Purely cosmetic procedures like botox, tummy tucks and boob jobs are not covered by Medicare. But this hasn’t stopped cosmetic surgeons from illegally billing them, at times by convincing clients to have procedures they definitely don’t need. Like this Melbourne woman, who underwent a full labiaplasty with devastating effects after her surgeon talked her into one.
Janine Kepert attended a consultation at NorthEast Plastic Surgery in Melbourne for a breast reduction because of her neck and back pain. She ended up undergoing the breast reduction and a full medical labiaplasty in 2018 which left her mutilated.
“It’s been amputated. I’ve had everything sliced off,” she told ABC’s 7.30.
A bombshell new investigation by the ABC, The Sydney Morning Herald and The Age has revealed the sneaky ways cosmetic surgeons illegally claim Medicare rebates on medically unnecessary procedures.
Janine said that during her consultation, the surgeon asked her if there was “anything else” she wanted to get done.
“I had some inflammation of my labia and I asked them to have a look at that. They also tried to talk me into doing a tummy tuck. I think the term they used was ‘mummy makeover’,” she said. Ah yes, shame the single mum about her body so she can spend $$$ getting it fixed to standard,
“That’s the cosmetic industry … you go in for one thing and they tell you there are other problems that don’t exist,” she said.
“But you leave there thinking, ‘I need this mummy makeover’.”
Janine said she was told that the more procedures she had done, the greater the discount. She eventually agreed to having the labiaplasty as well as the breast reduction after she was assured it was a “minor procedure” which would only remove a small amount of her labia tissue.
Instead, she ended up having nearly all her external genitals removed. The surgery resulted in a “permanent injury” where she lost sexual function of her external sex organs and now she suffers from incontinence.
How TF does this even happen?
Janine took legal action against the plastic surgeons who oversaw her procedure and as part of the legal process she was assessed by medical examiners.
One of them identified that the surgeon had incorrectly filled out Medicare billing in relation to her labiaplasty. A letter tendered as part of her legal proceedings said the item number referenced in the bill for her labiaplasty was “intended to deal with surgical repair of female genital mutilation or a major congenital anomaly … not covered by excising MBS items”.
“I doubt Ms Kepert was suffering from any of these conditions,” it said.
Which implies Janine underwent a medical labiaplasty so it could be rebated, as opposed to a cosmetic one.
Medicare expert Dr Margaret Faux also had a look at the Medicare records and agreed there was some dodgy billing going on.
“It was particularly horrendous for Janine because her surgery ended up actually inflicting that precise mutilation on her,” she said.
Dr Faux recently completed a PhD in Medicare and said the cosmetic surgery industry was the worst offender when it came to wrongly claiming things on Medicare. She previously told the ABC that around 30 per cent of Medicare’s yearly budget — so about $8 billion — is lost every year because of fraud, errors or waste.
Dr Sugitha Seneviratne, the cosmetic surgeon named in the billing, has strenuously denied any negligence.
“We all pay for Medicare through our taxes. And what we’re seeing at the moment is signs of system failure everywhere. We’re seeing ambulances ramping, public hospitals can’t cope, general practices in tatters. It’s all part of the same problem.” – Dr Margaret Faux #abc730
— abc730 (@abc730) October 17, 2022
In March this year, a medical panel determined Janine had suffered a serious and permanent injury and she reached a settlement in August.
However, she wants to warn other people about the risks of cosmetic procedures, especially at a time when dodgy billings are rife and the industry can be predatory.
“This insidious practice is happening under a veil of secrecy, injured women are unlikely to come forward due to [the] intimate and sensitive nature of the injury,” she said.
“Female genital surgery should only ever be for medical reasons.”