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Celebrity surgeon William Mooney under Medicare investigation


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Dr William Mooney, an eastern suburbs surgeon who claims on his website he performs “the highest number of nose jobs in Australia”, is currently the subject of a Medicare investigation into his billing practices.

Surgeon Dr William Mooney.

Surgeon Dr William Mooney.

Fairfax Media has previously revealed that two patients of the prominent ENT [ear, nose and throat] surgeon have died in recent times. The death in December of Alex “Little Al” Taouil, 41, and that of Pouya Pouladian, 24, on March 3 have been referred to the coroner.

Dr Mooney, who has denied any wrongdoing, said in a statement that he was “terribly sorry for Mr. Alex Taouil and Mr. Pouya Pouladian’s passing and the loss to their families.

“Each was a tragedy. But contrary to what the SMH alleges, neither was caused by a complication in my procedure.”

Medical sources have told Fairfax Media that Dr Mooney’s billing practices were flagged for investigation because of the number of Medicare items he was billing for his nose surgeries compared with others in the profession.

Medicare or a private insurance company will foot most of the bill for health-related surgeries, for instance where the person has trouble breathing or has suffered a trauma.

However, where patients elect to have surgery to correct the shape of their nose solely for aesthetic reasons, they cannot claim for that procedure.

Cosmetic surgery has no Medicare item number and the patient has to foot the entire bill.

Dr Mooney, who claims to be “Sydney’s Premiere Rhinoplasty Surgeon”, often appears on Channel Nine discussing the ins and outs of cosmetic surgery.

Industry sources say that Dr Mooney’s Medicare billings attracted attention especially since his practice is largely cosmetic.

“Dr Mooney’s extensive facial cosmetic skills has seen him transform the lives of many individuals, keeping in alignment with their own aesthetic while achieving stunning, subtle and natural looking results,” his website says.

According to medical sources, without any prospect of Medicare or your private insurer paying, this can make the procedure very expensive and therefore less attractive to a patient.

The Department of Human Services can direct a medical practitioner to repay the full amount of the incorrect Medicare benefits that were paid or in some instances recommend criminal proceedings for fraud-related offences.

According to the register of practitioners, Dr Mooney has conditions attached to his registration. While the conditions imposed on a doctor’s registration are “to protect public safety”, says the NSW Medical Council on its website, in this instance the nature of Dr Mooney’s conditions “are not publically available due to privacy considerations”.

A spokesperson for the council said: “Conditions 'which are not publically available' may relate to the practitioner's health or personal circumstances and are therefore confidential in the same way as health information is about any other member of the community.”

Dr Mooney did not respond to a request for comment on the Medicare investigation.

 

 

 

 
 

 

I’ll be honest.

 prior to undergoing rhinoplasty surgery  I had a consult with two surgeons one gave me item numbers the other one didn’t.  

So I had no choice but go with the surgeon who provided me an item number in order for me to claim from Medicare/ Private health insurance.  But I had a little functional airway disruption in my nose but a large percentage was purely aesthetics.

i would caution surgeons who provide item numbers to patient who are wanting rhinoplasty for purely aesthetics reasons as you wouldn’t want to face Medicare as to please explain scenario. 

 

It it can lead you to paying back Medicare or criminal conviction not worth the risk surgeons. 

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4 hours ago, TheFox said:

Agree @cosmetic but it is such a fine line - there are so many patients who have functional problems who probably would not have taken the surgical route but decided too because of the opportunity to aesthetically fix the nose too.

What was the price difference with the medicare/PHI rebate

Back in 2014 both surgeons fees where $9,900.00 for rhinoplasty.  

I got about $4200.00 back from my health fund/ Medicare.

I’m in a good health fund hence why the larger rebate other health funds/ Medicare  if lucky would only get about $1,000 - $2,000 back. 

When I looked online and saw what was charged to my health fund/ Medicare I caculated the total  being close to $16,000.00 so a savings about $11,000.00 with rebates!

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14 minutes ago, cosmetic said:

Back in 2014 both surgeons fees where $9,900.00 for rhinoplasty.  

I got about $4200.00 back from my health fund/ Medicare.

I’m in a good health fund hence why the larger rebate other health funds/ Medicare  if lucky would only get about $1,000 - $2,000 back. 

When I looked online and saw what was charged to my health fund/ Medicare I caculated the total  being close to $16,000.00 so a savings about $11,000.00 with rebates!

wow that is significant

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