Federal Health Minister Mark Butler says he is open to an independent inquiry by the Department of Health into claims made on the ABC’s 7.30 program that up to $8 billion is being siphoned off Medicare each year due to errors, over-services and fraud.
- A joint investigation by 7.30 and nine newspapers has uncovered flaws in Medicare systems that make it vulnerable to fraud
- Health Minister Mark Butler says cases of fraud are “only a tiny minority” of thousands of health professionals
- But he says every dollar that goes into the system is valuable, and he’s taking the issue seriously
“Maybe that’s where we’ll end up,” Mr Butler said at 7.30am. “I take these matters seriously.”
Mr Butler first demanded the Department of Health look into the allegations made to the ABC by Dr Margaret Fo and the department’s own compliance systems.
In the report of the auditor general for 2020-2021. on Medicare compliance found problems with the department’s systems for detecting fraud or misuse under the scheme.
It found that the department’s approach to meeting the demands of health professionals was only “partially effective”.
“Rotating” the system
Joint investigation at 7.30, The Sydney Morning Herald and The Age exposed flaws in Medicare’s systems that make it susceptible to fraud and overservice.
The estimated $8 billion leak represents about 30 percent of Medicare’s annual budget.
Dr. Fo, a Medicare expert, believes that improper claims apply to millions of Medicare bills across the health care sector.
She says the waste has been building up for decades, despite repeated warnings from successive governments.
The Australian Medical Association (AMA) was critical of Dr Fox’s findings, calling the $8 billion figure “grossly inflated”.
“We do not tolerate fraud, and examples of fraud must be investigated and eradicated,” the statement said.
Mr Butler said he wanted to see a “comprehensive report” and analysis of Dr Fo’s work.
But Dr. Fo is not the only one to report widespread abuse of the system.
Speaking at 7.30, former Medicare regulator Dr Tony Webber accepted Dr Fo’s findings.
In 2012, he estimated that abuse of the system costs Medicare up to $3 billion a year.
Mr Butler said the cases demonstrating fraud were “only a tiny minority of the tens and tens of thousands of honest, hard-working health professionals”.
“But where it happens, it’s picked up and prosecuted,” he said.
One example cited by 7.30 involved a dentist who was reprimanded for exposing children to unnecessary radiation in order to receive extra benefits under the Children’s Dental Benefits Scheme.
The dentist had to pay back $650,000 and received counseling.
Mr Butler says the punishment was “disproportionate” for someone who “so flagrantly mismanaged taxpayers’ money”.
“In particular, I asked to check whether the penalties applied for the most egregious examples of violations are proportionate,” he told 7.30.
“I think that’s something that all taxpayers would like to understand.”
Pressure on the budget
The revelations come as the Albanian government prepares to present its first budget.
“Virtually every Australian now understands how valuable every dollar that goes into the system is,” Mr Butler said.
“Doctors and health professionals understand this perhaps more than most.”
Mr. Butler said he recognized the seriousness of the problem and promised a gradual response to allegations of Medicare abuse.
Look 7.30Monday to Thursday at 7.30pm on ABC iview and ABC TV