AUSTRALIA: A STATE HEALTH DEPT. DEFRAUDS THE FEDS

How low-life can a public medicine system get?

Queensland Health is being investigated for Medicare fraud which doctors say could amount to "tens of millions of dollars" each year dishonestly obtained from the Federal Government, with senior staff potentially facing criminal prosecution. The scheme involves getting medical specialists employed by Queensland Health to allow other doctors, mostly young registrars, to use their Medicare provider numbers and bill the Federal Government for services provided. Medicare laws make it illegal for any person to bill the commonwealth for a service that was not provided directly by the holder of the provider number.

Documents provided to The Courier-Mail indicate the fraud could be widespread in Queensland Health, with a number of confidential emails from senior Queensland Health staff encouraging the practice and advising it is used in a number of Queensland hospitals. Another email outlines that administration officers "were instructed to get bulk-billing forms signed before the patient was seen", despite doctors advising that the practice was illegal. A complaint to the Commonwealth Health Insurance Commission by one doctor states "billing has been initiated without my consent".

A spokeswoman for federal Health Minister Tony Abbott last night confirmed the federal Health Department was aware of a number of potential alleged breaches by Queensland Health of the Australian Healthcare Agreement. "The Government is very concerned about these and the department has been actively pursuing these with Queensland Health," the spokeswoman said.

Senior staff who complained to Queensland Health that the practice was illegal have subsequently complained of "bullying, harassment, intimidation, discrimination and vilification". A number of formal complaints have been lodged with the HIC and the federal Department of Health.

Liberal health spokesman Bruce Flegg said he had spoken to the doctors concerned and was satisfied that the scheme constituted "a systematic fraud of Medicare". Dr Flegg said doctors who had expressed their concerns had their "salaries slashed for refusing to break federal laws". "It's an appalling way to treat Queensland Health staff by placing them at risk of serious criminal charges," Dr Flegg said.

After inspecting the documents obtained by The Courier-Mail, Australian Medical Association Queensland president Steve Hambleton said he was aware of the practice and had previously complained about it to Mr Abbott. "If the public hospital system is facilitating patient-signed Medicare vouchers without seeing the doctor whose provider number it is, it is both illegal and reprehensible," Dr Hambleton said. "A doctor must see a patient to raise a fee, otherwise it is fraud."

A Queensland Health spokesman said last night that allegations of this nature should be referred to the HIC for investigation.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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