Sixteen individuals and three pharmacies appear in Nelspruit District Court for fraud
The accused include pharmacists, government employees, a pensioner and three pharmacies in the Lowveld, one of which is allegedly based in Mbombela.
Sixteen accused and three pharmacies in the Lowveld were charged with fraud and appeared in the Nelspruit District Court on Monday March 6.
The Mpumalanga Directorate for Priority Crime Investigation (Hawks) released a statement identifying the suspects as Nkosazane Nyathi (40), Nelile Shabangu (34), Brenda Nzima (38), Nokuthula Ubisi (40), Thabo Ndlozi (38), Adekunle Moshood (56), Lucky Lubisi (37), Nomvula Maduna (61), Sipho Mkhatywa (50), Nomvula Tolla (42), Prisca Mokoena (40), Sarah Nyambi (53), Sharon Williamson (38), Veronica Keis (52), Vusi Mkhumbane (66) and Victor Mpofu (42).
Three pharmacies, one in Mbombela and two in Nkomazi, have also been charged. The names of these are known to Lowvelder, but will not be publicised until the paper has reached them for comment.
The accused were arrested and charged by the Nelspruit Hawks Serious Commercial Crime Investigation Unit for fraud and being in contravention of the Medical Scheme Act 131 of 1998.
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Members of the Government Employees Medical Scheme (GEMS) allegedly colluded with these pharmacies to defraud the medical scheme by means of claiming for services that were not rendered by the pharmacies in exchange for cash, or purchasing items that are not covered by the medical scheme.
The Mpumalanga Hawks’ spokesperson, Captain Dineo Sekgotodi, said the allegations relate to the submissions of claims by the three pharmacies to GEMS for services or goods that had not been supplied or rendered to the members.
She said it is further alleged that the accused colluded to receive non-medical goods in lieu of the false claims submissions.
Sekgotodi said GEMS had conducted internal investigations to determine the veracity of the alleged false claims. “During investigation, it was discovered that members of the medical scheme colluded with pharmacy directors Lucky Velaphi Lubisi, Thabo Ndlozi, Nelile Shabangu and Adekunle Moshood to make misrepresentations to GEMS, knowing that what they were doing was not in line with the prescripts regulating pharmacies.
She said the complaint was reported to the Hawks in 2020, and the investigation resulted in Monday’s arrest.
Sekgotodi said 14 of the accused, including the three pharmacies, were released on R1 000 bail each, four pharmacists were released on R5 000 bail each, and the pensioner was released with a warning that they should not commit any similar offence to the one for which they are out on bail.
She said the court also ruled that the accused should not interfere with witnesses or the investigation. They are also required to appear in court on the relevant dates.
The case was postponed to March 28 for further investigation. More arrests are imminent.
GEMS’s chief marketing officer, Dr Phumelela Dhlomo, said the accused are not employees of GEMS, but are members of the scheme. “The investigation and those charged are not subjects of GEMS, nor any agents thereof,” Dhlomo said.
