A mother whose daughter died in hospital last year has been convicted and handed a suspended sentence by the Bloemfontein Magistrate’s Court for defrauding the Government Employees Medical Scheme (Gems) of more than R400 000.
According to the Free State spokesperson for the Directorate for Priority Crime Investigation (Hawks) Lt Colonel Zweli Mohobeleli, Mamello Kate Khabo, who had two daughters, had taken one of them to a hospital when she got sick. Only one of the two girls was listed on her Gems medical aid. The sick child was not.
The ill girl later died in hospital.
“The accused defrauded Gems of more than R400 000 in medical aid claims. In August 2022, she admitted her daughter to Busamed Private Hospital, and the chid was later transferred to MediClinic, where she died,” said Mohobeleli.
“When it was time to register her daughter’s death and be issued a certificate, she had no choice but to confess she had admitted the child under the name of her surviving daughter, who is a beneficiary of Gems.”
Khabo was arrested in November last year.
She was sentenced to four years’ imprisonment, wholly suspended for five years on condition that she is not convicted of a similar offence during the period of suspension.
More fraud
And in another case of fraud, a Limpopo psychologist – Penelope Homu – appeared before the Giyani Specialised Commercial Crime Court, where she pleaded guilty and was sentenced to a fine of R120 000 or five years’ imprisonment, and declared unfit to possess a firearm.
Limpopo Hawks spokesperson Warrant Officer Lethunya Mmuroa said that in 2021, Platinum Health Medical Scheme (PHMS) had noticed a spike in claims between 2 February 2020 and 18 December 2020.
An internal investigation had established the claims were submitted by Homu.
“During the above-mentioned period, the PHMS received more complaints from members regarding claims submitted by the healthcare practitioner without their knowledge,” said Mmuroa.
“During analysis, the medical scheme found other anomalies, like claims for multiple beneficiaries and multiple referring practices.”
It was discovered that Homu had not rendered any services to the members or their dependants as she had claimed, based on falsified information.
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