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Physios take medical aid clawback fight to court

13 Oct 2021


Physiotherapists have launched legal action in the North Gauteng High Court against all 79 of South Africa’s medical schemes to adjust clawback audits of accounts which the schemes’ forensic units claim were billed incorrectly and/or fraudulently, reported Daily Maverick (13 October 2021).
“These clawed-back amounts, originally approved by the schemes,are unsubstantiated and often flagrantly prescribed, yet disputed years after payment, without conclusiveevidence, in violation of both the Medical Schemes Act (MSA) and the Prescription Act. Physiotherapists,in particular, have been targeted, but they are not the only medical practitioners to be singled out, as GPs,specialists and other technical professionals have also been victimised.”

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