Medicare Australia's performance under scrutiny
Medicare Australia, the agency the Federal Government has appointed to act as the superannuation clearing house for small employers, has received a critical analysis from the Australian National Audit Office (ANAO) regarding its handling of the Pharmaceutical Benefits Scheme (PBS).
An ANAO report, tabled in the Parliament yesterday, broadly endorsed Medicare’s administration of the PBS — but it also pointed to a number of deficiencies, including the accuracy of claims processing and performance. It also found that better operational guidance should be provided to key decision-makers.
The ANAO report has been tabled at a time when other, specialist superannuation clearing house operators have questioned the ability of Medicare to handle the task demanded of it by the Government.
Among the issues raised by the ANAO was its observation that Medicare Australia had adopted a practice “of adjusting Medicare Australia’s authority approval records to accord with the medicines actually dispensed in cases where there was a mismatch”.
The report said this practice carried with it the risk of failing to react to, or manage, evidence of incorrect dispensing of medicines.
It noted that Medicare had advised that it intends to address the issue through its nationally consistent quality control action plan, which it has recently endorsed.
Medicare has responded to the ANAO report by accepting the majority of its recommendations, some of which it said had been already implemented.
AUTHOR
Mike Taylor
Recommended for you
A relevant provider has received a written direction from the Financial Services and Credit Panel after a superannuation rollover resulted in tax bill of over $200,000 for a client.
Estimates for the calendar year 2024 put the advice industry on track for a loss in adviser numbers as exits offset gains from new entrants.
Adviser Ratings shares five ways that financial advice changed in 2024 with an optimistic outlook for 2025, thanks to the Delivering Better Financial Outcomes legislation.
National advice firm Invest Blue has announced several acquisitions, including the purchase of an estate planning and wealth protection business Lambert Group.
