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CMS invites role players to webinar on fraud, wastage and abuse

Following the inquiry into allegations of unfair racial discrimination and procedural unfairness by medical schemes, the Council for Medical Schemes (CMS) in collaboration with the Health Professions Council of South Africa (HPCSA) will be hosting the Fraud Waste and Abuse (FWA) webinar today, 11 March & 18 March 2021.

According to the Section 59 Investigation Interim Report released in January, these two key regulators can assist both schemes and providers in addressing FWA fairly and reasonably.

“We are committed to working together with all industry role players to resolve the issue of fraud, waste, and abuse in the sector. The collaboration with HPCSA forms part of the efforts in working towards addressing the scourge and finding a long-lasting solution,” says Dr Sipho Kabane, Chief Executive & Registrar of CMS.

Over the next two weeks, the webinars will unpack industry Codes of Good Practice and establish an FWA Tribunal. “The Industry Codes of Good Practice with standards exist to foster a culture of lawful, honest, cost-effective and ethical commercial activity in the private health sector, for the benefit of patients,” says Dr Kabane.

To ensure that the Industry Codes appeal to all stakeholders, Dr Munyadziwa Kwinda, Acting Registrar/Chief Executive Officer of the HPCSA will present on Provider Codes of Good Practice. “As a key regulator in addressing FWA fairly and reasonably, HPCSA is committed to collaborating with the CMS, not only for the FWA webinars but into the future. We are hopeful that this collaboration will provide a strong foundation in addressing FWA in provision of healthcare services and address the regulatory vacuum that existed in matters related to FWA ,” Dr Kwinda says.

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