The Government Employees Medical Scheme (Gems), the second biggest scheme in the country, had a problem in KwaZulu-Natal. It identified this province as the most problematic when it came to fraudulent claims.
In one example, Gems uncovered irregular claims of R93 million by a service provider who had 36 practices registered under its name.
But they are not alone.
Medical aid claims attributed to fraud, waste and abuse cost the sector between R22 billion and R28 billion a year….more