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HomeMedico-Legal84 Namibian doctors accused of defrauding state medical scheme

84 Namibian doctors accused of defrauding state medical scheme

The Namibian Ministry of Finance has identified a list of 84 doctors who are accused of stealing millions of dollars through the government's medical aid scheme. According to a report in The Namibian, the ministry has also instituted civil action against some providers and is contemplating slapping the alleged culprits with criminal charges.

This information is contained in a yet-to-be-published forensic report, which looked into the issue of fraud and the abuse of the Public Service Employee Medical Aid Scheme (Psemas).

The investigation was undertaken due to ever-increasing government medical aid spending, resulting in a 2017 resolution to investigate the claiming patterns of healthcare service providers.

Finance ministry spokesperson Tonateni Shidhudhu last month confirmed that forensic investigations were concluded in 2018. He said a peer review committee was set up, which identified a list of 84 doctors as out-layers, and it was recommended that they be investigated.

The Namibian reports that the finance ministry has not revealed how much has been lost through these scams, but a 2018 financial report by the International Monetary Fund (IMF) indicates the government has been losing about N$900m per year.

The finance ministry disputes this figure.

Psemas currently has over 240,000 beneficiaries – 50,000 members fewer than in 2019.

Earlier media reports quoting the Namibia Ministry of Finance, revealed in the 2019/2020 Accountability Report that there were 36,628 ghost beneficiaries on Psemas.
This was discovered during the second phase of the Psemas Membership Verification Project.
These individuals who appeared nowhere on the public service payroll system have since been removed.

The ministry also discovered that 32,000 members were not contributing to the medical aid but were enjoying all benefits. In the 2019/2020 financial year, the Ministry of Financial collected N$15 million in arrear payments from the non-paying members and the process is ongoing. The ministry had budgeted N$545 million in membership contributions to Psemas but it received N$109 million less than expected.

 

Full report in The Namibian (Open access)

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