What a compliance debt is
A compliance debt is what you owe us if you received a payment for a claim you made that does not meet all the requirements of the:
- Medicare Benefits Schedule (MBS)
- Pharmaceutical Benefits Scheme (PBS)
- Child Dental Benefits Schedule (CDBS)
- Practitioner Incentives Program (PIP).
You are legally responsible for repaying any such payments made to you and may have to pay an additional penalty.
Administrative penalties
We can apply administrative penalties to unpaid debts. The amount depends on if and when you tell us about an incorrect payment. A penalty may apply to any amount owing (the debt accrued). However, no penalty will apply to voluntary acknowledgements.
Civil penalties
A civil penalty is like a fine. The Federal Court can impose a penalty on an individual or corporation who:
- is responsible for documents relating to claimed services
- did not provide the service themselves
- has not complied with a notice to produce documents
- has seriously breached the prohibited practices provisions.
When a debt can be raised
You will have a compliance debt to us if you receive a payment for a claim that does not meet all legal requirements, whether it happened on purpose or by accident.
How you will know you have a debt
You might realise you received an incorrect payment, in which case you should make a voluntary acknowledgement as soon as possible.
We might also find incorrect payment through our routine compliance activities. In these cases, we will contact you.
Shared Debt Recovery Scheme
You can request for your debt to be split with the person who manages your billing and claiming under the Shared Debt Recovery Scheme, if you think this person is responsible for the incorrect claim.
How to pay a compliance debt
We will send you an invoice for the amount to be repaid within 28 days. You have various payment options. Make sure you include the invoice, reference number and account number when making a payment.
Failure to pay
If you are unable to repay the debt in full by the due date, contact us as soon as possible. We can consider other options to help you pay your debt.
If you don’t contact us and haven’t paid the full invoice amount by the due date, we can:
- apply interest charges to your debt
- set off the debt against your future payments
- issue information-gathering notices to third parties to ascertain your location and financial information
- garnish amounts from people who owe you money
- initiate legal action.
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