Dental fraud in South Africa 2007 - 2015

Abstract

Healthcare fraud wastes money properly allocated to patient treatment, and the extent, never researched, is difficult to determine, especially in the South African two-tier healthcare system. A retrospective, record-based study aimed to determine these data between 2007 and 2015. Data were sourced from the Health Professions Council of South Africa (HPCSA), from Discovery and from the Board of Health Care Funders (BHF). Cases against dentists and dental specialists at the HPCSA peaked in 2013 with 22 cases, while dental therapists faced 12 cases in both 2009 and 2014. While there is a gradual decrease in the number of fraud cases, the amounts involved are increasing. Discovery revealed that fraudulent cases involving dentists have decreased from a high in 2007 with 179 cases to 63 in 2015, with total fraud just more than ZAR13.6 million. Cases involving dental therapists have increased from 1 in 2007 to 22 in 2015. The total for all dental professionals at Discovery was ZAR18.1 million. BHF estimated that ZAR 40 million was lost to dental fraud over the nine year period Dental fraud appears to be on the increase. It seems that dental therapists have a higher incidence than amongst dentists or dental technicians.