Minister Using Race To Push NHI

MEDICAL AID: MOTSOALEDI SLATED OVER 'BIASED' CLAIMS

- Jarryd Westerdale

The Institute of Race Relations (IRR) has accused Health Minister Dr Aaron Motsoaledi of using a report into the racial bias of medical aid compliance standards to further his National Health Insurance (NHI) agenda.

The report, compiled by a panel chaired by advocate Tembeka Ngcukaitobi, concluded that medical aid schemes were unfairly discriminating against black practitioners when investigating fraud, waste and abuse (FWA) claims.

To reach this conclusion, the independent panel relied on an equation devised by a mathematician with a PhD from the University of Cape Town.

"The risk ratio is a tool we developed to work out the likelihood a black practitioner would be subjected to an investigation, a finding and a penalty, versus a white practitioner," said Ngcukaitobi.

"What we found is that the FWA procedures, for the recovery of monies allegedly owed, is unfair and violate the right to procedural fairness of individual practitioners."

The report has divided the industry, with some welcoming it and others challenging the methodologies and findings.