Health Minister Aaron Motsoaledi announced that the Council for Medical Scheme (CMS) is procuring legal expertise to address troubling findings of bias against black healthcare providers.

This decision awaits the recommendations set out by the Independent Section 59 Panel’s report, which uncovered significant evidence of discriminatory practices by medical schemes.

Motsoaledi’s remarks came in response to queries from ActionSA MP Kgosi Letlape, who pressed for definite measures to ensure accountability from the medical schemes implicated in the racial discrimination highlighted in the report.

Letlape expressed concern over the pressing need for effective sanctions to be implemented against offending schemes.

“The CMS is currently seeking a legal opinion that will guide its actions based on the findings of the Section 59 investigation,” stated Motsoaledi.

He elaborated that this legal assessment would not only delineate risks but also explore strategies to protect individuals affected by the discrimination unveiled in the report.

Furthermore, the CMS is anticipated to work closely with stakeholders to issue guidelines aimed at aligning regulatory frameworks between healthcare providers and funding bodies.

This collaboration is particularly vital within the context of tackling fraud, waste, and abuse in the healthcare sector.

Motsoaledi also confirmed ongoing engagements with the CMS since the long-awaited release of the Section 59 report, though he acknowledged the establishment of a multi-disciplinary stakeholder committee is pending.

Alongside this, an internal task team will oversee the implementation of measures in accordance with the report’s recommendations.

Echoing the call for reinforcement of oversight, the Minister stated his endorsement for legislative and regulatory changes that would enhance enforcement powers against discriminatory practices by medical schemes.

He highlighted various initiatives currently being deliberated, including a cooperative framework between CMS and the Health Professions Council of South Africa, as well as more frequent guidance issued by the CMS to address the issues raised in the report.

Health Portfolio Committee Chairperson Sibongiseni Dhlomo underscored the committee’s concerns regarding the disproportionate allegations of misappropriation directed towards black healthcare providers compared to their white counterparts.

“Accountability is crucial, and members have sought further details regarding potential punitive measures against schemes found guilty of discrimination,” he expressed.

Dhlomo further noted that the committee has outlined recommendations, including the establishment of an early warning system within medical schemes to prevent unwarranted scrutiny of honest practitioners.

He asserted that such a system would be fundamental in mitigating financial losses and protecting healthcare providers from transparently unfounded allegations.

In the committee’s efforts to tackle these concerns, Dhlomo mentioned plans to consult legal advisors on legislative amendments to foster transparency and responsibility within the sector.

Additionally, he stressed the necessity for a strategic approach to clear the current backlog of complaints lodged with the CMS.

IOL

Dhlomo further noted that the committee has outlined recommendations, including the establishment of an early warning system within medical schemes to prevent unwarranted scrutiny of honest practitioners.

He asserted that such a system would be fundamental in mitigating financial losses and protecting healthcare providers from transparently unfounded allegations.

In the committee’s efforts to tackle these concerns, Dhlomo mentioned plans to consult legal advisors on legislative amendments to foster transparency and responsibility within the sector.

Additionally, he stressed the necessity for a strategic approach to clear the current backlog of complaints lodged with the CMS.

IOL

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