Health funds want to ban high charging doctors from Medicare

The government has been called upon to consider banning high charging doctors from Medicare to control healthcare costs being driven up. HAVE YOUR SAY

Exclusive: Doctors who charge exorbitant fees should be black-listed from Medicare, according to the peak health fund lobby.

Private Healthcare Australia chief Dr Rachel David said doctors who charged patients gap fees of over $10,000 should not be eligible for Medicare or fund rebates, nor their patients.

One in every two patients who use their health insurance in private hospitals face gap fees or around $1,000 but one in 50 are charged gaps over $10,000.

“There should be no Medicare rebates for doctors who choose to charge high fees, Dr David said.

“If they want to charge high gaps they should operate outside the Medicare system,” she said.

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Dr Rachel David CEO of Private Healthcare Australia. Picture: Private Healthcare Australia.

Private Healthcare Australia chief Dr Rachel David said a series of carrots and sticks were needed to control healthcare costs being driven up by doctors charging enormously high fees with no evidence to support them.

The government will next year introduce a website where doctors can list their charges to help patients find the best value medical care and avoid hefty out of pocket charges not covered by their health funds or Medicare.

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However, it will be voluntary for doctors to take part in the new website.

Dr David said the government should provide an incentive in the form of higher Medicare rebates to doctors who take part in listing their fees on the site.

In return for the higher Medicare rebates doctors would have to agree to provide a gap free service to patients.

Commenting on the freeze in health fund rebates, Dr David said funds were not in a position to increase their rebates until they got a guarantee from doctors they would control their fees.

“The trade off for higher rebates from the funds will be participation in the website and an agreement by the doctors to provide a no gap service,” she said.

Australian Medical Association president Dr Tony Bartone said the health funds were using claims about egregious billing as a smokescreen to cover up the fact they hadn’t increased their rebates for up to five years.

“We’ve said all along we don’t support egregious billing,” Dr Bartone said.

However, he said any website listing doctors fees must also list the rebates provided by every health funds so patients received complete information about who was responsible for the gaps.

“The same doctor charging the same fee may find their patients end up with a gap fee of zero or a gap fee as high as $1,500, all depending on which health fund they belonged to,” he said.

This was because every health fund provided a different rebate for the same procedure and some were much lower than others, he said.

Originally published as Health funds want to ban high charging doctors from Medicare