The South African Society of Physiotherapy has lost its legal challenge against medical scheme clawbacks. The High Court in Pretoria dismissed the society’s application to have Section 59(3) of the Medical Schemes Act declared unconstitutional and invalid. The judgment ends a five-year legal battle involving the Minister of Health, the Council for Medical Schemes and the country’s medical schemes. The…
Tag: Fraud Waste And Abuse
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Section 59 Investigation: CMS Promises Binding Fraud Code
South Africa’s medical schemes regulator says it will implement the recommendations of the Section 59 Investigation into alleged discrimination against black healthcare providers. The commitment was made during parliamentary scrutiny of stalled reforms linked to both the Section 59 process and the Health Market Inquiry (HMI). The Council for Medical Schemes (CMS) launched the investigation after complaints from black providers…