This outcome was inevitable.
https://www.smh.com.au/politics/federal/unfit-medicare-syste…
Many medical centre are dodgy and charge for services that were never provided. No wonder many GPs drive high end luxury cars (Land Rover, Porche, Mercedes etc.) and own multi-million dollar houses.
Doesn't this show that the private businesses claiming from Medicare is the issue.
The whole system is out of order…
https://youtu.be/gpZuMQVrlUw&t=23s
You're out of order!
Order! Order!
The issue is that Medicare / government does little-to-nothing to close the gaps. Medicare has been systematically destroyed, and consecutive governments (both Labor and Liberal) appear to have done nothing to actually rectify it.
The latter two are likely due to decreased manpower.
Yeah, the governments haven't "touched" Medicare, they've just left it lying there malnourished in the corner, gasping for breath…
if the government closes the gaps, it will never end, the gaps will always appear again and again..
It’s like saying you are forever hired on fixed salary of 1970. No matter what is the cost of living now or the inflation index.
Sweet Jesus this is a load of BS.
Things like your former Minister for Health, Jill Hennessy, was under investigation by IBAC for awarding 3.4 million to a health union in grants. She later stepped down from the role under a cloud and left politics completely.
A public health centre CEO awarding a million dollar contract to someone they were in a relationship with. IBAC commissioner noted “The vulnerabilities highlighted in this investigation are not unique to this particular health service." https://www.ibac.vic.gov.au/publications-and-resources/artic…
In what universe is using a million dollars of public money that was meant to be used on health, to give to the company owned by someone you're in a relationship with, not corruption? IBAC specifically noted that the situation was not unique to that particular health service, but that the same vulnerabilities existed across the whole system. The IBAC site alone is full of many examples of corruption that was invested and reported on.
Your statement wasn't, there have been a couple instances of shady conduct in the health sector. It was:
You basically need to be corrupt to work for the state. Even if your'e an honest state employee you still need to be ready to engage in corruption when asked of you.
Which is utter horseshit.
@jsheroes: Nah, it's broadly true. Let's say you were a doctor at that health centre, do you really think the CEO was going to let you stand in the way if him greasing his relationship partner's palms with the million dollars!? He probably knew the Health Minister personally, tell me do you hav the Health Minister's personal phone number in your address book?
I too wish we had the pinnacle of public health services that a non government supported medical system brings, such as America :/
Extreme Desperation stories about normally good parents accidently murdering someone over $50 so they can afford life saving medication for their children, are tight !
My favourite are all the feel good stories we get about communities raising tens of thousands of dollars for procedures that us poor Australians don't have any out of pocket expenses for.
Doctors love it. You should see the fear of medicare for all they have on pagingdr forums.
I hear you.
But the deaf and broke won't be able to hear it.
no thanks, if you want private billing, move to the US. You will enjoy it very much.
I don't think someone who holds opinions like that should be allowed to work on the health system.
Did you even read the article you linked?
Your position and claim was immediately brought into question when it was clear that the evidence you linked was actually in SUPPORT of the medical profession, that they are clearly being targeted and victims of a mass smear campaign - there is obviously a political agenda to continue to underfund Medicare.
Thank you for bringing light to that agenda. Most of us would have missed the conclusion to that investigation amongst all the noise.
On Monday, Nicole Higgins from the RACGP issued a press release, based on early briefings of the review, saying doctors had been “slandered by baseless claims of ‘rorting’ for no good reason”.
“We have been vindicated and we await an apology,” she said.
Philip said most Medicare wastage stemmed from non-compliance errors rather than premeditated fraud and acknowledged that doctors had been offended by the allegations of intentional rorting.
“Australians know that the overwhelming majority of our doctors and health professionals are honest, hardworking and comply with Medicare rules,” he said.
What, the ridiculously skewed loaded poll answers didn't OP's bias away?
The poll had to match the inflammatory title. Fiction is hard to sell these days. You need to squeeze as much hyperbole as you can in such a short space.
Here is a recent example of compliance issues where GP's and practices now have to pay Medicare back.
The letter, seen by newsGP, states that item 10997 can be claimed if the patient has an existing GP Management Plan (GPMP), Team Care Arrangement (TCA) or Multidisciplinary Care Plan in place.
However, the AskMBS Advisory on GP services (page 5) states that it ‘would not be expected’ that it be ‘routinely claimed’ on the same day as items 721 or 723, raising questions as to whether co-claiming is allowed, or if GPs can only bill both items for a patient on the same day if they present for two separate attendances.
Previous advice was that claiming a 10997 with a 721 or 723 was correct and now Medicare have done a 360 saying it's not allowed.
We've been having this issue a lot lately where the claims are sent off to Medicare, Medicare staff approve the claim, money is paid and then much later they turn around and say it's not allowed. There's big issues internally at Medicare where even they don't know what can and can't be claimed. Giving the minister a real run for his money.
