Fake claims: PTA doctor in dockComment on this story
Pretoria - A Pretoria doctor has been arrested for allegedly defrauding a medical aid scheme and the Compensation Fund of almost half a million rand.
Doctor Ganesh Anil Anirudhra is just one of many doctors in the country who are believed to have defrauded the Compensation Fund of at least R28 million over the past three years.
Anirudhra is a general practitioner but has apparently been operating as a gynaecologist.
He was nabbed on Thursday by the Hawks at the Dr George Mukhari Hospital where he works after he apparently managed to evade arrest twice before.
Hawks spokesman Captain Paul Ramaloko said they had been monitoring him for more than a year.
Anirudhra is said to be a gynaecologist in training. By law, he may not practise as one until he has completed his studies.
“We have been following the doctor’s claims for over a year. He has at least 320 cases against him,” said Ramaloko.
The doctor has at least 218 known cases with Bonitas medical aid and at least 99 with the Compensation Fund. He is also said to have been carrying out illegal practices at the Brits Medi-Clinic.
“We arrested a 49-year-old doctor at the hospital for allegedly making illegitimate claims with the Compensation Commissioner in the Department of Labour between 2008 and 2012. With Bonitas, he made claims and said he had treated their members,” said Ramaloko.
“He has previous records and convictions for fraud. There is a case that we know of from 1989 and another from 1991 in Port Shepstone in KwaZulu-Natal.
“He is said to have been making fraudulent claims for the past five years.”
Ramaloko said fraud was a serious problem but the Hawks were hopeful that the arrest might deter other doctors from making similar claims.
Principal executive officer of Bonitas Medical Fund, Dr Bobby Ramasia, welcomed the arrest.
He thanked the prosecutor, Qhubeka investigators, the SAPS Commercial Crimes Unit and the Asset Forfeiture Unit in assisting Bonitas in its efforts to eliminate fraud, corruption and malpractices.
“We would like to assure our members that we take our responsibility as service providers very seriously. This is two-fold: protecting members’ funds and building a reputable and sound GP network.
Ramasia said the company would not allow any party to interfere with its efforts, or that of its peers in the industry.
“We also value our partnerships with the SAPS and their units. We are walking the talk, not offering empty words,” he said.
Director of risk management at the Compensation Fund, Twana Makhubela, said they were happy about the arrest and believed they had a strong case.
“We are picking up many doctors who are claiming for services they did not render.
“In the past three years, 11 doctors have defrauded the Compensation Fund of at least R28 million through such claims.
“Some of them have been arrested and others are still being investigated,” said Makhubela.
The doctor appeared on Thursday at the Brits Magistrate’s Court and was granted R20 000 bail.
The case was postponed to February 21.
His passport was confiscated as he was seen as a flight risk.