- About Medicare compliance
Our compliance program helps to ensure all Medicare claims are correct and legitimate. This helps keep our healthcare system sustainable and ensures we remain accountable to Australian taxpayers for payments we make under Medicare. - Our Medicare compliance approach
We are accountable for payments made under Medicare programs. We support health practitioners to comply with Medicare requirements, with a focus on prevention and education. We review and audit health practitioners’ claims to make sure they are legitimate. - How to comply with Medicare obligations
As a health practitioner, it is your responsibility to comply with Medicare obligations. It’s important to do the relevant training and understand the requirements and laws that apply. We provide lots of education and support to help you meet your obligations. - Current Medicare compliance activities
We recognise that most non-compliance is accidental, and we work with providers to resolve issues and promote good compliance practices. Find out more about our current activities. - Online Compliance Platform
The Online Compliance Platform (OCP) is a secure digital portal for health providers. If we contact you about certain Medicare compliance activities, we may also invite you to use the OCP. You can use it to self-review your Medicare claims, identify any potential errors and respond to us online. - Voluntary acknowledgement of incorrect payments
If you think you've incorrectly claimed a Medicare or practice incentive payment, you must let us know as soon as you can. You can do this by submitting a voluntary acknowledgement of incorrect payments form. - Non-compliance debts and penalties
You must repay any incorrect payments made to you under Medicare. You might also have to pay additional penalties. How you work with us can decrease or increase any penalty amount. - Reporting incorrect billing, claiming, or suspected fraud
We protect the integrity of health programs by making sure that correct payments are made for the right services. If you think a doctor or pharmacist has charged you, or claimed for, a service or product you didn’t receive, let us know here.
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