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‘Widespread and consistent’ racial bias by top medical schemes

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There was “widespread and consistent” evidence of discrimination in the outcome of investigations into fraud, waste and abuse by the top three medical schemes, according to evidence presented by Zaid Kimmie, director of the Foundation for Human Rights, to the medical scheme regulator’s inquiry on racial profiling, reports BusinessLive.

Black health-care providers are 42% more likely to be found to have perpetrated offences than their non-black counterparts.

Black physiotherapists were 2.2 times more likely to be found to have committed fraud, waste and abuse than nonblack physiotherapists; black psychologists were 3.3 times more likely to have an adverse finding against them; and black GPs were found to have committed these offences 1.6 times more often than non-blacks. There was no significant racial bias found among anaesthetists, independent specialists, and dentists. The only discipline where there was a significantly lower risk of an adverse finding among black practitioners was in pharmacy, the report states.

Kimmie, who has qualifications in mathematics and public health, was appointed to determine whether there was evidence of racial bias. Kimmie scrutinised the practices of the Government Employees Medical Scheme (Gems) and administrators Discovery Health and Medscheme over a seven-and-a-half-year period to June 2019.

The report says the panel did not provide Discovery Health, Medscheme and GEMS with Kimmie’s research before he publicly presented a redacted version, but they are expected to now make submissions in response.

The medical schemes regulator, the Council for Medical Schemes (CMS), is investigating allegations of racial bias by the National Healthcare Practitioners Association. The inquiry began in June, and its three-member panel is chaired by advocate Tembeka Ngcukaitobi.

Full BusinessLIVE report (subscription needed)

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