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Mediclinic News : SIU TO PROBE MEDICAL SCHEMES REGULATOR

Title

SIU TO PROBE MEDICAL SCHEMES REGULATOR

Date

2019-02-13

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News Description

BUSINESS DAY The Special Investigating Unit (SIU) is poised to launch an investigation into possible mal administration and corruption at the Council for Medical Schemes CMS, the watchdog agency for the country's medical schemes industry. The probe is set to send a ripple throughout the multibillion rand sector and is likely to extend into the private sector. The development takes place in parallel with an investigation the CMS plans to conduct into allegations of corruption against the head of its complaints and investigations unit head, Stephen Mmatli, whom it sus pended last week. The CMS's move has already shaken the industry, as it raises questions whether it has been turning a blind eye to matters that should have been scrutinised, or has directed inappropriate inspections at schemes and administrators. SIU head Andy Mothibi told Business Day on Tuesday that whistle blowers approached the unit alleging impropriety at the CMS's compliance and investigations department. He declined to provide details, saying only that they related to the processes handled by the department and included the allegation that an inspection had been stopped for no apparent reason. "I'm anticipating the investigation into the CMS could point further, into private sector players," Mothibi said. The SIU is expected to have prepared a draft proclamation for President Cyril Ramaphosa to sign by the end of the week, said Mothibi. The draft proclamation is to be submitted to the justice minister early next week, and then to the presidency, he said. Once an official proclamation has been published in the government gazette, the SIU will be authorised to begin probing the affairs of the CMS. Medical schemes are not for profit organisations that pool members' funds for future medical expenses, which are largely provided in the private health care sector. There were a total of 8.87 million medical scheme beneficiaries in 2017, who collectively paid contributions of about R180bn, according to the council's 2017/18 annual report. The CMS issued a circular to industry stakeholders on Friday, announcing that it had placed Mmatli on precautionary sus pension pending the outcome of an investigation into alleged corruption and misconduct. "We received anonymous tip offs alleging, among other things, that Mr Mmatli has been involved in corrupt relationships with organisations regulated by the CMS. Secondly, that he has deliberately misled the council to take decisions in favour of those organisations and benefited financially in return," the CMS said in the circular. No other CMS employees have been suspended. Mmatli's lawyer, Hope Chaane, said his client would oppose his suspension as Sipho Kabane, the acting registrar of the CMS, had failed to provide him with sufficient detail in his notice of intention to suspend his client. This would have enabled him to defend himself and offer reasons as to why he should not be suspended.
Created at 2019/02/19 01:25 PM by Mediclinic
Last modified at 2019/02/19 01:25 PM by Mediclinic