Chaired by advocate Tembeka Ngcukaitobi, the probe follows allegations made by members of the National Health Care Professionals Association (NHCPA) that they had been unfairly treated and had their claims withheld by medical aid schemes based on race and ethnicity.
After the submissions, the panel may request a deponent or a person to appear before it and be interviewed on specific aspects.
In a statement, the Council for Medical Schemes (CMS) said Ngcukaitobi would be able to get to the bottom of things.
CMS chief executive and registrar Dr Sipho Kabane said: “For the next four months, advocate Ngcukaitobi and his team of advocates, Adila Hassim and Kerry Williams will get to the bottom of these allegations.
“The CMA believes that advocate Ngcukaitobi, a respected legal mind, will help go to the root of the allegations of racial profiling, black listing for payments, blocked payments, demands of confidential clinical information, bullying and harassment, coercion, entrapment and use of hidden cameras.”
The CMS said the total cost of fraud in SA’s private healthcare system was estimated at about R22 billion every year.
At the start of 2019 at the Fraud Waste and Abuse Summit, private healthcare representatives signed an industry charter against fraud.
According to Section 7 of the Medical Schemes Act, the CMS’s mandate is to protect the interests of medical scheme members, and take any steps it deems necessary, the CMS said.
Written submissions from interested parties should be sent to [email protected] by no later than June 30.