A Pretoria pharmacist has accused medical aid company Polmed, a subsidiary of Medscheme, of soliciting a R200,000 bribe by 'unlawfully' withholding payments.
The Sunday Tribune reports that it was approached by Alfred Moloko Mokoditoa, who owns four pharmacies in the city, after recent reports that doctors were fighting medical schemes, which allegedly tried to extort money from them by withholding payments.
More than 250 doctors and health professionals formed the National Healthcare Professionals Association (NHPA) and approached the North Gauteng High Court via the association for assistance. They claimed medical aid schemes accused them of fraud, but could not prove it. They also accused schemes of illegally using spy tapes to monitor their practices.
According to the report, Mokoditoa said Polmed owed him R1.6m since 2010 for services at his pharmacies. “The scheme refused to pay and alleged fraud on all my claims. Payment due was unlawfully withheld. Certain employees of the forensic unit started to demand R200,000 for my payments to resume. They came into my pharmacy and requested I hand over the money in cash, but I refused.”
He said he reported the officials to the principal officer of Polmed.
“I received a letter from the principal officer who indicated he would conduct an investigation into the alleged extortion, but this was never done.”
Mokoditoa said after fighting, the scheme, it only paid back R300,000 owed to him last year, and still owed more than R1m.
“The scheme indicated it paid the above balance due to me to its member’s bank accounts. There is no proof the balance was paid to scheme member’s bank accounts and Polmed is refusing to provide me with evidence. The Medical Schemes Act states that the scheme must pay all amounts due, owing and payable to the service provider, directly to the service provider, not to its members. I have never heard of medical aids doing this before.”
He said he had exhausted all avenues in trying to recover his money and was considering approaching the High Court.
The report says Polmed spokesperson Marlene Eloff did not respond to questions.
[link url="https://www.iol.co.za/sunday-tribune/news/medical-aid-scheme-bribed-me-says-chemist-11656248"]Sunday Tribune report[/link]