A rise in bogus health practitioners has forced the Health Professions Council of SA (HPCSA) and medical schemes to strengthen their forensics units to curb fraud. A team at the HPCSA is conducting about 400 investigations into bogus practitioners. To date, just more than 40 arrests have been made, but prosecutions are slow.
Data from this special investigation unit suggests that about 7% of all medical aid claims in SA are fraudulent and stem from both bogus practitioners and unscrupulous ones.
Estimates are that this type of fraud costs the private sector R22bn a year.
Bogus practitioners include those who had previously been registered with the HPCSA, but were struck off for various infractions, while others had no medical qualifications or experience and used practice numbers belonging to registered healthcare practitioners.
Eric Mphaphuli, a senior inspector at the council, said on Monday that, initially, his team had issues getting the police on board