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.