Medicare need to sort their shit first. Advising GPs that item x and item x can be claimed together. Only to say months/years later "that's not allowed" and now you have to repay.
Essentially saying the stop sign means go and once you're through… oh sorry no that meant stop.
Do these non-compliance errors appear in other high profile professions? Nope…
Um… yes…
AMP continuing to charge dead ppl insurance, banking and superannuation commission, phoenixed builders, Victoria Police using a lawyer as a mole. They were all "oversights" and nobody went to jail.
All I can say then, is physician heal thyself.
I'd like to see you understand the intricacies of hundreds of forever changing claiming codes while focusing on the actual job of diagnosing disease.
The system is overcomplicated to the points where it is inefficient and adds costs - at both ends
Isn't this all done via their claims software. I really doubt GPs have the inclination nor spare mental capacity to work this out for themselves. Easier to run 5 ten minute consults and hurry patients along; than try and rort for multiple simultaneous claims on codes.
Most "efficient" practice was for specialist (not GP), he had set up a large space with curtains across, creating maybe ten rooms,
where a nurse would prep patients and he would rotate around spending 5 minutes in each and charging his $300. Not bad even with all the overhead.
@Elfarol: That is very much rorting the system. Most of the specialist MBS codes have a specified consult time. This would be with the physician and not the allied health staff (who have their own codes).
You can read about any MBS codes and requirements online.
The problem is that no other respectable profession has this problem.
Do these non-compliance errors appear in other high profile professions? Nope…
What do you class as high-profile professions?
Lawyers?
Police?
Politicians?
Accountancy, law and medicine are the three.
@stalker878: Not a profession, though (sadly) there are career politicians, they're not subject to accreditation requirements, or any sort of professional society and code of conduct.
@Assburg: Two questions:
1: What makes these professions so much more 'respectable' and 'high profile' than others, besides the fact you have to acquire qualifications for them?
2: What makes you think that law and accountancy are free of non-compliance errors?
That said, this isn't my definition, and it's more tied in the original meaning of the word, and I don't think it elevates a person's status. The traditionally guilded jobs including masonry and other crafts are just as admirable.
It's sort of esoteric but, I think there's as much pride in being a builder or a programmer as there is in being a doctor. As long as you're proud of what you do you do not need the title of 'professional'.
I think, to answer your concern that I think these are high profile jobs, no I think the highest profile thing you can do is work for yourself or with a few partners, doing what you like and what you're good at, with integrity.
Banks get fines all the time.
Define respectable profession? Because I'm pretty sure it's going on in in most professions to dinner degree.
Should be pretty simple.
Better auditing, simpler claim codes/descriptions, patients ability to flag or report claims in their Medicare history that do not align with their treatment (eg in medicare app) to allow for weighting in audits.
This would assist in reducing billing errors or straight up incorrect claims.
Here Here
Hear, Hear?
It's hear (him) hear (him).
The simpler answer is to let ChatGPT-6 sit in on all medical funded consults to make sure doctors are doing what they are meant to be doing.
Satire right?
Probably, but like a lot of satire, there's something there. I can definitely see a future where AI rates a consultation and checks for any anomalies.
I can even see a future where AI is first to consult with patients and doctors review the consultation. AI is cheap, doctor and people's time is expensive.
Even as a patient, I would prefer being able to get immediate consultation from an AI than having to go to the doctors or telehealth/teleconsultation.
AI good, doctor good, AI+doctor better.
Need an appropriate punishment to accompany compliance. Just do what the TPB or ATO does. Give written cautions, make periodic reviews, order mandatory education, issue fines/penalties, issue suspensions, withdraw/remove registrations and then censures. Nothing hurts more then losing money, livelihood or reputation (except a combo of all three).
They do this already. Abuse of Medicare gets your billing rights suspended or cancelled in severe cases. The idea that rort goes unpunished is part of the media spin designed to encourage us (the taxpayer) to demand that Medicare benefits (subsidies for taxpayers, not doctors) is cut.
Doctors will be fine when Medicare is defunded, in fact they will be able to make more money. The demand for their services will not decrease if patients need to pay more
Do you want to check if your medical centre is charging in your name? Just check medicare rebates.
Otherwise I dont think the greater amount medical centres are corrupt. I would think the specialists that charge an arm and a leg for basic stuff are more corrupt and are the ones driving the porsche
And on-top of that every medical practice is now linked to PRODA through their clinical software and can't do Medicare claims without it. The government can see so much more now, so it's harder to be "dodgy".
Evidently the long term plan is to try and make doctors employees instead of contractors.
Hey clear , is it normal that for breathing difficulties been asked to do ct scan then found nothing but later been asked to do endoscopy (fasting/shitting/anesthesia) due to 'abnormalities' found within intestine from ct scan report and turns out as nothing again.
