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Doctor prescribed jail time for false Medicare claims

Supreme Court Library Queensland
Date published
February 2020

Relevant impacts: Business impact and financial impact

A Queensland doctor was found guilty of defrauding Medicare out of more than $360,000. He used Medicare’s online system to lodge almost 4,000 false claims for providing services to patients who had died or on dates when he was overseas. The doctor owned four bulk-billing medical practices in Queensland at the time of the fraud. The man was sentenced to 4 years in prison. He was suspended from medical practice and might be deregistered or banned in the future.

Related countermeasures

Use declarations or acknowledgments to both communicate and confirm that a person understands their obligations and the consequences for non-compliance. The declaration could be written or verbal, and should encourage compliance and deter fraud.

Automatically match data with another internal or external source to obtain or verify relevant details or supporting evidence. This countermeasure is supported by the Office of the Australian Information Commissioner's Guidelines on data matching in Australian government administration.

Audit logging is system-generated audit trails of staff, client or third party interactions that help with fraud investigations.

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