Could you be unknowingly paying for someone else's Medicare fraud? Billions of dollars stolen from Medicare yearly

We all know that Medicare is a vital service that provides free or low-cost healthcare for eligible Australian residents. And as taxpayers, we fork over a pretty penny every year to keep it running smoothly.

But what you might not know is that there are some people out there who are taking advantage of the system and ripping off honest, hardworking Australians in the process – and their actions could be putting extra strain on your wallet.



According to a recent report, doctors are overcharging Medicare by billions of dollars every year by invoicing patients who have passed away or for procedures that either never occurred or weren't even necessary. Yep – you read that right!

The Minister for Government Services, Bill Shorten, acknowledged that Medicare has a 'payment integrity' issue during an appearance on the morning programme Today and promised that the government will take action to combat fraud.


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Reports alleged that billions of dollars are being rorted out from Medicare by ‘dishonest’ medical practitioners. Credit: Nine.


He said: ‘It drives taxpayers to despair if they think that some people are opportunistically rorting the system.'

Mr Shorten noted that while 'the vast majority of general practitioners do the right thing,' there are dishonest businesses who try to drain government funding by committing fraudulent activities.



'Payment integrity is a problem,' he added.

He argued that more resources were required in the back office to ensure thorough checks and compliance, asserting that past Liberal governments had 'neglected' the back office of Medicare.


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Minister for Government Services Bill Shorten said that the government is working on tracing these fraudulent transactions. Credit: SMH / Alex Ellinghausen.


'If you don't put enough effort into payment integrity and guardianship, you will get rorts,' he said.

'There needs to be tougher payment integrity checking.'



A collaborative investigation by The Sydney Morning Herald, The Age, and ABC's 7.30 programme discovered that there are significant issues with the Medicare payment processes.

The audit highlighted improper payments and errors that cost the government billions of dollars annually while asserting that some fraud was practically impossible to detect.

It was also estimated that the fraud accounts for up to 30 per cent of Medicare's annual budget or roughly $8 billion annually.



'Crooks do leave footprints,' Mr Shorten remarked.

He claimed that 'fraudsters and con artists' ought to be apprehended by the government.

Key Takeaways

  • Medicare is losing billions of dollars every year due to fraud.
  • The government is cracking down on fraudulent activity.
  • More resources are needed to ensure robust checks and compliance.
Fraudulent transactions in social services can cost us, taxpayers, dearly.

This is not only a huge financial loss for taxpayers, but it also takes away resources from those who really need them. It is estimated that fraud in the social services sector costs taxpayers billions of dollars every year.



Fraud in social services is a serious problem that needs to be addressed. We need to make sure that our tax dollars are going to those who need them the most and not lining the pockets of criminals.

What are your thoughts on this? Do you think the government is doing enough to combat this issue?
 
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We all know that Medicare is a vital service that provides free or low-cost healthcare for eligible Australian residents. And as taxpayers, we fork over a pretty penny every year to keep it running smoothly.

But what you might not know is that there are some people out there who are taking advantage of the system and ripping off honest, hardworking Australians in the process – and their actions could be putting extra strain on your wallet.



According to a recent report, doctors are overcharging Medicare by billions of dollars every year by invoicing patients who have passed away or for procedures that either never occurred or weren't even necessary. Yep – you read that right!

The Minister for Government Services, Bill Shorten, acknowledged that Medicare has a 'payment integrity' issue during an appearance on the morning programme Today and promised that the government will take action to combat fraud.


https%3A%2F%2Fprod.static9.net.au%2Ffs%2F9d31ed76-711e-4620-b056-cc079b90ae74

Reports alleged that billions of dollars are being rorted out from Medicare by ‘dishonest’ medical practitioners. Credit: Nine.


He said: ‘It drives taxpayers to despair if they think that some people are opportunistically rorting the system.'

Mr Shorten noted that while 'the vast majority of general practitioners do the right thing,' there are dishonest businesses who try to drain government funding by committing fraudulent activities.



'Payment integrity is a problem,' he added.

He argued that more resources were required in the back office to ensure thorough checks and compliance, asserting that past Liberal governments had 'neglected' the back office of Medicare.


https%3A%2F%2Fprod.static9.net.au%2Ffs%2F230c8c3d-6983-4261-8371-84ed28d4c604

Minister for Government Services Bill Shorten said that the government is working on tracing these fraudulent transactions. Credit: SMH / Alex Ellinghausen.


