Medicare exposed to rorts by medical chains: report - National - smh.com.au
Page 1 of 2
Home Âť National Âť Article
Medicare exposed to rorts by medical chains: report Mark Metherell July 25, 2007 THE potential for corporate medical chains to milk Medicare's payments of $11 billion a year to doctors has triggered moves to step up deterrents against overservicing. "One-stop-shop" clinics operated by publicly-listed health companies are now flourishing in Australia, increasing the scope for lucrative referrals by GPs to in-house diagnostic and other specialist services. A report to the Federal Government has highlighted a flaw in Medicare legislation which effectively shelters the growing number of medical corporations against surveillance of potential rorts, such as excessive and unnecessary services billed to Medicare. The report has called for systems to monitor corporations' influence on doctors and for tougher deterrents on corporations found to be "contributing to inappropriate practice" by their doctors. A spokeswoman for the Health Minister, Tony Abbott, said yesterday the Government agreed to the recommendations made in the report into the Medicare watchdog agency, the Professional Services Review. An advisory committee would be asked to advise on the specifics of monitoring corporations and on sanctions against offenders, the spokeswoman said. According to the report, they have been able to escape the full scrutiny of Medicare investigators because they engage their doctors as contractors rather than employees. "This enables corporate business owners to exert influence on contracted individual practitioners whilst remaining at arms length from any compliance intervention." The report said that more information on corporate practices relied on "anecdotal evidence ‌ There is no system to track corporate practices or monitor billing and referral patterns of general practitioners working in corporate practices." David Dahm, a medical practice management specialist who heads an Adelaide practice management firm, said the corporate medical firms "are flying under the radar". The companies were able to "hide behind the skirts of the doctor" while exerting influence on doctors to maximise business in a way that was potentially contrary to medical ethics and Medicare rules, he said. Whether the lack of scrutiny had triggered abnormally high referral rates "is the million-dollar question. "There is no way of monitoring that. The point is the motive is there and the motive is strong," Mr Dahm said.
mhtml:file://N:\0_PUBLIC\H&L Articles\Marketing Articles need filing\Medicare ex... 05/09/2009
Medicare exposed to rorts by medical chains: report - National - smh.com.au
Page 2 of 2
He welcomed moves to strengthen security of the corporations: "We are spending $11 billion a year on Medicare but we do not know how effectively that money is being used." But Edmund Bateman, chief executive of one of Australia's fastest growing medical corporates, Primary Health Care, said his company offered no incentives for doctors to refer patients in house. When news happens: send photos, videos & tip-offs to 0424 SMS SMH (+61 424 767 764), or email us. Did you know you could pay less than $1 a day for a subscription to the Herald? Subscribe today.
Copyright Š 2007. The Sydney Morning Herald.
mhtml:file://N:\0_PUBLIC\H&L Articles\Marketing Articles need filing\Medicare ex... 05/09/2009