The Caisse nationale d’assurance maladie au Mali (CANAM) has drawn up an action plan to combat health insurance fraud. It focuses on fraud prevention, detection and prosecution.
This need for accountability has revealed among other frauds: the cost of services not in line with the conventional tariff; unauthorized services, various forms of identity theft, invoicing of fictitious insured persons, use of CMSS insured persons’ numbers (civil servants) for the benefit of INPS voluntary insured persons.
Field inspections by CANAM’s medical inspectors have identified cases of fraud amounting to 08 million FCFA in a health center. There, prescribing physician was indulging in inappropriate prescriptions. Confounded, he admitted the facts and undertook, through a discharge, to reimburse the sum wrongly received.
Source here.
