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Compensation Fund failure to pay medical bills augurs badly for NHI

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In a failure that could intensify concerns about the administration of the proposed National Health Insurance (NHI), a multi-billion-rand government fund that compensates doctors and therapists for treating injured workers has not settled most of its bills since October 2019. Business Day reports that this is because the Compensation Fund’s new website to record accidents and lodge claims has been dysfunctional since then. Health professionals say this is putting “workers’ lives at risk”.

The fund was set up to cover the medical expenses of workers injured on duty and pays thousands of orthopaedic surgeons, doctors, radiologists and physiotherapists to provide medical care at a cost of almost R5.4bn a year, according to its 2019 annual report. The report says the Compensation Fund is the legal model for the NHI fund, which aims to pay for the health care of all South Africans like a state-run medical aid. Health minister Zweli Mkhize said recently the NHI would be run like other government schemes such as the Compensation Fund that “had set a precedent of good governance and accountability”.

The Health Department did not respond to requests for comment.

Labour lawyer Michael Bagraim, who is a Democratic Alliance (DA) member of parliament, said he received calls every day from frustrated doctors and physiotherapists who could not get claims paid. The Labour Department’s fund spokesperson Themba Mdluli said the website works on specific web browsers and an e-mail had been sent to tell claimants this. Industry body groups representing radiologists and lawyers for occupational therapists and physiotherapists said no claims had been paid to hundreds of their society members for five months.

Full Business Day report

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