Fraudulent claims are bleeding the industry dry - GEMS
According to the Government Employees’ Medical Scheme (GEMS) – SA’s biggest medical scheme for public servants - the country is losing R22-bn a year to fraud, waste and abuse in the healthcare industry, reported Fin24 (28 September 2021).
Globally, it is estimated that about R4 trillion is lost through healthcare fraud.
GEMS senior manager for operations and risk, Ishmael Mogapi, said the scheme investigated between 40 and 60 cases each month. Most of these related to pharmacies, followed by GPs, dieticians, physiotherapists and registered nurses.