Panel finds some medical aid schemes racially discriminated against black service providers

JOHANNESBURG - A section 59 investigation panel into the discrimination of black healthcare providers has made damning findings of racial discrimination by some medical aid schemes.

In 2019, healthcare providers, represented by two associations, made public allegations about their treatment from medical schemes and administrators.

They claimed they were being treated unfairly by schemes and administrators based on race and ethnicity.

The panel’s chair, Advocate Tembeka Ngcukaitobi SC, released the final report to Health Minister Aaron Motsoaledi on Monday.

In the written submissions in 2019, healthcare professionals alleged that some medical aid schemes were intimidating and bullying providers through the implementation of their fraud, waste and abuse systems.

This included refusing to reimburse providers directly and coercing them into agreeing to acknowledgement of debts.

The National Health Care Professionals’ Association told the panel it had anecdotal evidence that the schemes’ forensic audit process was more prevalent among black providers.

With the lion's share of the covered market, the exercise was limited to Discovery, GEMS and Medscheme.

Advocate Tembeka Ngcukaitobi SC spoke on the findings.

"We were not a court of law, we were not adjudicating individual complaints, we did not sit in a trial, we did not have to make legal findings, applying the Promotion of Equality and Prevention of Unfair Discrimination Act or applying section 9 of the Constitution, but what we did have the power to do was to make findings of fact and that finding of fact simply leads to one conclusion – the evidence of the risk ratios showed racial discrimination against black service providers by the schemes."

The medical aid schemes implicated have denied discriminating against black healthcare providers.