Compliance support
We have a range of supports to help providers comply with program requirements including:
- web content
- our Compliance Monitoring and Support Framework
- our online portal
- the Schedule of Service Items and Fees
- provider resources and notices
- our contact centre.
Compliance checks
We check that providers are meeting their obligations.
Contracting compliance
When you apply to become a provider for the Hearing Services Program, we will check your application against the program’s requirements. If we approve your application, you will receive a contract with the Department of Health and Aged Care. We will also provide you with information about meeting the program’s requirements.
Self-assessment
Providers must do an annual self-assessment, using our self-assessment tool (SAT) (on Citizen Space). This gives you an opportunity to:
- review your policies, procedures and systems to make sure they are in line with program requirements
- identify opportunities for improvements.
We will remind you each year when it is time to complete your self-assessment.
Read our provider SAT outcomes report.
Complaints
As part of dealing with complaints against providers, we also consider compliance with the program requirements.
You can find out more about the complaints policy and processes.
Claim reviews
We regularly review provider claims to make sure they are accurate. If we find potentially incorrect claims, we will let you now and you will have 10 days to review the identified claims. You must reimburse incorrect claims to the program.
Read our claims review guide.
Audits
We audit providers to make sure they’re complying with program requirements, either through:
- targeted audits – for providers that are at higher risk of compliance issues. We base this on claiming data analysis, claims audits, complaints and other risk signals
- random audit – for randomly selected providers.
Audits can be either:
- general – covering all program requirements
- limited scope – focusing on a specific requirement such as the minimum hearing level threshold or refitting.
We will work with providers to rectify any issues we identify in an audit. We may require providers to reimburse claims or clients or implement other actions to fix issues.
If we identify serious issues, we may conduct follow-up audits or refer to the departmental fraud area. We might do a check-up 3, 6 or 12 months after the end of an audit. This helps make sure the provider is implementing the agreed strategies to address non-compliance.
If there are risks to client safety or program integrity, or there is evidence of fraud, we will take further compliance action.
Read our audit guide.
Read our 2024 Compliance Update.
Reconsiderations and appeals
If you disagree with a decision we have made, you may be able to request a reconsideration.
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