DistantNews
Support us
🇦🇺 Australia /Health & Science

Allegations of double billing and charging for no service at Kalgoorlie hospital

From ABC Australia · () English

Summarized and contextualized by DistantNews.

At a glance

News Named sources Under investigation
  • An internal memo suggests radiologists may have signed off on referrals for Medicare rebates for ineligible services at Kalgoorlie hospital.
  • The memo warns of compliance risks and advises against co-signing referrals without direct patient care involvement.
  • The allegations concern billing practices by Integral Diagnostics' subsidiary, Apex Radiology, which operates at the Kalgoorlie Health Campus.

Radiologists at Kalgoorlie hospital may have improperly billed Medicare for services not eligible for rebates, according to an internal memo obtained by the ABC. The memo from Integral Diagnostics, a private medical imaging provider, indicates instances where radiologists allegedly signed off on referrals to enable Medicare rebates for services that did not meet eligibility requirements.

This practice carries significant compliance risks for yourself as the radiologist and may be interpreted as inconsistent with Medicare requirements.

— Integral Diagnostics memoWarning within the internal memo regarding the alleged improper billing practices.

The internal communication, circulated on June 4, explicitly warned radiologists about "significant compliance risks" and stated that such practices "may be interpreted as inconsistent with Medicare requirements." It directed them to "please refrain from co-signing referrals unless you are directly involved as the treating specialist responsible for the patient's care."

Effective immediately, please refrain from co-signing referrals unless you are directly involved as the treating specialist responsible for the patient's care.

— Integral Diagnostics memoInstruction issued in the memo to radiologists concerning referral sign-offs.

These concerns reportedly relate to the billing practices of Apex Radiology, a subsidiary of Integral Diagnostics, which operates imaging services like X-rays at the Kalgoorlie Health Campus. While the public hospital's radiology department is resourced by the hospital, it is operated by Apex. Integral Diagnostics managing director Ian Kadish denied any knowledge of wrongdoing when contacted by the ABC.

Integral Diagnostics is not currently aware of any incorrect billing.

— Ian KadishStatement from Integral Diagnostics managing director denying knowledge of wrongdoing.

Internal emails also reveal discussions about implementing clauses to shield radiologists from liability for incorrect billing, particularly when third parties like the WA Country Health Service (WACHS) handle the billing. An email from WACHS on June 3 reminded staff to "please ensure that staff are aware of billing rules" and avoid practices such as charging for consultations that did not occur or double billing for CT scans. Integral Diagnostics and Apex had previously raised concerns about Medicare rebate issues as early as 2022 with the Department of Health.

please ensure that staff are aware of billing rules

— WACHS emailGuidance from the WA Country Health Service to its employees regarding billing procedures.
DistantNews Editorial

Originally published by ABC Australia. Summarized and contextualized by our editorial team with added local perspective. Read our editorial standards.

More Stories

From Our Blog