Question NW630 to the Minister of Health

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15 April 2021 - NW630

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

What steps has he taken in response to the Interim Report into Allegations of Racial Discrimination by Medical Schemes, released on 17 January 2021, that was undertaken by the section 59 Investigation Panel which was launched by the Council for Medical Schemes in 2019?

Reply:

The findings outlined in the Interim Report into Allegations of Racial Discrimination by Medical Schemes are very disconcerting. As part of the processes to better understand the findings, the recommendations emanating from these and also to determine the most appropriate actions required to ensure that the findings do not occur again, we had a briefing session with the Section 59 Panel on the 22nd December 2020. Given the nature of the findings and that the report is interim, there are no immediate actions being implemented. However, once all stakeholders have made their inputs and comments on the report and it is then finalised by the Panel, it is expected that the Council for Medical Schemes (CMS) will submit the final report to the Department.

One of the proposed interventions identified in the Interim Report is that the Department has to ensure that the CMS and the Boards of the Health Professions Council of South Africa (HPCSA) determine the action plans they would be considering, particularly in relation to the Panel’s recommendations as to the two regulatory authorities and their areas of lack of oversight and guidance on matters pertaining to Fraud, Waste and Abuse. Additionally, it is expected that the CMS would investigate the provisions of Section 59 of the Medical Schemes Act, and where necessary propose legislative amendments (including supporting regulations) pertaining to schemes and administrators. This includes providing clear and consistent guidance to their regulated entities on current procedures followed by schemes to enforce their rights in terms of section 59 of the Act. I will also be requesting the CMS Board to provide me with regular updates on all actions taken to address the findings and progress on interventions implemented.

END.

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