The Council for Medical Schemes (CMS) is weighing legal options following the release of a damning report that found black medical practitioners are 1.4 times more likely to be flagged for fraud, waste, and abuse by medical aid schemes than their counterparts. The findings stem from a Section 59 inquiry into discriminatory practices within the industry.
Special Meeting and Advisory Panels
The CMS informed Parliament’s health committee on Friday that it would convene a special council meeting on Monday to address the report’s findings. Additionally, advisory panels will be established to scrutinize the data, understand the scope of the discrimination, and recommend ways forward.
Investigating Algorithmic Bias
John Letsoalo, head of legal at the CMS, stressed the importance of investigating the “human element” behind the algorithms used by medical schemes.
These automated systems may be embedded with racial biases that unfairly target black professionals, prompting questions about systemic discrimination in the healthcare sector.
Class Action and Equality Court Involvement
Letsoalo said the CMS is also considering whether a class action lawsuit could be launched on behalf of affected practitioners. The council is exploring if the Equality Court could have jurisdiction to hear such cases, which may involve claims for compensation from practitioners who have lost income or their professional reputations.
Next Steps
The CMS has committed to delivering a comprehensive response within four weeks, which will outline its legal position, potential policy changes, and actions to ensure accountability and justice for discriminated medical professionals.
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