Health bodies urge implementation of report on racial bias in medical aid schemes

SEVERAL years in the making, the fight for justice in South Africa's healthcare sector is far from over. Health bodies say the real test now lies in the implementation of key recommendations from a landmark report, which found that black healthcare providers were unfairly targeted by medical schemes often having their claims withheld based on race and ethnicity.

- NICOLA DANIELS

Health Minister Aaron Motsoaledi received the final report from the Section 59 Investigation Panel on Monday.

The investigation, commissioned in 2019, examined allegations of racial discrimination and procedural unfairness in the application of Fraud, Waste and Abuse (FWA) processes by major schemes and administrators, including Discovery Health, Medscheme, the Government Employees Medical Scheme (GEMS).

Covering the period from 2012 to 2019, the Panel reviewed statistical and testimonial evidence and found that black providers were disproportionately flagged, audited, or penalised through opaque FWA systems.