Health Payment Compliance Reports and Consultations

This page contains historical reports and consultations relevant to health payment compliance.

Page last updated: 29 August 2018

Health Payment Compliance Reports and Consultations

Current Reports and Consultations

There are no reports or consultations open for comment. Please check this page regularly for the opportunity to have your say.

Historical Reports and Consultations

Improving Medicare Compliance

Submissions on the Improving Medicare Compliance consultation paper closed on Sunday 8 October 2017.

PDF version: Consultation Paper: Improving Medicare Compliance (PDF 84 KB)
Word version: Consultation Paper: Improving Medicare Compliance (Word 155 KB)

Reviews and Reports

Fraud prevention and compliance – Increased billing assurance for the Medicare Benefits Schedule

The 2012-13 Budget measure, ‘Fraud prevention and compliance – Increased billing assurance for the Medicare Benefits Schedule’ (the Large Practices Project), was implemented over a three-year period from 1 July 2012 to 30 June 2015. The Budget measure was proposed in recognition of the Medicare compliance challenges associated with the changing nature of health practice, from small owner-operated medical practices to larger business enterprises. The objectives of the project was to understand and address compliance challenges for large health practices in billing accurately under Medicare.

PDF version: Fraud prevention and compliance – Increased billing assurance for the Medicare Benefits Schedule (PDF 6400 KB)
Word version: Fraud prevention and compliance – Increased billing assurance for the Medicare Benefits Schedule (Word 5427 KB)

Fraud prevention and compliance – Improve billing practices within public hospitals’ Budget measure

The ‘Fraud prevention and compliance – Improve billing practices within public hospitals’ Budget measure (known as the Inappropriate Billing Project ) was implemented over a four year period from 1 July 2012 to 30 June 2016. The aim of the project was to review, understand and address inappropriate billing of Medicare by hospital emergency departments for pathology and diagnostic imaging services. In late 2014, the scope of the project was expanded to include education and compliance interventions for a broader range of topics related to claims to Medicare in public hospitals. There was also a need to explore whether legislative amendments are required to resolve operational issues with undertaking compliance interventions in the public hospital sector.

PDF version: Fraud prevention and compliance – Improve billing practices within public hospitals’ Budget measure (PDF 1432 KB)
Word version: Fraud prevention and compliance – Improve billing practices within public hospitals’ Budget measure (Word 1215 KB)