Government has raised concerns over “unethical billing” by some healthcare providers under the free General Practitioner Partnership Programme (GPPP) and related health schemes.
Finance Minister Esrom Immanuel told Parliament yesterday that verification checks had uncovered irregular claims and non-compliance issues among some service providers.
“So, what I can say is there is unethical billing happening,” Mr Immanuel said.
He said the ministry had identified cases where clinics allegedly charged for both consultations and reviews on the same day, submitted multiple ECG claims, and billed for services outside agreed terms.
“This practice is non-compliant with the service agreement and constitutes unethical billing.”
Mr Immanuel also told Parliament that some providers had submitted consultation charges linked to pre-arranged procedures such as ultrasound scans, which he said were not separately claimable.
He said the findings came through routine verification checks designed to ensure only legitimate claims were processed under the scheme.
“Approximately 20-25 per cent of invoices are returned each week due to inaccuracies in the stated fees.”
He added that anomalies identified in claims processing had also contributed to delays in payments to some providers under the scheme.
He noted that general practitioners had been paid up to February 15 this year, while laboratory and dental providers had been paid up to March 22.
However, he said the Government remained committed to meeting its financial obligations.
“These delays are not due to a lack of commitment by the Government to honour its financial obligations.”
He said payments under the scheme total about $33.2million, covering more than 688,000 patient visits for 162,000 registered Fijians.
Mr Immanuel said Government was now reviewing the program, including possible restructuring and tighter oversight of billing practices.
