Due to a staggering number of illegal activities, ‘medical aid schemes would soon be rendered unaffordable to most private healthcare consumers’.
This trend meant that medical aid schemes would soon be rendered unaffordable to most private healthcare consumers, Mothudi said. Fraud included intentional deception, false statements, or false representation resulting in unauthorised benefit or payment, for which no entitlement would otherwise exist.
Waste referred to the extra costs incurred with overuse of healthcare services and incorrect billing. Among those at the summit were the head of the Special Investigative Unit Andy Mothibi, who last year established an anticorruption forum, which conducted a vulnerability assessment for the sector. The case was brought by Bonitas Medical Fund after it was discovered Mashego had been submitting fraudulent claims on behalf of members between 2014 and 2015.
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