Some pathology companies accused of pandemic rorting
Documents have revealed some private pathology companies engaged in systematic rorting of Medicare at the height of the COVID pandemic. The health department documents, obtained under freedom of information laws, show one doctor billed taxpayers for 21- thousand tests in a single day.
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00:00These are documents from the Department's Compliance Division that was overseeing that
00:06massive rollout of COVID testing we had during the pandemic. And they show some concerns
00:12about something called co-claiming. So, we would all remember going and getting that
00:15text message to say you're COVID negative or positive, but sometimes tests were also
00:20being tested for RSV and flu, which is really not what those drive-through and pop-up clinics
00:25were designed for, and consequently Medicare was getting extra billings. They also show
00:30concerns about referrals, without valid referrals to Medicare, and some inappropriate billing.
00:36So, there was these state-funded drive-through clinics that were joint-funded by the Federal
00:41Government, but at times Medicare was being billed instead, which meant there was a cost
00:46shift to the full Federal Government. Now, the clinics say, well at times the State Government
00:51simply wouldn't pay, so we had to bill Medicare. So, the documents we received show the Department
00:57got 47 tip-offs, which doesn't sound like a lot, but considering it's the sort of dry
01:02world of pathology, you have to kind of put that in context. The Department says to us
01:06that's 1% of the tips they got overall, but experts say that really should have been enough
01:11to send alarm bells ringing that something was going on. And obviously the Health Department
01:15had a big job to do at this time, but what the documents indicate is in response to some
01:19of these concerns, they sent warning letters to companies involved, which were a good proportion
01:25of the industry by the looks of it. Now, the Department has told us that that wasn't the
01:30extent of its compliance operations, but didn't elaborate any further on what it did, but
01:35it did say its approach to compliance is something that it's continuing to look at.