Medical schemes blackmail doctors
Johannesburg - A number of medical aids are extorting money from medical practitioners who over-service patients or claim for services not rendered, the Health Professions Council of SA (HPCSA) said on Wednesday.
"These medical schemes coerce and intimidate health
practitioners into signing acknowledgement of debt agreements where there are allegations of unethical conduct," senior manager for legal services, advocate Tshepo Boikanyo, told the media in Pretoria.
Boikanyo said he was not at liberty to name and shame them
because the council was still in talks with these schemes, hoping
they would stop this behaviour.
"We will only name them after engagement. We need to give them
an opportunity to correct their wrongs."
After obtaining "untested evidence" against these
practitioners, the medical scheme summons them to a meeting
where they can sign the plea settlement agreement for an inflated
amount of money.
Practitioners either had to do this or risk being reported to
the council for unprofessional conduct or even to the police.
"The pressure placed on the practitioner at the meeting often
leaves him/her no choice but to succumb to all the ridiculous
requests of the medical aid scheme concerned," said Boikanyo.
The HPCSA became aware of this a year ago. So far, 20
practitioners had come forward with information.
Boikanyo said they were expecting the number to increase.
There was also an increase in the number of patients complaining to the council.
Medical schemes were given three months to change their modus
operandi or they would be reported to the police, warned Boikanyo.
"Others stopped after we warned them but others are still
continuing. We will not tolerate this," he said.
If the doctors falsify claims then they are committing fraud and should be exposed as fraudsters.
Nothing wrong with medical aids auditing doctors claims, they are acting on behalf of the members who pay them.
I agree .... Arrest anyone who reports crime ! Undermining the people's right to steal cannot be allowed !