2020 Fraud, Waste and Abuse Summit
The 2nd annual Fraud, Waste and Abuse Summit will continue on the work of the inaugural summit, with the establishment of industry Codes of Good Practice when dealing with fraud, waste and abuse cases, in the interest of protecting medical scheme beneficiaries.
The highlight of the summit will be the launch and handover of the Section 59 Investigation Report to the Honourable Minister of Health.
The summit will feature discussions on:
- Implications of the Section 59 findings for the medical schemes industry
- Linking Section 59 outcomes with fraud, waste and abuse in the industry
- A recap of the Fraud, Waste and Abuse Charter and definitions
- An introduction of Industry Codes of Good Practice and standards
Why a Fraud, Waste and Abuse Summit?
The Council for Medical Schemes (CMS) is a statutory body which regulates medical schemes and related entities. In fulfilling part of its regulatory mandate, the CMS is looking at mechanisms to address the scourge of fraud, waste and abuse in the medical schemes industry.
This summit brings together stakeholders in the private healthcare sector including medical schemes, administrators, managed care organisations, policy makers and other role players to discuss strategies for dealing with fraud, waste and abuse towards a sustainable industry.
As an entity mandated with the protection of the interests of members of medical schemes in terms of the Medical Schemes Act, No. 131 of 1998; the CMS is committed to work together with all industry role players to resolve the issue of fraud, waste, and abuse in the sector.
What are the deliverables of the Fraud, Waste and Abuse summit?
To deal with fraud, waste and abuse for industry sustainability by:
- The signing of an industry agreement or charter where all stakeholders pledge to contribute to combating fraud, waste and abuse, in line with set standards. During the inaugural summit in 2019, a Charter was signed by role players in the industry. Access the Charter here. The review period for the FWA charter is every two years.
- Establishing standards for the industry to effectively deal with fraudulent activities. This includes fair sanctions for convicted fraudsters. The 2020 summit will focus on setting the scene for Codes of Good Practice for industry, for the benefit of the member.
- The establishment of a structure to continuously deal with fraud, waste and abuse post the summit.
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For any queries you may have, please contact the Conference Manager on the provided details. Please note that no registrations may be made via the Conference Manager.