FOLLOWING ABC Four Corners' investigation last week that revealed the fraud within the chronic pain industry, Private Health Australia (PHA) is welcoming an examination of their own health funds.
"PHA will immediately ask payment integrity experts within our health funds to investigate allegations of fraud, waste and abuse in spine surgery for back pain," said PHA Chief Executive Officer, Dr Rachel David.
"We expect the Department of Health and Aged Care will launch its own investigation as a matter of urgency and we'll be seeking confirmation of this."
After studying the billing records of more than 23,000 patients who had spinal surgery, Four Corners found that 77% were billed for more complex services than provided, 10% were billed for longer services than provided and 7% were billed for spinal fusions for chronic lower back pain without a diagnosis.
"With cost of living escalating and pressure increasing on family and government budgets, it is crucial the government and payors work together as a matter of urgency to restore trust in our medical payments system," said Dr David. JHM
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