Advocate Tembeka Ngcukaitobi who will chair the CMS investigation

Some of the country’s top legal minds have
been appointed to lead the Council for Medical Schemes (CMS) high-level
investigation into allegations of racial profiling against black, coloured and
Indian doctors by medical schemes.

Chaired by Advocate Tembeka Ngcukaitobi, the probe will also investigate complaints
relating to the non-payment of services, the blacklisting of some healthcare practitioners,
the use of designated service providers, confidentiality breaches and clawing
back on claims that have already been paid to providers. Advocate Ngcukaitobi
will be assisted by Advocates Adila Hassim and Kerry Williams, with the rest of
the investigating team comprising of two doctors with a forensic background, a
health actuary, project manager, medical ethics specialist, forensic compliance
specialist, data analyst and a communication specialist.

The Section 59 Investigation follows
allegations by members of the National Health Care Professionals Association
that they were being unfairly treated and their claims withheld by schemes based
on race and ethnicity. Medical schemes have denied the allegations.

“The CMS believes that Advocate Ngcukaitobi,
who is a respected legal mind, will help to get to the root of the allegations
of racial profiling, blacklisting for payments, blocked payments, demands of
confidential clinical information, bullying and harassment, coercion,
entrapment, and the use of hidden cameras,” CMS CEO and Registrar, Dr Sipho
Kabane said.

The investigation will commence next month
and interested parties have until the end of this month to make submissions to
the investigating panel. Based on the submissions, interviews and public
hearings will be conducted from 8 July to the end of September and the final report
will be delivered on 1 November, Dr Kabane said. Submissions should be sent to cmsinvestigation@medicalschemes.com

After the submissions, the panel may
request a deponent or any other person to appear before it and be interviewed
on specified aspects.  The public
hearings will be open to the media.

Advocate Ngcukaitobi is an advocate of the
High Court and was recently nominated for Senior Counsel status by the
Johannesburg Bar. Advocate Hassim is an advocate of the High Court who
practices in various areas of the law with the focus on Constitutional Law and Kerry
Williams is an advocate of the High Court who has advised extensively on
healthcare matters over the past 15 years.