The federal government has labelled an investigation uncovering widespread rorting of Medicare as "troubling," declaring it will seek to get to the bottom of the issue and ordering a report from the Health Department.
A joint investigation by the ABC and Nine newspapers has found doctors are abusing the $28 billion system, at times putting patients at risk and even billing dead Australians to boost profits.
Medicare expert Margaret Faux has estimated the leakage has cost about $8 billion a year, or nearly 30 per cent of Medicare's annual budget.
Some of the examples of rorting include a doctor caught charging dead people in aged care homes in February, and radiologists over-servicing terminally ill cancer patients to access government payments.
On the back of the revelations, Health Minister Mark Butler asked his department to provide him with an analysis of Dr Faux's findings, as well as a report on the department's existing compliance and audit programs.
"Australians know that the overwhelming bulk of Australia's doctors and health professionals are honest, hardworking and comply with Medicare rules," Mr Butler said.
"But they also understand that, after nine years of cuts and neglect, every dollar in Medicare is precious and must be spent directly on patient care.
"All governments must apply strict compliance standards to any publicly funded system — including Medicare — to ensure that the small minority that do the wrong thing are picked up quickly and dealt with."
Speaking from Canberra on Monday, Treasurer Jim Chalmers described the revelations as concerning.
"Very troubling revelations and something that we will get to the bottom of," he said.
"We don't want to see a single dollar rorted or thieved from the system when it could go to helping people who are vulnerable."
Prime Minister Anthony Albanese said the majority of doctors were using the system appropriately.
"The idea that we denigrate those people or tar them with this brush is in my view entirely inappropriate because overwhelmingly, GPs are out there providing fantastic service."
Experts have long raised concerns with successive governments about flaws in Medicare's systems that make it easy to rort.
In 2012, Tony Webber, a GP and former head of Medicare watchdog the Professional Services Review (PSR), estimated the misuse of Medicare was costing Australians up to $3 billion a year.
He said the Medicare Benefits Scheme was "riddled" with incentives for practitioners, with some doctors claiming items that have not helped patient care.
Dr Webber said when he raised concerns with health ministers from both sides of politics, or the federal health department, he was shut down.
AMA slams reports as an 'unjustified slur' on doctors
In a statement, the Australian Medical Association (AMA) said it was extraordinarily disappointed by the ABC and Nine Newspapers investigation, describing it as an "unjustified slur" on the profession.
"Doctors will be sickened by today's reporting which is an undeserved attack on the whole profession based very much on anecdotes and individual cases," AMA President Steve Robson said.
"Australia's doctors have worked incredibly hard through COVID – treating Australians during lockdown, rolling out the nation's vaccine efforts, putting themselves at risk every day to treat COVID patients on the front line – so today's coverage is as appalling as it is inaccurate.
"We do not tolerate fraud and examples of fraud should be tackled and stamped out — but the figures reported today are grossly inflated."
A series of questions were sent to the Department of Health and Aged Care, including Dr Faux's estimate that up to 30 per cent of Medicare claims were leaking from the system from fraud, errors and overservicing.
The department said it has a strong compliance program to ensure the integrity of Medicare, involving assessment of external tip-offs, analysis of claiming patterns and trends and advanced analytics. It said it takes any allegations of non-compliance seriously.
