Dr Nick Coatsworth warns the entire Medicare system is under threat

dr. Nick Coatsworth has issued a brutal wake-up call to the doctors responsible for deliberately defrauding Medicare out of an eye-watering $8 billion a year.

A report published this week by the Sydney Morning Herald and the ABC has revealed massive overspending by physicians charging for services they failed to provide, which could amount to 30 percent of the entire Medicare budget.

The Australian Medical Association (AMA), the highest body representing physicians, has strongly retaliated against claims, calling it “an unwarranted blot on the medical profession” and that $8 billion was an “exaggerated figure.”

dr. Coatsworth said a more “appropriate” response to the report would have been had the AMA admitted there was a problem within the medical world.

“I think Steve Robson and the AMA, he’s the president, are all wrong. It’s not a stain on the medical profession,” he told the Today Show on Wednesday.

“If I, as a medical leader, can offer an alternative view, the right response is to come out and say, ‘We think the number is exaggerated, but we recognize that we have a problem within our profession and we know it’s a problem. Medicare’s survival depends on us cleaning up our own act”.’

dr. Coatsworth said low-level fraud was “endemic” in the medical world and that there were “financial drivers” driving doctors to pay inappropriate bills.

The doctor said the Australian National Audit Office (ANAO) – the government’s internal auditor – had estimated that $2.2 billion was wasted every year.

dr. Coatsworth estimated for every $12 taxpayers spend on Medicare, $1 was wasted by the medical community (pictured, customers queue at a pharmacy in Western Sydney)

“That means that for every $12 taxpayers spend on Medicare, one dollar of that is wasted by the medical community,” he said.

“We have to figure out what we’re doing as a profession, we have to do our part to save Medicare and not go back to the trenches every time someone interrogates us.”

The doctor continued his rant on Twitter Wednesday morning, tweeting that the medical profession should be open and “solve our problems.”

Danielle McMullen, vice president of AMA, said the medical agency was not afraid to hold a “few” of doctors who had defrauded Medicare to account or for the system to be “modernized.”

AMA Vice President Dr Danielle McMullen (pictured) said the medical agency hadn’t shied away from holding a “few” of doctors who had defrauded Medicare to account

A report from the Sydney Morning Hrald and the ABC this week has revealed a massive overspending by physicians that can amount to as much as 30 percent of the entire Medicare budget.

“But portraying doctors as greedy thieves doesn’t improve the system for patients. It’s the system that needs fixing,” she tweeted Tuesday evening.

“The problem is broader than fraud,” Dr Coatsworth replied.

The ANAO estimated the cost of waste/over-service/fraud at $2.2 billion. As a professional group, we cannot ignore that, even if we think the estimate of 8 billion dollars is too high.’

The report published this week alleged that doctors have routinely charged the government for time and services they failed to provide by falsifying data and misdiagnosing to demand more money.

More extreme cases included a primary care physician who charged for dead people in a retirement home, a dentist who exposed children to radiation for unnecessary procedures, and doctors who misdiagnosed conditions such as diabetes to claim a higher Medicare discount.

The sums of money could be mind-boggling if a GP in a western Sydney suburb of Fairfield Heights is ordered to reimburse $1 million for prescribing addictive painkillers to patients without an appropriate management plan in place.

The report alleged that doctors have routinely charged the government for time and services they failed to provide by falsifying and misdiagnosing data in order to claim more money.

Treasurer Jim Chalmers has lashed out at the ‘larvae’ who siphon $8 billion a year into Medicare with fraudulent claims

“The AMA is extremely disappointed with the allegations being suggested in the media today that up to $8 billion is defrauded from Medicare by health professionals, including physicians, each year,” the association said on its Twitter account.

“These claims are an unjustified stain on the medical profession.”

Treasurer Jim Chalmers lashed out at what he called the “larvae” sucking Medicare out of much-needed resources.

“If these numbers are true, it’s absolutely appalling,” Dr Chalmers said Monday.

“Every dollar stolen, be it from Medicare or the NDIS, is a dollar stolen from people who need and deserve good health care.”