The National Compliance Program
Medicare Australia’s National Compliance Program 2008–09
Medicare Australia’s National Compliance Program 2008–09 [PDF, 41Kb]
is now available.
In developing this year’s Program we have spoken with key stakeholders to better understand the issues and circumstances facing the health care sector. We will continue to stay in contact with providers and industry stakeholders and will publish updates on compliance outcomes and achievements.
The Program is intended to inform providers and industry stakeholders about what they can expect from us and where we will focus our compliance efforts. It details our compliance approach which includes an appropriate mix of education, support, deterrence and enforcement to encourage high levels of voluntary compliance.
Our commitment to building a compliance culture, our compliance philosophy and our major initiatives for the year ahead are also key aspects of the Program. The document explores our commitment to:
- ensuring the right person receives the right payment at the right time—no more, no less
- creating a culture of voluntary compliance by providing high quality, accessible education and information products and services to support providers to ‘get it right’
- dealing with noncompliance appropriately and proportionately, with responses ranging from education and counselling through to recovery of payments, suspension and criminal prosecution
- pursuing all instances of fraud and deliberate noncompliance.
The Program sets out the strategic risks impacting on compliance behaviour that we need to understand and manage. The following five risks have been identified in consultation with industry stakeholders:
- Increasing complexity.
- Growth of services and provider groups.
- Changes in practice.
- eBusiness impacts.
- Community demand.
Information sheets
For information on Medicare Australia's compliance information sheets please see Medical Practitioner - Helpful Fact Sheets.
Targeted compliance audits are specific, in-depth reviews aimed at confirming compliance with the appropriate legislation or benefit schedules. They are part of a number of strategies applied to address threats or abuse against the various programs administered by Medicare Australia. Audits are conducted by Medicare Australia program review staff in consultation with professional advisers.
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Last updated: 25 August, 2011