Supporting and ensuring Medicare compliance

We are accountable for payments made under Medicare programs. Our role is to ensure that health professionals comply with program requirements.

We focus on prevention and early intervention. We educate and support health professionals, often in partnership with peak bodies and stakeholders. We also give tips that may help you lower the risk of incorrect billing under Medicare.

Our monitoring and data matching activities help us to find possible incorrect billing, inappropriate claiming and fraud. If we look into the data further, we may do audits and investigations. We may refer cases for a professional review.

Initiatives and programs

We offer a range of support services and education resources to help you meet your compliance goals:

Peak body engagement

Peak bodies are not-for-profit non-government organisations. Many practising health professionals are members of these peak bodies. We try to get as much information to Australia's healthcare practitioners through the peak bodies they subscribe to as we can.

Last updated: 
9 June 2021

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