Medical imaging companies have been accused of exploiting a Medicare loophole to charge patients and the government more for services.
The ABC has learned some companies are making vulnerable patients who need multiple scans return over a number of days.
The practice helps them avoid a Medicare billing regime where set fees are reduced for second and subsequent scans conducted on the same day. Making patients return can save imaging practices as little as $5 or as much as half the standard cost of a scan.
It comes after the ABC revealed earlier in the year specialist doctors could be raking in millions of dollars by forcing patients back to their GP for a fresh referral each year.
But the imaging industry said sometimes there were legitimate medical or logistical reasons to ask patients to return on different days. Charging at the higher rate also gave them more capacity to bulk-bill patients. However, in cases where practices do not bulk-bill, it results in the maximum gap payment for patients.
Consumer advocates said asking patients to make unnecessary repeated visits was a waste of time and money.
“If it’s not medically relevant … then this could be a significant cost burden on the Australian health system and one that requires review,” Consumer Health Forum chief executive Adam Stankevicius said.
Government spending on imaging has risen more than 40 per cent in the past five years and makes up about 10 per cent of the Medicare budget. The patient gap charges, the difference between the cost and the Medicare rebate, are also up with the average imaging gap now $88.
Patients billed for cancelled appointments
Medical advocate Lorraine Long says the imaging industry has many poor practices.
The Medical Error Action Group founder has personally been bulk-billed twice for appointments she made but later cancelled.
“There’s obviously a pattern that when you make an appointment they obtain your Medicare number, then they bill Medicare whether you turn up or not,” Ms Long said.
She said she frequently saw evidence of “double-dipping” by medical practices.
In some cases, patients were bulk-billed for clinicians they never saw or billed for visits they never attended.
“I think it’s conniving more than rorting. Because I’m seeing it right across the board,” Ms Long said.
“I’m not just seeing it in Sydney, I’m seeing it across Australia, and I see a lot of Medicare patient history reports that have that view.”
Patients encouraged to report fraud
A Department of Human Services spokeswoman said the department had compliance activities to address inappropriate practice and fraudulent activity.
“Any changes to Medicare would need to be considered by the Department of Health,” she said.