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Section 59 Investigation Interim Report

The Section 59 Investigating Panel has concluded its investigation and publishes an interim Report for comment by close of business on Friday, 5 March 2021.

Find the summary of the Section 59 Investigation here

Find the full Section 59 Investigation Interim Report here

Annexures to the report

Racial Bias in FWA outcomes

Racial Discrimination in identifying FWA: A Review of Processes & Outcomes

About the Section 59 Investigation

In May 2019, members of the National Health Care Professionals Association (NHCPA) and Solutionist Thinkers, made public allegations that they were being discriminated against by medical schemes and administrators and their claims were being withheld based on their race and ethnicity.

Medical schemes and administrators were making use of section 59 of the Medical Schemes Act (131 of 1998), to withhold payments to these medical practitioners once they had rendered healthcare services.

The CMS then constituted a multi-disciplinary Steering Committee – consisting of the complainants, industry associations and co-regulators – that supported the establishment of an independent investigation to conduct an inquiry into the above allegations.

The CMS launched the Section 59 Investigation into allegations of racial discrimination by medical schemes and administrators in terms of its regulatory mandate, under section 7(a)(b)(c)(d), 8(a) and (k) and 9(2) of the Medical Schemes Act, (131 of 1998) in July 2019.

An independent panel consisting of Advocates Tembeka Ngcukaitobi SC, Adilla Hassim and Kerry Williams led the Section 59 Investigation, tasked to investigate the complaints, identify trends and make recommendations that may require legal or policy interventions, amendments to legislation and regulations.

The panel issued a call for written submissions and thereafter held public hearings from July 2019 – January 2020, with the intention of releasing a preliminary and final report on the findings.

Comments should be submitted to the Panel’s secretariat, Lawtons Africa:
• Mr SJ Thema: sj.thema@lawtonsafrica.com
• Mr Ushir Ahir: ushir.ahir@lawtonsafrica.com

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