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EDITORIAL
Online Early

Questionable evidence and argumentation regarding alleged misuse of Medicare

Jeffrey C. L. Looi https://orcid.org/0000-0003-3351-6911 A B * , Stephen Allison https://orcid.org/0000-0002-9264-5310 B C , Tarun Bastiampillai https://orcid.org/0000-0002-6931-2913 B C D , Paul A. Maguire https://orcid.org/0000-0001-5002-9918 A B and Stephen J. Robson https://orcid.org/0000-0003-2752-4309 E F
+ Author Affiliations
- Author Affiliations

A Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Building 4, Level 2, PO Box 11, Canberra, ACT 2605, Australia.

B Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia.

C College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.

D Department of Psychiatry, Monash University, Wellington Road, Clayton, Vic, Australia.

E Department of Obstetrics and Gynaecology, The Australian National University Medical School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia.

F Australian Medical Association, Barton, Canberra, ACT, Australia.

* Correspondence to: jeffrey.looi@anu.edu.au

Australian Health Review https://doi.org/10.1071/AH24168
Submitted: 19 June 2024  Accepted: 1 July 2024  Published: 15 July 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

What is known about this topic? We discuss a recently published paper that alleges clinicians are causal agents of non-compliant billing of Medicare. What does this paper add? The paper’s arguments are partially supported by unreferenced assertions, potential logical fallacies, inaccurate reporting of referenced material and unsubstantiated rhetoric. What are the implications for practitioners? Due to the lack of substantive evidence, it cannot be concluded that clinicians are the causal agents of non-compliant billing of Medicare.

References

1  Ryan JB. Lessons from the ‘legitimate’ misuse of Medicare Benefits Schedule Item 45503. Aust Health Rev 2024; 48: 254-258.
| Crossref | Google Scholar | PubMed |

2  Cliff E, Berquist T. Medicare rorts? We read Dr Faux’s thesis so you don’t have to. 2022. Available at https://insightplus.mja.com.au/2022/41/medicare-rorts-we-read-dr-fauxs-thesis-so-you-dont-have-to/ [accessed 12 June 2024].

3  Looi JCL, Allison S, Maguire PA, et al. Medicare fraud claims unsubstantiated. 2022. Available at https://www.ama.com.au/act/publications-and-resources/canberra-doctor/issue-4-2022 [accessed 12 June 2024].

4  Philip P. Independent Review of Medicare Integrity and Compliance. 2023. Available at https://www.health.gov.au/resources/publications/independent-review-of-medicare-integrity-and-compliance?language=en [accessed 12 June 2024].