Medical aid scheme bribed me, says chemist
* The story has been updated to include comment from AfroCentric Health, owners of Medscheme.
DURBAN - A Pretoria pharmacist has accused medical aid company Polmed, an administrator of Medscheme, of soliciting a R200 000 bribe by “unlawfully” withholding payments.
More than 250 doctors and health professionals formed the National Healthcare Professionals Association (NHPA) and approached the North Gauteng High Court via the association for assistance.
They claimed medical aid schemes accused them of fraud, but could not prove it. They also accused schemes of illegally using spy tapes to monitor their practices.
Mokoditoa said Polmed owed him R1.6 million since 2010 for services at his pharmacies.
“The scheme refused to pay and alleged fraud on all my claims. Payment due was unlawfully withheld.
Certain employees of the forensic unit started to demand R200 000 for my payments to resume. They came into my pharmacy and requested I hand over the money in cash, but I refused.”
He said he reported the officials to the principal officer of Polmed.
“I received a letter from the principal officer who indicated he would conduct an investigation into the alleged extortion, but this was never done.”
Mokoditoa said after fighting, the scheme, it only paid back R300 000 owed to him last year, and still owed more than R1m.
“The scheme indicated it paid the above balance due to me to its member’s bank accounts. There is no proof the balance was paid to scheme member’s bank accounts and Polmed is refusing to provide me with evidence.
The Medical Schemes Act states that the scheme must pay all amounts due, owing and payable to the service provider, directly to the service provider, not to its members. I have never heard of medical aids doing this before.”
He said he had exhausted all avenues in trying to recover his money and was considering approaching the high court.
Polmed spokeswoman Marlene Eloff did not respond to questions.
Botshelo Nkosi, a spokesperson for the AfroCentric Health, which owns Medscheme, said: "Th
e alleged solicitation of R200 000 bribe from Alfred Mokoditoa by Medscheme fraud investigators back in 2010 when the scheme was administered by another contractor at the time, not Medscheme".
"We wish to put it on record that only Medscheme is a wholly owned subsidiary of JSE listed AfroCentric Group. Polmed is not a subsidiary of Medscheme," said Nkosi.