In response to the HPCSA warning to practitioners against colluding with medical aid schemes and preferred provider networks administrators

One of the reasons The Board of Healthcare Funders’ Forensic Management Unit (BHF_FMU) was established, was to ensure that the investigation of fraud and abuse within the private healthcare sector, was conducted in an ethical, transparent and legal manner. The BHF_FMU will under no circumstances condone illegal or unethical conduct by any of its members, however, will strongly support and encourage its members to recover any monies lost due to fraud and abuse. It must be remembered that any monies lost by medical schemes due to fraud and abuse, in fact belong to the members contributing to those schemes and the trustees have an obligation to ensure that these monies are recovered as far as possible. Fraud and abuse contributes significantly to the high cost of private healthcare and in order to ensure the sustainability of the industry needs to be dealt with decisively. The industry is not only under pressure from consumers to control the cost of healthcare, but also from government.