Criminal networks are targeting your medical aid rands but could you be part of the problem too?
Criminal syndicates and unscrupulous doctors may be defrauding the private health sector of millions as experts warn that medical schemes may reach a breaking point.
“The health care sector is being targeted by criminal syndicates and even devious practitioners. It is a direct threat to the financial viability of medical schemes in the country, including any National Health Insurance initiative we attempt,” says medical advisor on healthcare forensics at medical aid administrator and risk management service, Medscheme Gregory Pratt. Pratt was speaking at the Board of Healthcare Funders Southern African Conference this week in Cape Town.
“The affordability of medical schemes in the country will soon reach a tipping point.”
In 2013 alone, Discovery Health recovered R300 million in fraudulent claims alone – a number that in 2014 CEO Jonathan Broomberg told