Counting the costs of medical aid fraud

Counting the costs of medical aid fraud“The reduction and elimination of fraud, waste and abuse will impact on medical aid contribution increases,” says Gerhard van Emmenis, Acting Principal Officer of Bonitas Medical Fund. More importantly, benefits could be enriched to pay for even more critical healthcare and treatments. He says, “Fraud, waste and abuse is one of the biggest contributors to escalating healthcare costs as the fee-for-service model of payment encourages people to over-charge or over-service for profit.”
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Hollard partners with Cigna

Brooks Mparutsa, executive director of Hollard's international business.
Brooks Mparutsa, executive director of Hollard’s international business.</span>Insurer Hollard planned “significant acquisitions” on the continent in the next few years and was partnering with global health insurer Cigna to offer health insurance to companies operating in Africa, said Brooks Mparutsa, executive director of Hollard’s international business.
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New law crimps hospital cash-back plans

Photo: Mediclinic
Photo: Mediclinic</span>The demarcation regulations clearly distinguish between medical insurance products and medical aid schemes. For the consumer, this means that while limited gap cover and hospital cash-back plans will still be allowed, primary healthcare insurance policies will no longer be available. All existing policies will need to align with the regulations from 1 January 2018.
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Mind the gap

Gerhard van Emmenis, acting principal officer, Bonitas
Gerhard van Emmenis, acting principal officer, Bonitas</span>Medical insurance products, including hospital insurance and gap cover, have got a (not necessarily undeserved) bad rap for overselling and under-delivering, to the extent that the National Treasury stepped in to ensure consumers are safeguarded.
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