An article in The Australian this week suggested that the Commonwealth Government would be seeking to reclaim funds from doctors working in public hospitals, and that State Governments will not accept responsibility for any ‘double dipping’.
The article cites Freedom of Information (FOI) documents that suggest that the State and Territory governments want to shift the blame for so-called ‘duplicate Medicare payments’ to individual doctors in the hospital system.
Of course, the AMA would not stand for State and Territory Governments who may try to blame doctors for any funding issues they are facing under the current Commonwealth-State public hospital funding agreement. Equally, the AMA would not accept the Commonwealth going after doctors to claw back these funds.
We sought urgent clarification. Thankfully, that is not what is occurring.
The AMA has been engaging with the Federal Department of Health regarding their compliance activities, including any future activities under the shared debt recovery powers recently introduced and legislated.
In doing so, the AMA has continually pointed out that in public hospital settings the billing is often managed by the hospital; that, under team arrangements, billing can be complex, particularly in the areas of pathology and diagnostic imaging; and that practitioners do not have line of sight where State Governments also bill an episode of care under Activity Based Funding (ABF).
Furthermore, the AMA has highlighted that, in any attempt to undertake an audit, it will need to be hospitals, not practitioners, that take the lead on looking at the records, as often a practitioner will not hold them all.
The AMA has received assurances from the Department of Health that this is indeed understood, and that the intent is not to pursue individual practitioners for the recovery of funding, where there is identified ‘double dipping’ alongside an ABF payment.
The AMA position is that State Governments, their bureaucrats, and hospital administrators must take responsibility for the running of their public hospitals and their side of the bargain in the Commonwealth-State agreements.
No doubt there has always been a blame game between the Commonwealth and the States when it comes to public hospital funding. This, in large part, stems from the fact that there is simply not enough funding for our public hospitals.
While it is appropriate that compliance action be undertaken where there is clear wrongdoing, the AMA has continued to advocate that it is the hardworking doctors, nurses, and other health workers who keep the system going amid ongoing and critical funding and resource shortages. As such, they should not be the target of this action. Thankfully, we believe this message has been heard.
The AMA will continue to work with Governments, State and Federal, on this issue, while calling for a greater focus to be put on funding our hospitals to be better, not just busier.
