Health Minister Mark Butler says he is open to improving the Medicare watchdog after it was revealed it investigates just 0.07 per cent of health professionals each year and is led by bureaucrats with strong links to the powerful Australian Medical Association.
But he stopped short of directly addressing concerns that the AMA – a union that represents about a third of the country’s doctors – wields a veto power over whom the federal government wants to run the regulator, known as the Professional Services Review (PSR).
Health Minister Mark Butler said he would wait for a report from the department before determining whether any changes were needed to the Medicare watchdog, called the Professional Services Review.Credit:Alex Ellinghausen
Butler is expected to appoint the next director of the PSR next year, but in accordance with section 83 of the Health Insurance Act “must not appoint a person unless the AMA has agreed to the appointment”.
Asked whether he would consider changing this requirement, Butler said he was “open to sensible suggestions about ways in which we can improve the Professional Services Review arrangements”.
But he added he would wait for a report from the Department of Health “about the state of our Professional Services Review system” before determining the next steps.
“I want to deal with this in a sensible, measured way. I’ll receive the report from the department [and] I’ll start to have some discussions with stakeholders who have an interest in this, which will be a very broad discussion. We’ll see where we go from there,” Butler said.
Butler commissioned the PSR report following a joint investigation by The Sydney Morning Herald, The Age and the ABC’s 7.30 program that has uncovered an array of fraud, inappropriate billing and overservicing by medical professionals that was never detected by the PSR.
He has also requested a separate departmental report analysing research by Dr Margaret Faux, whose PhD on the Medicare claiming and compliance system concluded nearly 30 per cent of Medicare’s annual budget, or about $8 billion a year, is being lost through fraud, incorrect payments and errors.
But his decision to opt for internal inquiries has been criticised by a number of experts who believe an independent inquiry is warranted.
The AMA, which has been a fierce critic of Faux’s research and the media coverage, called for the reports to be made public, believing it will vindicate its concerns.
“The minister should commit to releasing the review into these claims, which we are confident will show there is no evidence to support the allegations of $8 billion of fraud, which in fact does not even appear in the PhD upon which the story was based,” federal president Professor Steve Robson said.
“This figure has also been debunked by the former head of the PSR, the former head of the Medicare Review and health experts such as Stephen Duckett.”
The PSR examines only about 100 cases of fraud and inappropriate billing every 12 months, which represents just shy of 0.07 per cent of the 150,000 medical professionals the regulator is responsible for monitoring.
The acting head of the PSR, Dr Antonio Di Dio, also sits on the board of the AMA and is a recent former president of the lobby group’s ACT branch. His term expires in March. Previous directors have also been members of the union. This masthead is not suggesting any of these individuals engaged in any wrongdoing, but rather that ties to the AMA give the PSR the appearance of a body that lacks true independence.
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