“These allegations have already been proven false”: GPs rebut latest Medicare “overbilling” claims

The Royal Australian College of GPs (RACGP) has again strongly refuted an attack on GPs, after the Health Services Union (HSU) repeated debunked and speculative claims of Medicare overbilling to support their pay negotiations with the New South Wales Government. 

The erroneous HSU claims state that incorrect billing could account for 30%, or $10 billion, of Medicare spending. This has already been soundly disproven via an independent review by health economist Dr Pradeep Philip in 2023, which was also cited by the HSU as a low-end “estimate”. Dr Philip’s independent report into claims of Medicare rorting made by the 7 30 program and Nine papers in an October 2022 joint “investigation” concluded that: 

• “leakage” in the Medicare system stems predominantly from non-compliance errors due to the complexity of the Medicare system rather than premeditated fraud 

• fear of the punitive compliance regime in place is actually leading to many GPs to underbill Medicare. 

Subsequent University of Sydney research found GPs undercharge at a rate of eight times they overcharge. 

RACGP President Dr Michael Wright called for HSU to retract the claim. 

“These allegations have already been proven false,” he said. 

“A thorough independent review of the claims the HSU is now repeating found no evidence to support them. It showed where there was incorrect billing, this was rarely fraud and mostly inadvertent errors, and that GPs too often underbill Medicare due to its complexity and fear of punishment. 

“GPs work under a tremendously complex Medicare system which features over 6,000 individual items, on top of all of our other responsibilities, and we do our best every day for patients. Dr Phillip’s independent, comprehensive investigation found that the vast majority of Australia’s GPs are trying to do the right thing. Not only that, many GPs are underbilling out of fear of compliance, with our 2022 Health of the Nation report finding almost half of doctors either avoided providing some services or claiming patient rebates out of fear of Medicare compliance.” 

Dr Wright said the claims were the last thing GPs and practice teams needed at a time when they were needed by their communities more than ever before. 

“I know it’s not easy, but I urge GPs to ignore the latest reports, hold their heads high, and continue doing what they do best – providing high-quality care to patients across Australia,” he said.  

~ENDS 

RACGP spokespeople are available for interviews: We will respond promptly to all requests on - [email protected].