Skin cancer GPs under microscope

Authorities are investigating whether GPs marketing themselves as skin cancer experts are misusing taxpayer-funded Medicare rebates.

 

Amid increasing tensions over a federal government freeze on Medicare rebates, and questions over claims for items such as chronic care plans, a key commonwealth agency has revealed that the cost and efficacy of skin cancer services are again in the spotlight.

For more than a decade, specialist dermatologists and plastic surgeons have raised concerns about rogue GPs in skin cancer clinics who they fear may be doing patients a disservice. Now Medicare’s investigative arm, the Professional Services Review, has highlighted the claiming pattern of several GP skin cancer experts to illustrate the need for reform.

One practitioner saw more than 7000 patients in a year, providing an average of three services per patient and claiming rebates of about $1 million in total. Another practitioner saw about 2500 patients in a year with an average of seven services per patient for rebates of about $1.2m. A third practitioner saw 450 patients but provided more than 13 services per patient on average, leading to total rebates of about $800,000.

Skin cancer is a major health issue in Australia and increased awareness is at least partly responsible for the increase in Medicare rebates for skin cancer services, which topped $240m last financial year, an increase of more than $100m in a decade.

The PSR, in its annual report tabled in parliament yesterday, noted it was a “complex matter” that it had raised with stakeholders and the ongoing review of the Medicare Benefits Schedule, which is examining whether some items need to be removed and others governed by strict guidelines.

The PSR is also monitoring misuse of chronic disease management rebate items that have been claimed by doctors in large clinics despite a “lack of clinical relevance” to patients.

After Health Minister Sussan Ley yesterday highlighted the PSR’s concerns, Australian Medical Association president Brian Owler questioned whether the government had politicised the PSR.

Associate Professor Owler said abuse of chronic disease management rebates was not widespread and may have been in response to the government’s freeze on Medicare rebates.