Did they do this for fun and money , just to find nothing ?
They're pretty standard tests for breathing difficulties. A CT could be show early onset lung cancer, penumonia, bronchiectasis, lung inflammation, blood clots, fluid in the lung, among many many other conditions. An endoscope with a camera lets the doctor see what's actually inside you and can show things that a CT cannot, as well as being able to take tissue samples.
@dcep: I wouldn't see it as being shafted. An endoscope revealed a large tumour inside me that a CT, MRI and MRCP wouldn't show and an endoscopic ultrasound showed a potential lymph node with surgery revealing half a dozen.
They're important tests to have. Prep time is just a nightmare unfortunately, however I believe they're much safer than the endoscopic camera pill you can swallow. Way less prep, but the risk of complications is higher.
PRODA is just the authentication to submit claims. Prior to this, providers still had to register with Medicare and would use their Medicare/Services Australia private certificate (issued via postal mail and on a CD-ROM) with those certs getting lost, duplicated and used by dodgy providers. There was a low level of confidence the provider was actually who they claimed to be.
Last couple of years you'd get those through PRODA instead of the mail. What I said is true though. The government are saying that more information will go through it than before.
Hey, i just found out a charge from my local medical centre that I wasn't aware of…
What can I do to investigate further?
Post it in ozbargain! or find someone that knows health coding/medicare — if you are unsure
Or contact medicare
There will be a lot of information there that is not common knowledge
show us the item
it does say the code that can be searched on MBS…
but what should I do if I find that claim was done without my knowledge? should i report it? but to where?
or should i just move on if it doesn't affect my medicare cap anyway?
@meong: my advice show someone who might know first
or ask the centre
or ask medicare, if it was a major item I would go medicare first, if it is small change probably not worth your time to check out.
@meong: Was the item charged at the same time you visited the doctor? If so then it could be legitimate as some visits will use different or multiple item numbers depending on what you were being seen for.
If it's a completely random item number and you haven't been to the GP recently, had a blood test etc. then it could be a reason for concern.
@Clear: No, i didn't remember making a visit to that clinic…
Last time I've been to that clinic was a while ago.
No wonder many GPs drive high end luxury cars (Land Rover, Porche, Mercedes etc.)
None of these are "high end luxury" cars anymore and have basic entry level versions. You can get a Porsche Macan for $80k, hardly the pinnacle of luxury.
and own multi-million dollar houses.
a $2m (since you said multi million ) isn't that huge anymore dude. Also it is possible that people had investment properties or other investments that paid off.
And at the end of the day, doctors have to do a lot of training in a specialised field in order to treat people, why shouldn't they be successful?
I thought everyone on has a lambo?
What colour is your Bugatti?
Blue. It's the lego one.
Your poll options are a little lacking
any government scheme is open to exploitation. Medical practices aren’t all GP owned, some are. Absolutely some practice Medicare fraud, others are accused of it but may not be. That’s why there’s a system in place to fine people who exploit it. Same with NDIS providers if not worse. Radiology companies are well known for it too.
Unfortunately I think the ship has sailed in terms of primary healthcare mostly being provided by private for profit businesses which are largely run in public subsidies (via Medicare). One option would be more government run primary healthcare so the private sector has to compete to survive. The reality is people want access to healthcare free or low cost, doctors won’t accept lowered pay, so the gov via our taxes will pay one way or another.
The reporting is usually extremist was well. The report says that the estimated level of non-compliance is between 1.5 and 3 billion, and non-compliance includes both deliberate fraud as well as accidental billing. The headline reporting goes straight to up to 3 billion in fraud.
Mate, wait till you hear about NDIS abuse. NDIS can be billed at 4x medicare amounts and is extremely vulnerable to multiple layers of double, triple, quadruple billing.
At least providers get bent over when Medicare catches them.
People need to be more vigilant in monitoring their medicare billing.
NDIS is the real cashcow. So many remedial massage shops are signing up to NDIS to provide the same service for significantly more money. And I'm talking the kind you find next to the supermarket.
If you are a scammer and not on NDIS or have an NDIS billing business you are doing it wrong.
The Coalition turned NDIS into the new Training Colleges. Companies pop up to suck all the funding they can, and provide next to no services.
I remember a Dude trying to get people for a free x-rays for a specialist.
Anybody would do .
The problem is indexation, most medicare items are not indexed and frozen all the time, sometimes decades.
Poorer health care outcomes are because the only way to earn money from medicare is by volume.
There is a reason your typical GP sees you for about 1minute before ushering you out. There is a big incentive for alot of health professionals to get return visits.
There are alot of studies of NHS in the UK about excessive waste in the medical system, just the nature of it really, anything government sponsored.
Naturally noone wants a America-style system, but whats the alternative? Im lucky enough to have dual-citizenship and Ive seen so called fully sponsored medicare for all.
