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GPs’ $4 million Medicare rort

The ongoing investigation into the Medicare Benefits Scheme (MBS) has uncovered a $4 million rort by doctors claiming benefits in the last financial year. 

A review panel consisting of doctors investigating their peers has issued a report that has found that health practitioners rorting the MBS rose by 40 per cent in the last financial year, and doctors are now being ordered to pay back the funds for which they have claimed.

So far the report has uncovered these key points:

  • claims of GPs rorting the MBS rose by 40 per cent in 2014–15
  • 70 per cent of these investigations resulted in further action
  • doctors have been ordered to repay more than $4 million of claimed benefits
  • the Federal Government’s independent Professional Services Review (PSR) Agency’s 2014–15 annual report will be released today.

 

As a result, there have been reprimands and restrictions placed on offending health practitioners, preventing them from future access to Medicare benefits.

Federal Health Minister Sussan Ley said the PSR report underscores the reason why such claims are being made, including GPs failing to record patient medical histories and not following up on chronic disease management plans, which may not have been required in the first place. The misuse of chronic disease management benefits alone has cost the government $2.7 billion since being introduced nine years ago.

“We need clear, strong rules around the use of individual Medicare items to make sure they’re clinically relevant, they reflect contemporary practice and they’re not, of course, misused for financial gain – small though that misuse is,” said Ms Ley.

“The instances of non-compliance are very small,” she continued. “However, for patients who are not getting the benefit of the treatment they’re supposed to, the outcome for them is poor, and for the taxpayers footing the bill, the outcome is unacceptable.”

The report’s release coincides with the Government’s continuing investigation and review of more than 5700 items on the Medicare Benefits Scheme.

Read more at www.abc.net.au

Have you had any experience with a GP who has failed to follow up on your health management plan? What do you think of doctors who rort the Medicare system? Are you satisfied with them having to pay back these wrongful claims? Or do you think further action should be taken?

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