Lead

Integral Diagnostics, one of Australia's largest medical imaging providers, has announced it will conduct an external audit following allegations of improper Medicare billing at a regional public hospital in Western Australia. The company's subsidiary, Apex Radiology, operates the radiology department at Kalgoorlie Health Campus, where concerns have been raised over incorrect billing practices.

The Western Australian health minister has referred the matter to the state's corruption and crime watchdog, according to reports from the ABC. The referral comes after internal documents and emails surfaced suggesting that some services billed to Medicare were not eligible for bulk billing.

Coverage Comparison

Two reports from the ABC, Australia's public broadcaster, have detailed the allegations. Both reports agree on the core facts: Apex Radiology operates the radiology department at Kalgoorlie Health Campus, and concerns have been raised about billing practices that may not comply with Medicare requirements.

The first report focused on an internal memo from Integral Diagnostics, dated June 4, which warned radiologists about signing off on referrals for services that were not eligible for Medicare rebates. The memo stated that such practices "carry significant compliance risks" and instructed radiologists to refrain from co-signing referrals unless directly involved in patient care.

The second report added that the WA health minister had referred the matter to the state's corruption watchdog, and that internal emails showed the company had raised concerns about non-Medicare compliant billing as early as 2022. Both reports noted that the company's managing director, Ian Kadish, denied knowledge of any wrongdoing.

Key Claims

  • Improper billing at Kalgoorlie Health Campus: Both ABC reports state that Apex Radiology, a subsidiary of Integral Diagnostics, operates the radiology department at Kalgoorlie Health Campus, and that concerns have been raised about incorrect billing practices. The allegations include instances of radiologists signing off on referrals to enable Medicare rebates for ineligible services.
  • Internal memo and emails: An internal memo obtained by the ABC, dated June 4, warned radiologists about the compliance risks of co-signing referrals for ineligible services. Internal emails also revealed that the company had previously raised concerns about Medicare rebate issues, and sought legal protection for its staff.
  • Company response: Integral Diagnostics' managing director, Ian Kadish, denied having knowledge of any wrongdoing when approached by the ABC. Company secretary John Merity said the company was "not aware of any billing issue on our part" but would conduct an external audit "out of an abundance of caution."
  • Government involvement: The WA health minister, Meredith Hammat, has referred the matter to the state's corruption and crime watchdog. This follows an earlier statement that a government investigation did not identify any concerns.
  • Billing practices: The ABC reports that some bills for Apex's imaging services are entered into the system by WA Country Health Service (WACHS) staff. An internal WACHS email urged staff to comply with Medicare billing rules and listed examples of improper practices, including incorrect billing codes, double-billing, and charging for services not received.

Perspectives

Integral Diagnostics / Apex Radiology: The company denies knowledge of any wrongdoing and has announced an external audit to confirm there are no billing anomalies. They emphasize that they are cooperating with authorities and taking the allegations seriously.

WA Health Minister and Government: The health minister has referred the matter to the corruption watchdog, indicating a serious concern about potential misconduct. Earlier statements suggested a government investigation had not identified issues, but the referral suggests a shift in position.

WA Country Health Service (WACHS): WACHS staff enter billings for some Apex services. An internal email urged staff to comply with Medicare rules, suggesting awareness of potential issues. WACHS has been contacted for comment but has not yet responded publicly.

Radiologists and Medical Professionals: The internal memo warned radiologists about compliance risks, indicating that individual practitioners may be concerned about their liability. The memo advised them to refrain from co-signing referrals unless directly involved in patient care.

This article is based on reporting from the ABC. Further details may emerge as the investigation progresses.