Doctor avoids jail despite $318,000 Medicare fraud
Date published
October 2023
Relevant impacts: Financial impact, human impact, reputational impact, and business impact
A Melbourne doctor has avoided prison after lodging false Medicare claims. The 78-year-old used the personal details of 330 patients that he had obtained while employed as a general practitioner at several clinics across Melbourne.
The false Medicare claims were made between 2011 and 2016, and related to more than 5000 medical services provided from his private home and a derelict office building.
The doctor was sentenced to 3 three years in prison, which was suspended on the condition of an 18-month good behaviour bond.
Related fraudster personas
Related countermeasures
Confirm the identity or attribute of the individual.
Evidence of identity should be collected and verified using policies, rules, processes and systems to make sure only known, authorised identities can gain access to information stored in networks and systems.
Verify any requests or claim information you receive with an independent and credible source.
Make sure forms or system controls require mandatory information to support claims or requests.
Fraud detection software programs automatically analyse data to detect what is different from what is standard, normal or expected and may indicate fraud or corruption.
These are penalties for customers, staff or third parties that commit fraud or do not comply with rules, processes and expectations.
Match data with the authoritative source and verify relevant details or supporting evidence.
Services such as the Identity Matching Service can be used to verify identity credentials back to the authoritative source when the information is an Australian or state and territory government issued identity credential.
This countermeasure is supported by the Office of the Australian Information Commissioner's Guidelines on data matching in Australian government administration.
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