Fraud, Waste & Abuse Webinar 2021 | Agenda & Speakers
The CMS is pleased to announce that the inaugural Fraud, Waste and Abuse Summit will be held at the Sandton Convention Centre, in Johannesburg on 28 February - 1 March 2019.
fraud, waste, abuse, medical, scheme, summit, conference, Sandton, convention, center, industry, standards, medicine
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Please click on a name to view the speaker’s biography. Speakers marked as TBC do not have a biography to view yet.

 

Grace Khoza
Clarence Mini
Sipho Kabane
Andy Mothibi
Nozipho Sangweni
Katlego Mothudi
Lerato Mosiah
Hleli Nhlapo
Paul Midlane
Marius Smit
Ishmael Mogapi
Lynette Swanepoel
Garth de Klerk
Simon Mangcwatywa
Sello Motaung
Aneesa Mohamed
Barry Childs
Gary Feldman
• Umunyana Rugege (TBC)
Angela Drescher
Mvuyisi Mzukwa
Frikkie de Bruin
• Nokuzola Mtshiya (TBC)
Elsabe Klinck
Elijah Nkosi
• Sara Mather (TBC)
• Boitumelo Ntsoane (TBC)
Dumisani Bomela
Prudence Buthelezi
• Vuyo Mafata (TBC)
Olurotimi Modupe
Michael Willie
Neo Khauoe
Gregory Pratt
Heyn van Rooyen
Charlton Murove
Guni Goolab
Tebogo Phaleng
Anri Hornsveld
Corrin Holgate
Eugene Burger
Nkululeko Conco
Maile Ngake

Thursday, 28 February 2019
Programme Director:
Ms Grace Khoza – General Manager: Stakeholder Relations – Council for Medical Schemes
Time Presentation Speaker
08:30 Opening and welcome Ms Grace Khoza
General Manager: Stakeholder Relations
Council for Medical Schemes
08:45 Opening address Dr Clarence Mini
Chairperson of Council
Council for Medical Schemes
09:10 Presentation by the CMS: The journey thus far – unpacking fraud in private
healthcare
Dr Sipho Kabane
Chief Executive & Registrar
Council for Medical Schemes
Click here to view the presentation PDF
10:00 Q & A Ms Grace Khoza
General Manager: Stakeholder Relations
Council for Medical Schemes
10:00 TEA BREAK & EXHIBITION
10:00 Press briefing
Dr Clarence Mini
Chairperson of Council
Council for Medical Schemes
Dr Sipho Kabane
Chief Executive & Registrar
Council for Medical Schemes
Adv. Andy Mothibi
Head
Special Investigating Unit
10:45 PANEL DISCUSSION:
Overall effect of fraud in the industry and beyond
Facilitator:
Dr Nozipho Sangweni
Principal Officer
Discovery Health Medical Scheme
Council for Medical Schemes (CMS) Dr Sipho Kabane
Chief Executive & Registrar
Council for Medical Schemes
Special Investigating Unit (SIU) Adv. Andy Mothibi
Head
Special Investigating Unit
Board of Healthcare Funders of Southern Africa (BHF) Dr Katlego Mothudi
Managing Director:
Board of Healthcare Funders
Healthcare Funders Association (HFA) Ms Lerato Mosiah
Chief Executive Officer
Healthcare Funders Association
Q & A Dr Nozipho Sangweni
Principal Officer
Discovery Health Medical Scheme
11:45 PRESENTATIONS:
Environmental Scan: setting the scene
Healthcare Forensic Management Unit (HFMU) Dr Hleli Nhlapo
Chairperson: Healthcare Forensic Management Unit
Board of Healthcare Funders
Click here to view the presentation PDF
Medscheme Mr Paul Midlane
General Manager: Healthcare Forensics
Medscheme
Click here to view the presentation PDF
Discovery Health Mr Marius Smit
Head of Forensics
Discovery Health
Click here to view the presentation PDF
Government Employees Medical
Scheme (GEMS)
Mr Ishmael Mogapi
Senior Manager: Operations Risk
Government Employees Medical Scheme
Southern African Fraud Prevention Service
(SAFPS)
Ms Lynette Swanepoel
Manager: New Business, Healthcare & Insurance
Southern African Fraud Prevention Service
Click here to view the presentation PDF
Insurance Crime Bureau Dr Garth de Klerk
Chief Executive Officer
Insurance Crime Bureau
Click here to view the presentation PDF
Sizwe Medical Fund Dr Simon Mangcwatywa
Principal Officer
Sizwe Medical Fund
Click here to view the presentation PDF
Q & A Ms Grace Khoza
General Manager: Stakeholder Relations
Council for Medical Schemes
13:15 LUNCH
14:15 PANEL DISCUSSION
Stakeholder Interaction Part 1
Facilitator:
Dr Sello Motaung
Medical Advisor
Legal perspective Ms Aneesa Mahomed
Director: Corporate & Commercial Law
Gildenhuys Malatji Attorneys
Actuarial Society of South Africa Mr Barry Childs
Chair of the Committee:
Actuarial Society of South Africa
National Department of Health (NDoH) Adv Maile Ngake
Chief Director
National Department of Health
Financial Intermediaries Association (FIA) Mr Gary Feldman
Financial Intermediaries Association
Section27 Mr Nkululeko Conco
Attorney
Section27
Consumer Representative Ms Angela Drescher
Consumer Activist
South African Medical Association (SAMA) Dr Mvuyisi Mzukwa
Board Vice-Chairperson
South African Medical Association
Public Service Coordinating Bargaining Council (PSCBC) Mr Frikkie De Bruin
General Secretary
Public Service Coordinating Bargaining Council
Q & A Dr Sello Motaung
Medical Advisor
15:30 PANEL DISCUSSION
Stakeholder interaction Part 2
Facilitator:
Ms Nokuzola Mtshiya
Head of Marketing
Board of Healthcare Funders of Southern Africa
Health Consumer perspective Ms Elsabe Klinck
Managing Director
Elsabe Klinck and Associates
Independent Practitioners Association Foundation (IPAF) Dr Elijah Nkosi
Chief Executive Officer
Independent Practitioners Association Foundation
Click here to view the presentation PDF
Pharmaceutical Society of South Africa (PSSA) Ms Anri Hornsveld
Pharmaceutical Society of South Africa (PSSA)
Hospital Association of South Africa (HASA) Dr Dumisani Bomela
Chief Executive Officer
Hospital Association of South Africa
National Health Providers Association Prudence Buthelezi
Secretary General
National Healthcare Professionals Association
Compensation Fund Ms Milly Ruiters
Acting Commissioner
Compensation Fund
Q & A Ms Grace Khoza
General Manager: Stakeholder Relations
Council for Medical Schemes
16:30 Closing & Announcements Ms Grace Khoza
General Manager: Stakeholder Relations
Council for Medical Schemes
18:00 for 19:00 Gala Dinner

