Health professionals overcharge Medicare by $10 million
Minister for Human Services, Tanya Plibersek, has released a report outlining Medicare Australia’s ongoing compliance program after high levels of overcharging by doctors were detected.
The report details that Medicare completed 3,594 audits and review cases to identify incorrectly claimed benefits in the last financial year.
More than $10.29 million in incorrect claims were identified, including $7.88 million from 477 practitioners.
Some 159 investigations were completed into suspected fraudulent behaviour, which involved 21 medical practitioners, seven pharmacists and 131 members of the public.
In one case, a medical practitioner was ordered to repay $180,000 after bulk-billing for procedures not discussed during patient visits.
In another case, a member of the public was convicted and ordered to repay almost $4,000 after making false claims to obtain rebates.
Medicare assisted the Commonwealth Director of Public Prosecutions to successfully prosecute 12 individuals, all members of the public.
Medicare provided face-to-face education to almost 3,000 medical practitioners and received roughly 34,000 visits to education pages on its website
Ms Plibersek said the report warns doctors who bill patients for more expensive services than are required, routinely order unnecessary blood tests, and incorrectly prescribe PBS medicines to patients who do not meet requirements.
She said the National Compliance Program report outlines where compliance efforts will be focused and encourages doctors and pharmacists to use Medicare and the Pharmaceutical Benefits Scheme (PBS) correctly.
