Health Fraud Scandal
The Sun Herald
Saturday June 13, 1992
AUSTRALIA'S Medicare system is being ripped off by doctors, pharmacists, patients and receptionists using scams costing millions of dollars each year.
As the nation's Medicare bill spirals to $4.2 billion per annum, a major Sun-Herald investigation today exposes:
* The doctor who defrauded $556,762 by forging Medicare forms: his receptionists and nurses signed forms for services they hadn't received; and 12 doctors he employed signed blank forms "for administrative convenience"before he claimed for fake services under Medicare.
* The pharmacist who admitted making an extra $10,000-$15,000 a month through false claims: he was claiming for repeats on prescriptions when the maximum number of repeats on the original prescriptions had already been issued; he finally admitted $190,000 worth of fraud.
* The receptionist who forged receipts worth $72,000: she filled out forms using patients' Medicare numbers kept on file; she then forged patients'signatures and cashed the Medicare cheques when they arrived at the surgery.
* The patient who stole documents from a pathology lab and made claims to Medicare for services not received: he was paid in cash at a Medicare office.
* Other patients who altered doctors' accounts to obtain more money, and altered item numbers to claim for services not received.
Australia's top health fraud investigator Richard Karling - an ex-Federal Police officer who now heads the Health Insurance Commission's Professional Review Division - summed up: "With the recession a lot of people try various avenues to get money.
"The health system - through Medicare - is a prime target. It's the golden goose."
Above all, the experts emphasise the cost of this massive health care fraud is being funded by ordinary Australian taxpayers.
For people with private health insurance - about half the population -their bill is at least 8 per cent higher because of fraud against private companies like MBF, Medibank Private and HCF.
For example, Neil Swindells, MBF's NSW manager, estimates MBF pays $20 million a year to dentists alone in fraudulent claims.
WE NAME THE CROOKS: Pages 12-13
© 1992 The Sun Herald