Friday, 17 September 2021 16:29

GEMS to host virtual Symposium to address Fraud, Waste and Abuse in Healthcare.

By Lehlohonolo Lehana.

Healthcare in South Africa, although not a commodity, is a multi-billion-rand industry. The industry’s sheer size and nature place it at major risk of Fraud, Waste, and Abuse (FWA). To share the intricacies with a view to curbing FWA, GEMS will hold a virtual Symposium where industry stakeholders will discuss and educate attendees on FWA in healthcare.

Themed Fraud, Waste and Abuse in Context, the Symposium will provide a platform for engagement on current and emerging issues around FWA in healthcare. The event is open to the public, Scheme members, stakeholders, and healthcare industry partners. It will be held via Zoom on Thursday, 23 September 2021 from 09h00 – 12h00. 

Speakers will address current and emerging challenges in FWA, and will provide opportunities for industry experts, healthcare providers, employees, Scheme members, and the public to share their views on how policy reform and technology can be used to mitigate FWA.

Topics for discussion will include the following, among others:

  • How has the Section 59 Interim Report shifted the way we need to think about FWA in healthcare?
  • Lessons learnt on FWA pre-Covid-19 and during the pandemic
  • Employers’ and members’ perspectives
  • GEMS FWA policy and policy reform
  • The future as we look ahead.

Speakers will include the following policymakers and industry experts:

  • Dr Chana Pilane-Majake, Deputy Minister: Department for Public Service and Administration (DPSA);
  • Ms Yoliswa Makhasi, Director-General: DPSA;
  • Dr Sebayitseng Millicent Hlatshwayo, Chairperson: GEMS Board of Trustees;
  • Dr Hleli Nhlapo, Healthcare Forensic Management Unit (HFMU);
  • Dr Ntuthuko Bhengu, Alchemy Health Technologies;
  • Dr Stanley Moloabi, Principal Officer: GEMS
  • Prof. Morgan Chetty, Independent Practitioners Association; 
  • Mr Frikkie De Bruin, Public Service Coordinating Bargaining Council (PSCB);
  • Mr. Vishal Brijlal, Senior Director Clinton Health Access initiative (CHAI)
  • Mr. Ishmael Mogapi, Senior Manager: Operations Risk: GEMS;
  • Ms. Masingita Chavalala, Senior Manager: Project Management Office: GEMS;
  • Dr Vusi Nhlapo, CEO: South African  Association (SAMA);
  • Dr Benny Malakoane, President: National Health Care Professional Association (NHCPA);
  • Mr. Thabiso Mphehlo Senior Manager: Networks and Provider Relations: GEMS;               
  • Mr. Rogier van Bever Donker, President: The South African Society of Physiotherapy (SASP); and
  • Dr Simon Strachan, CEO:  Specialist Group: South African Private Practitioners Forum (SAPPF).

According to Dr Stanley Moloabi, Principal Officer at GEMS, "To address FWA in healthcare, we need to gain perspective from all stakeholders and an understanding of the drivers of these patterns to ensure that we take a holistic and more realistic approach to addressing FWA in healthcare.

"The reality is that Fraud, Waste and Abuse does not happen in isolation and it is not committed by one party only. Our experience is that FWA can be committed by healthcare providers, medical scheme members and even in some instances, officers of the Scheme. We want to use this platform to drive broader conversations on FWA with industry experts and ordinary members of the public; it will require the efforts of the entire medical community and Scheme members to address. At the virtual GEMS Symposium, we will explore the opportunities technology presents to mitigate FWA. We will also engage with the issues emerging from the Section 59 Interim Report", concluded Dr Moloabi.