Categories: Stories

Cimas suspends online drug claims after losing $1.2m to fraud

Cimas Medical Aid Society has suspended online drug claims after losing $1.2 million in fraudulent claims, with the society incurring a $3.4 million drug bill during the first quarter of this year compared to $2.2 million in the last quarter despite a fall in membership.

The society, which is the second biggest in the country by membership, said the issue came to light recently after a woman attempted to buy drugs using stolen cards.

“When arrested she was found to have numerous medical aid cards from different medical aid societies,” said Cimas in a statement yesterday.

“During the first quarter of 2014 we spent $2.2 million on drugs for 205 000 beneficiaries. In the first quarter of 2015, with a reduced membership of 202 000 beneficiaries and reduced cost of drugs, we incurred a $3.4 million drug bill. That is a difference of $1.2 million in just three months, or an increase in drug costs of 54 percent.”

Cimas said there were discrepancies between online claims made by some pharmacists and the hard copy prescription forms.

“Drug claims submitted by pharmacies electronically do not always tally with the physical hard copy of the prescription,” it said.

Some members were also allowing their relatives and friends to use their cards and that despite the cards having photographs of the holder, some pharmacies were not verifying the cards.

Members also receive a text message notifying them of their online drug facility transactions but few notified Cimas when they receive a notice about a transaction they had not made.

“I don’t think most of our members realise that it is their funds that are at risk and that fraudulent claims reduce the amount of money that is available to pay their legitimate claims,” said the company.

Cimas clients will now pay cash for drugs and the company said it would process claims ‘expeditiously.’- The Source

(203 VIEWS)

This post was last modified on May 16, 2015 11:47 am

Charles Rukuni

The Insider is a political and business bulletin about Zimbabwe, edited by Charles Rukuni. Founded in 1990, it was a printed 12-page subscription only newsletter until 2003 when Zimbabwe's hyper-inflation made it impossible to continue printing.

Recent Posts

Reserve Bank of Zimbabwe expects more foreign currency sellers to join the interbank market

The gazetting into law of the payment of quarterly taxes on a 50-50 basis in…

December 4, 2024

Zimbabwe 2025 citizens’ budget

Zimbabwe has today unveiled a ZiG276.4 billion budget for 2025 during which it expects the…

November 28, 2024

To go or not to go- Mnangagwa in a quandary

Zimbabwe President Emmerson Mnangagwa has repeatedly stated that he is not going to contest a…

November 25, 2024

ZiG loses steam, falls against US dollar for five consecutive days

The Zimbabwe Gold fell against the United States dollar for five consecutive days from Monday…

November 22, 2024

Indian think tank says Starlink is a wolf in sheep’s clothing

An Indian think tank has described Starlink, a satellite internet service provider which recently entered…

November 18, 2024

ZiG firms against US dollar for 10 days running but people still do not have confidence in the currency

Zimbabwe’s new currency, the Zimbabwe Gold (ZiG), firmed against the United States dollars for 10…

November 16, 2024