Million’s ripped off of Medicare and no charges will be laid

 

 

 

 

 

 

http://www.news.com.au/adelaidenow/story/0,,26002003-911,00.html

MORE than a thousand doctors claimed more than $1 million in Medicare benefits last year – with one GP alone claiming $1.4 million.

The highest-claiming GP in Australia received more than 26,000 Medicare payments for servicing 5200 patients for a total of $1,386,749.

Based on an average consultation of $33.55, that would mean the doctor seeing 158 patients every working day of the year, the Sunday Herald Sun reports.

But the doctor concerned – and those like him – are unlikely to face any real scrutiny for overcharging despite promises by the Rudd Government to crack down on medical fraudsters.

Under existing laws, doctors who are audited through the Department of Health are not legally required to substantiate their Medicare claims.

Medicare Australia’s program review division general manager Colin Bridge said this meant “non-compliant individuals could essentially choose not to be audited”.

And there is no financial penalty for doctors found to have received incorrect payments above a specified amount.

While Medicare Australia has been allowed to increase audit levels from 1 per cent – about 500 doctors – to 4 per cent of doctors under last year’s Budget, the measures to force doctors to provide evidence to justify claims and the powers to fine doctors have stalled in Parliament.

Under existing laws, there were only four successful prosecutions of doctors last year. While some doctors received community service orders and suspended sentences, most were simply required to pay back amounts owing.

Medicare Australia retrieved $25 million last year via compliance measures, which covered “incorrect claiming” (mistakes), “inappropriate and opportunistic behaviour” (unnecessary servicing) and “fraudulent and illegal behaviour” (claims for services not provided).

Over the past financial year, 747 separate instances of health professionals incorrectly claiming MBS items were identified, totalling $4 million.

In one case in 2007-08, a GP was criminally convicted of 63 counts of “knowingly making false statements”.

The charges were the result of an investigation that revealed the GP had amended bulk-bill claims to add additional services that had not been performed.

In another case, complaints were made by doctors concerned their health professional numbers were being misused.

Medicare Australia investigated and discovered the practice manager had been submitting fraudulent Medicare benefit claims for more than two years.

In another case, a doctor was found guilty of 59 counts of dishonest claims totalling $15,435.

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“Under existing laws, doctors who are audited through the Department of Health are not legally required to substantiate their Medicare claims.

Medicare Australia’s program review division general manager Colin Bridge said this meant “non-compliant individuals could essentially choose not to be audited”.

And there is no financial penalty for doctors found to have received incorrect payments above a specified amount.”

so much for rudd cracking down on medicare cheats..the australian tax payer pays for these..158 patients a day..what the hell is going on?..and for white collar crime you just have to pay it back..no jail time for doctors

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~ by seeker401 on August 31, 2009.