Independent review into Medicare compliance

The Albanese Government has appointed respected health economist Dr Pradeep Philip to conduct an independent review into the integrity of Medicare and its compliance mechanisms.

The Hon Mark Butler MP
Minister for Health and Aged Care

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The Albanese Government has appointed respected health economist Dr Pradeep Philip to conduct an independent review into the integrity of Medicare and its compliance mechanisms. 

As the Lead Partner at Deloitte Access Economics and a former Secretary of the Department of Health and Human Services in Victoria, Dr Philip has a long history working at the highest levels of public policy in Australia. 

A 2020 Australian National Audit Office (ANAO) report estimated the value of Medicare non-compliance at between $366 million and $2.2 billion a year. 

The independent Philip Review will assess the possible value of fraudulent, non-compliant or over servicing risks in Medicare and provide a methodology and evidence-based estimate of the likely value of non-compliance in Medicare. 

More than 500 million Medicare services are delivered each year totalling around $32 billion in government spending. 

After nine years of cuts and neglect, the review comes at a time of great pressure on the health system in Australia. 

Dr Philip will provide an interim report to the Government by 31 January 2023, with the final report to be submitted by 28 February 2023. 

Quotes attributable to Minister Butler:   

“Australians are rightly proud of Medicare and of the committed group of doctors and other health professionals who deliver Medicare services.” 

 “Australians know that the overwhelming bulk of Australia’s doctors and health professionals are honest, hardworking and comply with Medicare rules. But they also understand that, after nine years of cuts and neglect, every dollar in Medicare is precious and must be spent directly on patient care.” 

“My Department has provided a report on the existing compliance efforts, along with a rundown of the various estimates on the scale of the problem from the ANAO and others.” 

“The report found no evidence of the $8 billion in Medicare fraud and inappropriate billing estimated by Dr Faux.”  

“I’ve asked Dr Philip to measure and report on the true extent of non-compliance in Medicare and identify fixes to protect the integrity of the system, for all who use it.” 

“All governments must apply strict compliance standards to any publicly funded system - including Medicare - to ensure that the small minority that do the wrong thing are picked up quickly and dealt with.” 

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