Council for Medical Schemes chair, Dr Clarence Mini, opens the Fraud Summit

Adv. Andy
Mothibi, head of the Special Investigations Unit (SIU), told members of the
media shortly after the start of the Council for Medical Schemes’ (CMS’s) two-day
Fraud, Waste and Abuse Summit in Sandton yesterday that he was encouraged by
the fact that the CMS “came to us” with the fraud and corruption allegations facing
its own Manager of Compliance and Investigations, Stephen Mmatli.

Mothibi was
reacting to a media comment on the irony of the council holding a fraud summit
when the organisation itself was being investigated for fraud.

The council
suspended Mmatli last week after being alerted by a whistle-blower of Mmatli’s
alleged involvement in corrupt relationships with CMS-regulated organisations
and believed to have benefitted from deliberately misleading the council to
take decisions favouring these organisations.

In a direct
response to the media “irony” comment, CMS chair Dr Clarence Mini expressed disappointment
at the ‘press pushing the narrative’ on this particular issue: “The registrar
sent a communique (circular) to all stakeholders as soon as it became apparent through
a whistle-blower that one of our senior officers had been found to allegedly have
been involved in fraudulent activities.

“To say that the
CMS is in trouble is not correct. We have done everything from our side. If we
had something to hide, we wouldn’t have sent out the circular. We were also
very aware that the outcome of this particular case could extend well beyond the
CMS and that’s why we engaged with the Special Investigating Unit.

“In fact, we
want people to see this as a demonstration of our own commitment to root out
fraud and corruption,” Mini added.

“We are
encouraged by the fact that the CMS came to us with the problem,” said the SIU’s
Mothibi, acknowledging that the implications of the case in question did indeed
go beyond the CMS and therefore had to be and were being investigated

“This must be
seen as a commitment on the part of the CMS, something we would expect from
other state institutions as well.”