US laws to catch healthcare frauds could net $1 billion

THE Federal Government could raise up to $1 billion by introducing US-style laws that financially reward whistleblowers for speaking up on fraudulent practices within the medical and pharma­ceutical industries, medico-legal experts have argued.

Under US laws, whistleblowers and legal firms who bring law suits can be awarded up to 30% of damages recouped by the Federal Government from healthcare companies or providers successfully prosecuted for making fraudulent and false claims.

Such activities can include billing for goods and services never delivered or misrepresenting the true wholesale price of prescription medications.

In Australia, such a scheme could include any fraudulent claims made by pharmaceutical companies to secure PBS pricing or product sales.

The proposal was put forward in the most recent MJA, and co-author Associate Professor Thomas Faunce, senior lecturer at the Australian National University, said most fraudulent