most of the schemes will go down, it is very critical that we lay the base and identify the vulnerable areas.”
The Conference ends on Wednesday.
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