‘Inappropriate radiotherapy’ is the exception: RANZCR

3 minute read

The radiologists’ college says it’s been proactive about complex Medicare billing education for members, and the vast majority do the right thing.

Allegations of Medicare rorting and incorrect billing to the tune of $8 billion have been made by the ABC and Nine newspapers, which have reported finding flaws in the system that make fraud easy and nearly impossible to spot.

While the allegations seem to mainly apply to GPs, radiation oncologists and radiologists have also been mentioned. “Some of the more disturbing practices driven by Medicare rorting include … radiologists overservicing terminally ill cancer patients to access government payments,” the ABC News Online article said.

“Inappropriate radiotherapy was the most shocking for me because here was an instance of pure greed and clearly the patient was being very disadvantaged,” Dr Tony Webber, former head of the Professional Services Review (PSR), told 7.30.

The Royal Australian and New Zealand College of Radiologists (RANZCR) released a statement in response yesterday saying, “The high standards of the vast majority of RANZCR members do not in any way reflect the reports in the media.”

The RANZCR statement noted the “complexity of Medicare billing” and the organisation’s support of “measures to remedy incorrect billing behaviour”.

It says it has taken proactive measures to give members “up-to-date information on the appropriate billing of Medicare”.

“RANZCR has a close relationship with its members and communicates with them on a regular basis, in particular industry updates, government policies and regulations,” college president Clinical Associate Professor Sanjay Jeganathan told Oncology Republic.

“We provide information to our members on Medicare billing via our eNewsletters, articles in InsideNews magazine (our quarterly publication), and seminars at our annual scientific meetings. For example, in 2021 there were information sessions and presentations on Medicare billing and compliance by the Department of Health at our annual scientific meeting.”

“RANZCR supports Medicare appropriate compliance activities and when incorrect billing practices are identified we have always worked with Department of Health and educate our members,” Professor Jeganathan said.

“Our radiation oncologists work very hard to make sure that patients receive the health care they need, putting their patients first.”

The dollar figure reported in this week’s media stories, which equates to about 30% of the annual Medicare budget, comes from Dr Margaret Faux, a Medicare billing expert and past contributor to The Medical Republic. She told journalists millions of wrongful claims go unnoticed. “The bottom line is we don’t know exactly how much is fraud, deliberate abuse and how much is errors, but it actually doesn’t matter any more. Whether it’s deliberate or unintentional, it has to stop,” the ABC has quoted her as saying.

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