Medical aid fraud rises

November 20 2017 – MEDICAL aid societies are incurring huge losses through fraud, a phenomenon blamed on the lack of specific laws designed to deal with healthcare fraud in the country.

In discussions and presentations at the Healthcare Fraud Indaba in Harare on Thursday it was noted that medical aid societies were incurring huge losses through fraud. There was general agreement among medical aid societies, pharmacists, hospitals, doctors, laboratories, lawyers and other stakeholders on the need to address this problem.

The Healthcare Fraud Indaba, which began on Thursday and continued on Friday, was initiated by the Association of Healthcare Funders of Zimbabwe (AHFoZ). It coincided with International Fraud Awareness Week, which ran from November 12 to 18.

AHFoZ chief executive officer Shylet Sanyanga said AHFoZ had decided to host the event as a way of engaging various stakeholders to fight healthcare fraud, which, she said, had escalated.

“We realised that we cannot fight fraud alone. Therefore we have taken the lead in bringing key stakeholders on board,” she said.

She said the fact that the indaba coincided with the International Fraud Awareness Week, showed that fraud, including healthcare fraud, was not a Zimbabwe problem alone but an international problem.

In a presentation on the role and needs of key stakeholders in fighting fraud, waste and abuse, Dr Tinashe Magumise, AHFoZ risk management committee convener, said the key stakeholders in fighting healthcare fraud were medical aid society members, service providers, employees, healthcare funders, auditors, investigators and legislators, with the first three being instrumental in both instigating and fighting fraud.

One of the challenges in fighting healthcare fraud in Zimbabwe, he said, was the absence of specific laws on healthcare fraud. In some other countries, he said, there was legislation dealing specifically with healthcare fraud. – Herald