Government will review after-hours home-visit doctor services after ‘dodgy’ Medicare claims

EXCLUSIVE: After-hours medical services will be put under the microscope after a government review found some visiting home doctors were making ‘dodgy’ lucrative Medicare claims.

After-hours, home-visit doctor services are flourishing.

TAXPAYERS are forking out hundreds of millions of dollars a year to privately run doctors’ groups for lucrative after-hours house calls despite the Health Department identifying dodgy Medicare claims by some providers.

A recent government review found that visiting home doctors were increasingly billing Medicare between $130 and $153 for “urgent” after-hours consultations for ­uncomplicated medical issues such as a rash or fever.

Figures by the Health Department also show the number of “urgent” after-hours payments increased by more than 150 per cent in the past five years. These “urgent payments” cost the federal government $250 million in the last financial year.

The Sunday Telegraph can reveal that recent audits by the Health Department also identified “incorrect claiming” of after-hours services.

National Home Doctor Service chief medical officer Dr Umberto Russo says after-hours GP services divert people from the higher-cost hospital emergency departments.

Another issue identified by the department was the “continuing and widespread marketing” of after-hours services which, it said, was providing a substantial return for healthcare providers.

The Royal Australian College of General Practitioners has called for greater scrutiny of the services, arguing that home doctors should instead bill Medicare for the non-­urgent rate of $75 to avoid a cost blowout.

But National Home Doctor Service chief medical officer Dr Umberto Russo said after-hours services saved taxpayers $180 million a year because they diverted people away from the higher-cost hospital emergency departments, where a similar consultation could cost almost $400.

“After-hours home visits are an essential Medicare service used by over one million Australian families and any cuts to the service would result in emergency departments being flooded with new ­patients,” Dr Russo said.

“Just like in general practice, individual doctors make the decision about which Medicare item is appropriate and there is a guidance in place to support doctors in making that decision.” The National Home Doctor Service also said the rate of GP-type presentations in emergency departments had fallen from 7 per cent of all presentations, but that figure had stagnated in recent years.

Federal Health Minister Greg Hunt intends to ask serious questions of after-hours medical services. Picture: AAP

Federal Health Minister Greg Hunt said he would meet with after-hours providers and ask them to respond to some of the “serious concerns” raised by ­medical groups.

“Patient care and quality is paramount,” Mr Hunt said.

“I take these concerns very seriously.

“They should and will be investigated.”

He said the government ­remained committed to funding after-hours doctors, but would be ensuring every service provided was genuine.

Originally published as Government will review after-hours home-visit doctor services after ‘dodgy’ Medicare claims