Aged Care Sector Hits Back Over False Claim Allegations
17 December 2015 at 10:10 am
The aged care sector has taken the Federal Government to task over claims that service providers were making false funding claims resulting in some media reports alleging that they were “rorting” the subsidy system.
The stoush followed the Turnbull Government’s Mid-Year Economic and Fiscal Outlook (MYEFO) in which it announced a stronger compliance regime, including tough new fines and better-targeting of funding, to protect what it described as “the integrity of Australia’s residential aged care sector”.
Minister for Aged Care Sussan Ley said that, for the first time, fines would be introduced for aged care providers caught making repeated false claims under the government’s $10.6 billion Aged Care Funding Instrument (ACFI), which directly subsidised providers to deliver care services for residents based on their level of need.
But the Not for Profit aged care peak body, Aged and Community Services Australia (ACSA), said that as a result of the Minister’s statement it was “appalled” to see media reports claiming service providers were allegedly “rorting” or being “fraudulent” in their subsidy claims.
“There is absolutely no evidence that this is the case. I would be very surprised if anyone was fined in the future,” acting ACSA CEO, Illana Halliday, told Pro Bono Australia News.
“We are all for going after people doing the wrong thing. What aged care providers have been doing is maximising funding to care for an increasingly frail ageing population using the current process which is not illegal. They are just finding ways to ensure there is sufficient funding to care for residents properly.
“Governments have consistently refused to undertake a cost of care study to examine how much it actually costs to deliver quality aged care covering all inputs and locations across Australia, so there is no evidence current funding actually covers the cost of care delivery.
“We have never supported anyone misusing the Aged Care Funding Instrument and in the face of allegations of misuse, we called for increased scrutiny. However, data has never been provided to us by the Government to support the alleged misuse and patterns of where it is occurring.”
ACSA had initially called on Minister Ley’s office to provide a retraction to the media. Halliday told Pro Bono Australia News that after speaking to the Minister and expressing her “very extreme concern”, she was no longer demanding a retraction.
Minister Ley said the new measure responded to figures showing as many as one in eight of the 20,000 ACFI claims audited last year (2014-15) were deemed to be incorrect or false.
She said this figure was already tracking even higher at one in seven in 2015-16.
“At the same time there was an unexpected $150 million overspend in the ACFI last year,” she said.
Ley said the fine would be worth $10,800 per offence to ensure it had “teeth” and would also be supported by stronger auditing, better education and targeted funding for certain high claims for complex health care services to ensure they were reserved for those residents with the highest needs.
She said the MYEFO measure was estimated to save taxpayers more than $500 million, including reducing the number of incorrect or false claims by a further $60 million over the next four years.
“Unfortunately we’ve seen a concerning number of incorrect claims and unaccounted-for growth in spending in complex health care creeping into the system in recent years,” she said.