Investigation: Doctors were required to repay a total of more than $1.5 million

Source: SMH

One doctor billed the taxpayer for seeing more than 500 patients in a single day, and more than 200 patients on several other days, according to the Medicare watchdog.

The case is in the annual report of the Professional Services Review agency, which disciplines doctors for inappropriate practice.

The doctor, who worked for a company that provided workplace health and safety services, including vaccinations, told the agency they had ”eyeballed” each patient.

A GP who provides 80 or more services on 20 or more days of the year is generally considered to be guilty of inappropriate practice, because professional bodies say it is not possible to effectively treat such large numbers of patients.

The doctor, whose details are not disclosed, billed Medicare for 90 or more services on 29 days, potentially running up a bill of several thousand dollars in inappropriate services. The doctor negotiated a confidential settlement with the agency, which included an acknowledgement that they had engaged in inappropriate practice.
Over the year, 26 doctors were required to repay a total of more than $1.5 million and 11 were suspended from Medicare.

The agency reported that some of the GPs referred for investigation for very high levels of servicing worked in large, extended hours clinics. The agency said these doctors argued they were responding to demand.

The agency expressed concern about possible abuse of generous rebates for chronic disease management. Doctors can charge Medicare more than $135 to prepare a plan to co-ordinate the management of a patient’s disease.

One plan simply listed the patient’s conditions and entered the word ”dental” under goals. Other doctors populated the plans with template entries. In one case, a plan for a patient who had never smoked included advice on strategies for giving up smoking.

The Department of Human Services referred 45 cases to the agency in 2012-13, a 50 per cent increase on 2011-12. However, the increase may be partly attributable to legal challenges, which disrupted the agency’s operations between 2010 and last year.

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