The report has also urged the federal government to consider a ''national framework'' for the rehabilitation of all workers injured on the job to replace the fragmented state and territory-based approaches in place.

The federal government has published the study by former Defence Department boss Allan Hawke, which forms part of a broader review of the $1.2 billion scheme that insures 218,000 public servants and another 164,000 private-sector workers.

The review has made 147 recommendations to rewrite Comcare's legislative framework in an effort to modernise the 25-year-old scheme, and rein in the costs of the taxpayer-funded insurer, which lost more than $500 million in 2011-12.

With the lifetime cost of more than 10,000 ''open'' claims in the federal and ACT public service estimated at more than $2.6 billion, Dr Hawke identified ''cost leakage'' through payments for inappropriate medical care.

He wrote that the insurer's clinical panel, established in 2011 with the power to intervene in the treatment of workers claiming benefits, had produced some results and had made changes in 87 per cent of the 476 cases it examined last year.

''Despite these successes, progress has been slow,'' Dr Hawke wrote. ''Given Comcare has over 10,000 open premium claims, there is a need for quicker review.

''There is also a need to introduce more disciplines in the clinical panel to review other types of treatment.''

The broader review, ordered last year by Workplace Relations Minister Bill Shorten, cited a case of taxpayers paying nearly $30,000 for massage therapy that had ''no curative effect'' and another of a Brisbane bureaucrat flown to a Buddhist meditation retreat in Alice Springs to treat his anxiety disorder.

Comcare has also moved to tighten its medications policy to stop unscrupulous pharmacists profiteering or taxpayers' funds being used to support drug habits. Dr Hawke has also called for the government to tackle the ''complex task'' of a national uniform approach to rehabilitation with an Australia-wide framework, which he believes would provide more options for the return to work of injured employees. Among Mr Hawke's other recommendations to improve the long-term financial health of Comcare, the minister was urged to lift a ban, imposed by the federal government in 2007, on any more private-sector entrants into the scheme.

Mr Shorten said the moratorium, imposed to appease states and territories that feared a private sector exodus from their own workers compensation schemes, would stay in place until a deal was struck on national health and safety laws still being resisted by two states.

''Victoria and Western Australia have, to date, refused to bring their systems into line with the rest of the country,'' Mr Shorten said.

''In the absence of co-operation from all states, the government must consider the continuation of the moratorium placed on national employers joining the Comcare scheme.''