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CMS warns public against unaccredited healthcare brokers

By Staff Writer
The Council for Medical Schemes (CMS) released a statement earlier this week cautioning the public against working with Nyameka Stella Booi. The CMS is the regulator for the medical schemes industry.
 
According to the CMS, Booi does not have the proper accreditation from the CMS in terms of the Medical Schemes Act (MSA) 131 of 1998, which would allow her to “render broker services as a healthcare broker.”
 
CMS warns against Nyameka Stella Booi
 
The CMS denied Booi’s application for accreditation as a healthcare broker following her submission of a false senior certificate (matric certificate) and her failure to meet the accreditation requirements.
 
Daniel Lehutjo, acting registrar and CEO of the CMS told Justmoney: “The CMS has recently introduced a process of verifying the qualifications submitted by applicants (for the purpose of accreditation) with the relevant institutions. This incident is the first since CMS commenced with the process on 1 March 2015.”
 
Lehutjo explained: “Booi submitted a certified copy of a senior certificate along with her application form. Upon verifying the contents of the certificate presented, it was confirmed that the applicant did not obtain the senior certificate and that she presented a false document in an effort to obtain accreditation. She similarly failed to demonstrate relevant experience as a requirement. The employer was notified of the findings and she was not employed.”
 
The CMS stated: “Booi applied for accreditation as a healthcare broker in Port Elizabeth in terms of the MSA and indicated that she would be employed by an accredited brokerage, Independent Distributions Network (Pty) Ltd.”
 
Booi was previously employed by Charlene Grigor and Charmeir Consultants CC. The CMS has since withdrawn Grigor’s individual accreditation, as well as Charmeir Consultants CC brokerage accreditation.
 
Lehutjo told Justmoney the reason for the removal of the accreditation: “She was no longer fit and proper in terms of both [the Medical Schemes Act and the FAIS Act] (honesty and integrity) since she submitted a fraudulent accreditation certificate to administrators of medical schemes in order to be compensated for the services she provided to her clients (members of medical schemes) in terms of the contract concluded with that particular scheme, of which the accreditation had already expired.”
 
Ensuring your broker is accredited
 
Section 65 and Regulation 28(B) of the MSA detail the minimum qualification and experience criteria that a broker needs to have in order to attain accreditation. The CMS advises that consumers or companies wishing to appoint healthcare brokers or brokerages should verify that the brokerage or broker is accredited to provide these services.
 
It is possible for a broker or brokerage to have their accreditation revoked, so it is important to make sure that your broker or brokerage is currently accredited.
 
Lehutjo explained: “[Accreditation will be revoked] when there is a contravention of the Medical Schemes Act, contravention of fit and proper requirements together with the General Code of Conduct for Financial Service Providers determined in terms of FAIS Act, 2002. Accredited brokers are required to comply at all times with provisions prescribed by both Acts.”
 
He added: “Accreditation is granted for two years. Applicants must apply for renewal of accreditation three months prior to the date of expiry. Failure to apply on time will regrettably result in the applicant remaining unaccredited during the period in which the applicant was in default. The Act prohibits medical schemes to compensate brokers for providing broker services whilst they are not accredited.”
 
The minister for Higher Education Blade Nzimande is reportedly calling for a blacklisting of anyone who lies about their qualifications. An audit of qualifications in the civil service will be conducted by the Department of Higher Education in partnership with the South African Qualifications Authority. According to reports, if qualifications are found to be false or fraudulent, criminal charges will be laid.
 
To check if a broker or brokerage is accredited and to access their records, click here.
For the list of CMS accredited medical scheme administrators, click here.
For the list of CMS accredited managed care organisations, click here.

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