'If you don't put enough effort into payment integrity and guardianship, you will get rorts,' he said.

'There needs to be tougher payment integrity checking.'



A collaborative investigation by The Sydney Morning Herald, The Age, and ABC's 7.30 programme discovered that there are significant issues with the Medicare payment processes.

The audit highlighted improper payments and errors that cost the government billions of dollars annually while asserting that some fraud was practically impossible to detect.

It was also estimated that the fraud accounts for up to 30 per cent of Medicare's annual budget or roughly $8 billion annually.



'Crooks do leave footprints,' Mr Shorten remarked.

He claimed that 'fraudsters and con artists' ought to be apprehended by the government.

Key Takeaways

  • Medicare is losing billions of dollars every year due to fraud.
  • The government is cracking down on fraudulent activity.
  • More resources are needed to ensure robust checks and compliance.
Fraudulent transactions in social services can cost us, taxpayers, dearly.

This is not only a huge financial loss for taxpayers, but it also takes away resources from those who really need them. It is estimated that fraud in the social services sector costs taxpayers billions of dollars every year.



Fraud in social services is a serious problem that needs to be addressed. We need to make sure that our tax dollars are going to those who need them the most and not lining the pockets of criminals.

What are your thoughts on this? Do you think the government is doing enough to combat this issue?
People, practitioners who rort the system cost us money. The cash economy, tax evaders, black marketeers, Centrelink fraudsters, corporations with overseas tax havens, rip-off merchants, online scammers, drug dealers, etc. The list goes on...and on. If you want to receive, you must be willing to give (pay). Nothing is free. It comes down to your personal values and honesty. Can you sleep at night with your decisions? Do you care? If not, why not? At the end of your life, who will you see in the mirror?
 
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If you have been going to a GP for years, which most senior are, including me, then there is a mutual respect between the two. Has anyone else spoken to their doctor about how much they get paid for Medicare consultations? I am led to believe that there has NOT been a rise in the subsidy they receive for more than sixteen years. Could you run a business in these circumstances? The cost of running a surgery and staff has grown considerably in that time. I believe they should be fairly paid for the hours they spend with patients. This would negate the need for them to consider dishonestly claiming costs!
Don't blame the doctors when our government is at fault.
 
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Reactions: Ezzy
There is NO excuse for fraud. However, I doubt the alleged Medicare fraud is as great as this article is making out. I have worked for many doctors over the last forty years. Most of the time, it was my job to process the Medicare claims. I have never seen any evidence to suggest doctors were committing fraud. What I DID see were Medicare rebates that consistently failed to meet the costs involved, and a "temporary" government freeze on Medicare rebates that lasted for years while costs continued to rise. Not only that, in some cases the Medicare rebates were reduced, not increased. Every year, Medicare rebates are subject to review and adjustments are made. Everyone assumes that they will stay the same or increase to meet the rate of inflation, or the CPI or other economic indicator. Most people don't realise that they are sometimes reduced instead. Meanwhile Medicare has unrealistic rules that result in our Medicare money being wasted. For example, in my last job in paediatrics, the paediatrician was not allowed to refer children to certain other medical services, such as psychology/psychiatry, on their first visit. So the doctor had to make them come back for a second, unnecessary visit in order to be allowed to do the referral. There is absolutely no justification for this waste of resources, particularly in an area of medicine that is critically short of doctors. I could go on about the stupidity of many of the Medicare regulations but it would make this post too lengthy. I have written to various politicians (including the Minister for Health, Shadow Minister for Health, etc) about these issues and have been ignored by every one of them. Couldn't even get the courtesy of a response.
 
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Unfortunately, it's not uncommon for fraudulent activity to happen, and it can be hard to detect. The best thing you can do is to be vigilant and report any suspicious activity you come across. Also, make sure you understand your Medicare coverage and know what you're paying for. If you're a small business owner or entrepreneur, check out https://ibgportland.com/health-insu...regon-small-business-owners-and-entrepreneurs for some options that may work for you. It's important to be informed and stay on top of your healthcare expenses. And remember, if you suspect any fraudulent activity, report it to the appropriate authorities immediately.
 
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