You start to get exploitations by the patients hoarding drugs they dont use. Caps and limits on patients for Dr per day , like a lottery trying to get onto a specialist.
Nothing is free. You pay for it one way or another.
Assuming the $368b so generously gifted by Australia to the US military industrial complex isn't going to fund itself, we are now being told we have to cut out so-called 'rorts' in healthcare, social spendings, etc and at the time increase taxes significantly on everyday working Australians.
Free universal healthcare since Medicare was founded by Bob Hawke in 1984 have ended in Australia with the loss of bulkbilling doctors and ED long wait times.
I honestly believe we will eventually end up with an expensive healthcare system like US where the Military Industrial Complex has entrenched itself and which over decades had leached trillions off the US budget over healthcare/education/welfare.
Its called entropy. Order gradually degrades into chaos over time.
Some well-designed systems degrade slowly. Like Medicare. Other poorly-designed systems fall apart almost immediately, and in no time become a rort for those who want to exploit it. Like the NDIS, which is just totally out of control. Thanks Julia.
When they do they can't just be fixed. Too many people have figured out how to arrange how to do things to beat them. They have to be thrown out and started again.
The problem is in Australia is that is the reform is done during a period power is held by the conservatives, the Liberals, it will be used to further the things the conservatives want. Which all too often is out of step with what most people want. And if it is done by the progressives it will be used to further progressive causes. Which are probably closer to what most people want, but it will be done badly, like the NDIS was.
it will be done badly, like the NDIS was.
What do you think was done badly?
I think I'm going to have to book an appointment with my GP and ask her whether I'm suffering from dementia, or Alzheimers, or something. I remember writing that. But not earlier today.
I truly DO respect education and being a doctor is not a dream job it used to be.
The number of doctors I know and the ones I have seen dying whilst working their guts out and not even finding time for their own treatment is a truly horrible sight.
Out of all professions I think only pilots fear worse giving their educational input and what they get out of it.
Sure some black sheep are out there but the majority is rather depressed and has a risky job of being infected by patients or find themselves struck down in a totally overloaded system.
Australia is very lucky to have mining income to enable residents a fully free medical system. But sadly what is free is also the most abused system in the world.
If everybody had to pay at least $2 to even enter a medical practice perhaps the system would have an incentive to become more honest!
It's hardly news. This is has been going on for 30+ years that I've personally observed.
Any "bulk bill" joint seems to tote up any number of services while you're in there that you have no idea what they relate to ("I just came in to have 'x' looked at"), but because the patient isn't paying, it's just shrug your shoulders and move on.
Instead of just making up stuff, take a login at https://www.servicesaustralia.gov.au/medicare and then
https://www.health.gov.au/topics/medicare/compliance/reporti…
This is has been going on for 30+ years that I've personally observed.
You seem to have 30 years of evidence
Which bit am I making up? My own observations? Or something else?
OP:
Many medical centre are dodgy and charge for services that were never provided.
You:
This is has been going on for 30+ years that I've personally observed.
Any "bulk bill" joint seems to tote up any number of services while you're in there
and
have no idea what they relate to
Me:
Instead of just making up stuff, take a login at https://www.servicesaustralia.gov.au/medicare
I'm saying that you can't accuse people of fraud and also say "have no idea what they relate to".
Your next steps:
Step 1: login at https://www.servicesaustralia.gov.au/medicare
Step 2: See all the transactions under your name
Step 3: Find that fraud you are talking about personally observing for 30+ years
Step 4: Report it here: https://www.health.gov.au/topics/medicare/compliance/reporti…
Step 5: I suspect you won't make it this far because you've just made it up
I'm saying that you can't accuse people of fraud and also say "have no idea what they relate to".
It's the provider that totes up all these services and then says sign here.
The punter can't reconcile the services on the bill with the services they've received … but since they're not paying, they don't care and sign away.
The above problem is far less prominent in non-bulk bill scenarios … when people are paying out of their own pocket, they are far more likely to challenge the bill of services.
But, you know, "free Medicare" seems to be all you want to hear, so I guess I'll just vote for that.
@Seraphin7: I gave you the steps to prove it.
Am I to take this as you have no evidence what so ever to back up your claim.
@deme: Thanks. I went on and found an enormous number of fraudulent services on my file.
Now I have the evidence to prove it and will be illustrating this to relevant authorities.
Thanks for helping me demonstrate my point.
Now I have the evidence to prove it and will be illustrating this to relevant authorities.
Wait… how did you conclude there was fraud before looking at this?
It's the provider that totes up all these services and then says sign here.
I make an appointment. I arrive. I wait. The GP sees me. I walk out. I don't sign anything. I have no idea what is being charged, or being charged for.
AustriaBargain on 04/04/2023 - 06:57 Comment score below threshold.
