Queensland Health bureaucrats have failed to claim money from Medicare and health funds, costing the department tens of millions of dollars.#qldpol
Queensland Health has clawed back almost $12 million in revenue it should have claimed for private surgery carried out in its public hospitals, but Health Minister Lawrence Springborg fears tens of millions of dollars have been lost forever.
Mr Springborg ordered the recovery operation after the auditor-general found sloppy record keeping and massive amounts of foregone revenue in his investigation last year.
But a report obtained by the ABC under Right to Information showed only $11.6 million had been recovered.
“These are amounts of money that should have been billed that weren’t being billed,” Mr Springborg said.
“This has been going on for years. We’ve only been able to recover the stuff we had records [for] going back a couple of years.
“Who knows what happened prior to us coming to government.”
The July report, titled Private Practice Reform and Revenue Recovery Program, raised concerns about the record keeping.
“Medicare assignment forms are the only evidence of a patient’s election to be treated as a private patient and are critical in supporting the validity of all outpatient revenue that is billed,” it said.
“Queensland Health guidance is currently that these can be destroyed shortly after receipt of funds.”
Investigators also abandoned attempts to recover money from private patients that were admitted through emergency departments “due to difficulties with data sources and manually pulling records”.
Impacts in radiology and radiation oncology in new fees system
A new system of fees has been introduced for private surgery in public hospitals, but the report warned it could have a negative impact.
“The implementation of the full services fees in FY15/16 [currently at 50 per cent of the full rate] will result in a negative remuneration impact for some specialties,” it said.
“The most significant impact will be in radiology and radiation oncology.
“These specialists may choose to leave Queensland Health which could have negative implications for service delivery.”
But Mr Springborg doubted they would quit.
“I don’t believe that there will be any reasonable practitioner out there who will object to what the auditor-general has said and that is if you are utilising public facilities to raise private income and revenue then you should pay something for it,” he said.