Department assists in health professional compliance


9th October 2018

While the vast majority of Medicare providers do the right thing, the Department of Health has a role in ensuring that health professionals comply with the requirements of the Medicare Benefits Scheme (MBS) and other Medicare programs such as the Prescription Benefits Scheme (PBS) and incentive payment programs. This ensures that Medicare is serving the needs of Australian patients. 

The Department has a strong program that protects Australia’s health payments system through the prevention, identification and treatment of incorrect claiming, inappropriate practice and fraud by health care providers and suppliers. 

The Department continues to improve Medicare compliance arrangements by: 

  • using data analytics to better target compliance activities 
  • better targeting fraud, inappropriate practice and incorrect claiming investigations 
  • assessing all tip-offs received as indicators of previously unknown compliance issues  
  • using better debt recovery mechanisms and practices 
  • using behavioural economics-driven approaches 
  • making available education support resources for health professionals. 

Source: http://www.health.gov.au/internet/main/publishing.nsf/Content/health-compliance 


Website: Department of Health

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