Discovery, the Government Employees Medical Scheme (GEMS) and Medscheme acted “unfairly and in a racially discriminatory manner” towards black healthcare providers according to a report handed to Health Minister Aaron Motsoaledi on 7 July 2025. – BusinessLive.
The report is the result of an investigation by a panel appointed by the Council for Medical Schemes (CMS) in 2019 following allegations from black service providers that they were being treated unfairly by medical schemes based on race.
According to the report statistical analysis of risk ratios over several years showed that black (including coloured and Indian) practitioners “faced a disproportionately higher likelihood of investigation and sanction compared to their white counterparts”.
The inquiry also found that Fraud Waste and Abuse (FWA) processes used to audit and claw back funds from practitioners violated rights to fair treatment.
The inquiry’s proposals to reform how schemes investigate fraud, included legal amendments, an independent tribunal, transparency algorithms and annual racial monitoring.