92% of GPs think underbilling needs to be included in Medicare review

Yasmin Clarke

writer

Yasmin Clarke

Data analyst; Journalist

Yasmin Clarke

GPs call for balance.

Over 90% of GPs want the government’s Medicare review to examine underbilling and unpaid work by GPs, Healthed’s latest survey suggests.

Yesterday, we asked GPs: “Do you agree that the upcoming inquiry into Medicare misuse should include an attempt to quantify the value of underbilling and non-billable services performed by doctors?”.

Almost all GPs who responded (92%) said ‘yes’.

While recent mainstream media coverage speaks of ‘leakage’ of Medicare funds into the hands of doctors as a unidirectional phenomenon, this is only one side of the story.

Healthed recently estimated that GPs are doing over a billion dollars worth of ‘free work’ every year, based on BEACH data.

No recent studies have quantified the value of free work that GPs contribute into the healthcare system.

Over the weekend, health minister Mark Butler, announced an independent review into Medicare compliance following media reports of ‘rorting’ by doctors.

The review will examine the value of fraudulent, non-compliant or over-servicing risks in Medicare and provide an evidence-based estimate of the likely value of non-compliance.

The review will examine “improvement” of compliance mechanisms, but does not mention improvements that would benefit general practitioners specifically.

Healthed contacted Mark Butler’s office to ask whether underbilling and unpaid admin work by GPs would be included in the independent review into Medicare compliance.

Mark Butler’s office referred Healthed to the terms of reference for the review and provided comments.

The terms of reference do not specify whether the issues of underbilling and unpaid work will be examined in the review.

In the comments, health minister Mark Butler acknowledges the commitment and hard work of doctors who have been dealing with a Medicare system that has undergone “cuts and neglect” over nine years.

“I’ve asked Dr [Pradeep] Philip [the health economist overseeing the review] to measure and report on the true extent of non-compliance in Medicare and identify fixes to protect the integrity of the system, for all who use it,” the health minister said.

His department again confirmed that they found no evidence of the $8 billion in Medicare fraud and inappropriate billing estimated by Dr Margaret Faux.

However, the comments provided did not address Healthed’s questions as to whether the issues of underbilling and unpaid work will be examined in the review.

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