To align with South Africa’s constitutional commitment to equality, experts argue for a new standard of AI governance. This includes rigorous algorithmic impact assessments, transparency in the variables used for profiling, and clear pathways for individuals to appeal automated decisions. Artificial intelligence (AI) tools used by South African medical schemes to detect fraud are perpetuating racial bias against black healthcare…
Tag: Council for Medical Schemes (CMS)
-
Medical Scheme Solvency Issues Impacting Members
Three medical aid schemes – Medihelp, Sizwe Hosmed Medical Scheme, and Transmed Medical Fund – did not maintain their medical scheme solvency ratios at or above the statutory minimum of 25% in 2023. This was a key finding in the Council for Medical Schemes (CMS) Financial Performance Industry Report 2023, released last week. While the total number of medical aid…