CMS taking legal advice on whether black medical practitioners can launch class action suit against 3 medical schemes for discrimination

CAPE TOWN - The Council for Medical Schemes (CMS) said that it would take legal advice as to whether black medical practitioners can launch a class action suit against three medical aid schemes for discrimination. 

This week, a Section 59 inquiry in terms of the Medical Schemes Act ruffled feathers in the industry for its findings that black doctors were 1.4 times more likely to be deemed to be committing medical aid fraud, waste and abuse than other ethnic groups.

On Friday, the council told Parliament’s health committee that it would convene a special council meeting on Monday to interrogate the findings.

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The CMS said that it would be setting up advisory panels to probe the findings of the Section 59 report and how to address them.

The council’s legal head, John Letsoalo, said that it may also be necessary to investigate the human element involved in the algorithms used by medical schemes that flagged black professionals for fraud.

Letsoalo said that it also needed to be determined whether a legal case could be mounted to compensate those who had been discriminated against and those who had even lost their livelihoods.

"We are also testing legally, internally as a regulator, could the Equality Court have jurisdiction to adjudicate on some of the issues that individual practitioners may want to institute against individual schemes." 

The council said it would take at least four weeks to deliver a comprehensive response to the panel’s findings.