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Fraud Zone
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The GEMS Difference
Click here to find out how GEMS made a difference in these members' lives.  BANNER 2.jpg')
2013 GEMS Trustee elections The voting period starts on 22 April. Click here to view the candidate list.  BANNER 3.jpg')
2013 GEMS Trustee elections The voting period starts on 22 April. Click here to view the candidate list.  Banner 4a.jpg')
2013 GEMS Trustee elections The voting period starts on 22 April. Click here to view the candidate list. The husband and wife team at the helm of Selfmed Medical Scheme have been suspended and are to face a disciplinary inquiry, following an interim out-of-court agreement reached by the Council for Medical Schemes and the Selfmed scheme.
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Medical schemes continue to battle against fraudulent claims. In March, The Times reported that corrupt doctors, pharmacists, physiotherapists, radiologists and pathologists were ripping off medical schemes to the extent of about R22bn/year.
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No money or credit card is needed when shopping at South Africa's first cashless fashion boutique, The Exchange in Cavendish Square. All one has to do is to register as an organ donor with the Organ Donor Foundation in exchange for some high-end fashion and accessories from the country's top designers.
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Mrs Lebo Montshiwa of Mahikeng waited more than five years to see justice done and to do right by her medical scheme, GEMS.
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Corrupt doctors, pharmacists, physiotherapists, radiologists and pathologists are ripping off medical aids to the tune of R22-billion a year - resulting in members having to fork out thousands of rands more in premiums.
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The probe into private healthcare has been welcomed by dentists, who allege medical aid administration and broker commissions are driving soaring tariffs at a time when below-inflation payouts are putting them out of business.
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An inquiry into pricing and possible collusion in the healthcare market will begin on 1 April 2013 according to the Competition Commission.
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News that corrupt doctors and other healthcare practitioners are defrauding medical aid schemes of as much as R22 billion a year has met calls for action - from the DA to Cosatu.
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It is evident that the Medical Aid industry continues to be very much exposed to fraud and its related activities, although it is pleasing to note positive trends compared with previous surveys. The purpose of this survey, as with its predecessors, is to measure the response to fraud and to consider trends in terms of prevalence and frequency. It is our desire that the survey will serve as a tool in the fight against fraud.
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The Molope Regional Court sentences Tshegofatso Patricia Maubane owner of Omphemetse Pharmacy in Unit 9, Mahikeng to four years imprisonment and wholly suspended for three years. This was for the hundred and fourteen chatges of fraud against government employees medical scheme, GEMS, amounting to R26000 between December 2007 and February 2009.
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