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Pay back the money, says Ngcukaitobi to medical aid schemes

He has chaired an inquiry into discrimination against Black, Coloured and Indian health professionals by medical aid schemes, which has released a scathing report on Tuesday.

FILE: Advocate Tembeka Ngcukaitobi at the North Gauteng High Court on 12 December 2018. Picture: Abigail Javier/Eyewitness News.

JOHANNESBURG - Advocate Tembeka Ngcukaitobi said if medical schemes had deducted money unfairly from health professionals, they should pay it back.

He has chaired an inquiry into discrimination against Black, Coloured and Indian health professionals by medical aid schemes, which has released a scathing report on Tuesday.

READ MORE: Medical aids discriminated against black practitioners - report

He said the schemes violated the Constitution by making findings against professionals without affording those accused the opportunity to answer to the charges against them.

“Primarily, what the CMS ought to do is provide individual relief to affected doctors."

Ngcukaitobi said Discovery, Medscheme and GEMS had been unfairly classifying Black, Coloured and Indian health professionals as likely to commit fraud.

And their sheer intimidation of professionals in some instances made them close down and that meant patients were affected.

He said the Council for Medical Schemes would start a process where individual doctors could lodge complaints.

“And those complaints can be validated and there is concrete action that can be taken. If monies have been deducted unfairly, they need to be paid back.”

Some of the professionals said they were forced to close down after being forced to admit guilt and others were forced to pay back fees they couldn’t afford.

FAKE PATIENTS

The panel has also told how medical aid schemes sent fake patients to trap health professionals.

Ngqukaitobi said: “But we would be failing in our duty if we ignored the degrading and humiliating impact if racial discrimination against the individuals who testified before us.”

The panel heard how practitioners were targeted simply because their claims were higher than their peers.

“The work has already begun. We saw a drop in outcomes during the lifespan of this investigation, the numbers showed a significant decline,” he added.

The panel accepts that fraud should be investigated but said fair and due process must be followed.

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