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Medical Scheme Boss Accuses CMS of ‘Sabotage’ and Racial Bias
3Sixty GSG, a medical scheme administrator, alleges that the Sizwe Hosmed medical scheme, a black-owned administrator, was deliberately sabotaged by regulators and industry insiders. 3Sixty GSG executive chairperson Khandani Msibi sent a letter to the CMS chairperson outlining alleged conspiracies involving managers, trade union leaders, and the regulator. Msibi alleges a deliberate campaign to undermine Sizwe Hosmed through corruption, sabotage, and regulatory capture.
Key Allegations:
- Conspiracy: Msibi accuses Joe Seloane and Irvin Jim of conspiring to destroy black-owned enterprises. He claims Seloane aimed to force a merger benefiting KeyHealth medical scheme, where he allegedly has business interests.
- Financial Sabotage: Msibi states Sizwe Hosmed’s financial troubles were artificially created, with Seloane deliberately collapsing benefit options, causing membership migration and declining solvency. Seloane allegedly instructed actuaries to overstate the scheme’s liabilities.
- Regulatory Bias: Msibi portrays regulatory bias against black-owned enterprises and questions the appointment of Lebogang Mpakati, someone without industry experience, as curator. He alleges Mpakati cut off 3Sixty Health’s access to the scheme’s bank accounts, halting payments to healthcare providers.
- CMS Involvement: The CMS allegedly directed SA Local Government Association members from Sizwe Hosmed to KeyHealth. Msibi claims Sizwe Hosmed continues to operate despite multiple investigations and curatorships, while former members pay more for inferior benefits.
- KPMG Report: An investigation by KPMG found only R17m in duplicate claims, significantly below the industry fraud benchmark, but Msibi alleges the report was weaponized against 3Sixty.
Msibi demands Mpakati’s removal, warning the CMS against destroying black businesses. CMS chairperson Musa Gumede stated that these issues were previously addressed in court during a curatorship application.
Sources:
https://www.medicalbrief.co.za/medical-scheme-boss-accuses-cms-of-sabotage-and-racial-bias/