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Australian Doctors Accused of Defrauding Government

by Gopalan on Apr 17 2009 11:38 AM

At least seven Australian doctors have been accused of milking the government of millions of dollars by making false claims over treatments and procedures.

A legislation is now on the anvil demanding more doctors hand over medical records while claiming Medicare payments.
In seven case studies released to The Courier-Mail yesterday, most of the unnamed doctors were forced to pay back hundreds of thousands of dollars and some were prosecuted.

One doctor claimed he removed skin lesions, which had a higher dollar value than the procedure actually performed.

The GP was forced to repay $400,000 to Medicare Australia and was disqualified from using Medicare Benefit Scheme provider numbers relating to skin cancer for three years.

In another case, three providers from the same practice were identified as having "unusual billing histories".

The trio had incorrectly claimed for procedures performed and were forced to repay $260,000.

While Human Services Minister Joe Ludwig has defended a legislation to frustrate such manoeuveres,  the Australian Medical Association and the Australian Privacy Foundation hit out at the move, claiming it could create a black market for medical histories.

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"This legislation isn't about the way a doctor interacts with a patient or potential cases of inappropriate practice," Ludwig said.

"It's about verifying a patient has received a service that Medicare has already paid for - we want to make sure taxpayers' money is provided correctly and efficiently."

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He said Medicare paid doctors billions of dollars a year but some were defrauding the Commonwealth "on a large scale."

"This reinforces the need to protect the integrity of the Medicare scheme."

But the Australian Medical Association is angry and contends that the legislation reverses “current legal protections for patient privacy, ensuring no part of the patient record is protected. The patient record will be completely exposed, extracts obtained, copied, retained and potentially submitted in court for all to see.”

AMA President, Dr Rosanna Capolingua, described the legislation as “deeply disturbing.”

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