A Health Professions Council of SA unit is conducting about 400 investigations into bogus medical practitioners, with more than 40 arrests to date. Data from the unit suggests that about 7% of SA medical aid claims are fraudulent and stem from both bogus practitioners and unscrupulous ones.
Business Day reports that prosecutions have been slow. Estimates are that this type of fraud costs the private sector R22bn a year.
The report says bogus practitioners include those who had previously been registered with the HPCSA, but were struck off for various infractions, while others had no medical qualifications or experience and used practice numbers belonging to registered healthcare practitioners.
Eric Mphaphuli, a senior inspector at the council, is quoted in the report as saying that initially, his team had issues getting the police on board and had to convince the authorities that the problem was serious and on the rise. Since that conversation took place, arrests were being made every other week. “Recently a practitioner was arrested and sentenced to 20 years for practising illegally,” Mphaphuli said.
Bonitas Medical Fund, the second-largest open scheme in South Africa, had identified more than R79m in irregular claims involving medical practitioners in 2016 and recovered about R20m, according to Gerhard van Emmenis, Bonitas’s principal officer, who said the biggest single deterrent to fraud, waste and abuse was making it known that schemes were actively investigating every suspicious or unusual claim or activity.
In 2016, Bonitas introduced advanced analytical software into the live claims environment, using a mix of technology, analytics and expert skills to identify fraud, waste and abuse. During this process, Bonitas red-flagged 574 healthcare professionals, 34 of whom were charged, while another four were arrested.
“We believe the HPCSA are too lenient on offenders. According to Section 66 of the Medical Schemes Act, medical aid fraud, committed either by a member or a healthcare practitioner, is a criminal offence which carries a fine or imprisonment or both,” he said.
Meanwhile, the National Education, Health and Allied Workers Union said it was concerned about rising corruption in the healthcare system. Union spokesperson Khaya Xaba is quoted in the report as saying that bogus practitioners compromised the healthcare system and the union was concerned about this.
United Democratic Movement general secretary Bongani Msomi said the Department of Health needed to “blacklist” bogus practitioners.
Two bogus doctors, and a doctor who employed them, have appeared in the Rustenburg Magistrate’s Court in the North West, on charges of fraud and contravening the Health Professions Council Act. News24 reports that Dr Parbold Jogi, 44, Aboubacar Mabungu, 36, and Jimmy Omange, 39 were arrested by the Directorate for Priority Crimes Investigations (Hawks) after a complainant alleged that the trio may be practicing as doctors in the town without the required qualifications.
The Hawks said that expired medicines and more than 5,000 patient files were seized during the arrest.
The report says an investigation by the HPCSA found that Mabungu and Omange were not registered medical practitioners.
Police Captain Tlangelani Rikhotso is quoted in the report as saying that Jogi had been released on R50,000 bail, and that, although he was a doctor, he was also facing the same charges, due to his failure to disclose that the other two suspects were not qualified. Rikhotso said Jogi owned a practice in which both Mabungu and Omange charged people R330 for a consultation. The two had separate consulting rooms.
Provincial Hawks head Major General Linda Mbana expressed her confidence in her team and the law putting bogus doctors in jail. “We have had seven successful convictions of these bogus doctors since last year, and I am confident that the law will prevail once again,” said Mbana.
Mabungu and Omange have been held in custody, and all three will appear at the Rustenburg Magistrate’s Court on 27 September.
The HPCSA Inspectorate Office in conjunction with the Medicines Control Council (MCC) and the South African Police Service(SAPS) reports that it has conducted another inspection at the practices of Dr Tshepo Stanley Maebane in Ga-Rankuwa and it found that the person practising at the premises is Rasheed Ayoade Albi.
According to the HPCSA register, Albi registered with the HPCSA as a student intern in 1997 and the registration expired on 30 September 1999. Maebane
is based in Limpopo.
Albi, was taken into custody at the Ga-Rankuwa SAPS and was charged for contravening the Health Professions Act, (Act 56 of 1974), for practising illegally while not registered with the HPCSA.
The Citizen reports that the SAPS, working with the HPCSA have arrested two unregistered practitioners – Modjadji Ngobeni and Henry Hanes.
HPCSA spokesperson Daphney Chuma said Ngobeni, who practiced at Mamaila village, was arrested as a result of a tip off received from a member of the community regarding alleged illegal operations. “Ms Ngobeni indicated that she had just completed her nursing qualifications but (had) not registered with the South African Nursing Council. She was detained at the Mamaila village satellite police station,” Chuma said.
“The other arrest, also in the Limpopo province, was on 13 September involving Mr Henry Haynes and Mr Emmanuel Davel, who were both practising as clinical psychologists at 21 Magazyn Street in Modimolle,” Chuma added.
“Mr Emmanuel Davel is registered with the HPCSA. At the time of the inspection, Haynes was found treating a minor. When questioned on site, members of the community and several police officers indicated that they were also referred to the practice of Haynes by their respective general practitioners.”
They were both released on a R1,000 bail each, with the bail condition being that Haynes may not practice as a clinical psychologist while the matter is pending.
The report says the HPCSA Inspectorate Office is advising practitioners registered with the HPCSA to adhere to the ethical guidelines and to operate within their scope of practice.
“The HPCSA welcomes the tip offs that members of the community have provided thus far. Members of the community are encouraged to continue to report all suspected illegal practices by unregistered persons (bogus practitioners).”
Law enforcement agencies have, meanwhile, apprehended another bogus doctor in Soweto for allegedly issuing fake medical certificates to motorists seeking to apply for public driver’s permits, reports The Times. The doctors are all originally from the Democratic Republic of Congo and were using the practice number of a local doctor to conduct their business‚ the Road Traffic Management Corporation (RTMC) said.
“The female doctor tried to run away as law enforcement agents from the National Traffic Anti Corruption Unit‚ the Hawks‚ the HPCSA‚ the MCC and Home Affairs raided her surgery‚” the RTMC said.
The report says investigations by the RTMC have revealed that there are more than 32‚000 unlawfully issued public drivers’ permits. “Holders of these documents are believed to be on the roads driving busses‚ trucks and taxis. These people are placing the lives of other road users at risk as they might not be medically fit to be driving vehicles‚” the agency said. “These documents will be cancelled as soon as investigations have been completed‚” it added.