 

Friday, 1 March 2019
Time Presentation Speaker
09:00 Opening and recap Ms Grace Khoza
General Manager: Stakeholder Relations
Council for Medical Schemes
09:15 Ethics of billing (Coding) Dr Olurotimi Modupe
Senior Manager: Clinical Unit
Council for Medical Schemes
Click here to view the presentation PDF
09:25 Role of coding in fighting FWA Mr Michael Willie
General Manager: Research & Monitoring
Council for Medical Schemes
Click here to view the presentation PDF
09:35 Q & A session
10:00 PANEL DISCUSSION
Role of ICT systems in Fraud, Waste & Abuse
Facilitator:
Ms Neo Khauoe
Principal Officer
POLMED
Medscheme Dr Gregory Pratt
Senior Clinical Advisor
Medscheme
Medihelp Mr Heyn van Rooyen
Principal Officer
Medihelp
Board of Healthcare Funders (BHF) Mr Charlton Murove
Head of Research
Board of Healthcare Funders of Southern Africa
MMI Mr Eugene Burger
Head: Claims Risk
MMI
10:50 Q & A session Ms Neo Khauoe
Principal Officer
POLMED
11:00 TEA BREAK
11:30 Draft Definitions and Charter
Click here to view the Charter
Dr Guni Goolab
Principal Officer
Government Employees Medical Scheme
Dr Tebogo Phaleng
Chief Strategy Officer
Discovery Health
12:00 Symbolic signing of the industry Charter Board of Healthcare Funders
Health Funders Association
Representative of the Independent Schemes
12:20 Roadmap Dr Sipho Kabane
Chief Executive & Registrar
Council for Medical Schemes
12:40 Closing remarks Dr Clarence Mini
Chairperson of Council
Council for Medical Schemes
12:50 Signing on the Commitment wall (Banners) by Stakeholders Medical schemes, Associations, Regulators, and
other stakeholders
13:00 LUNCH AND NETWORKING SESSION