MBS update: Department of Health and Aged Care
Date published:
19 Feb 2024
The Department of Health and Aged Care has contacted the College with an important update for members.
The Department of Health and Aged Care (the department) is responsible for ensuring the integrity of Australian Government health program payments. The department if undertaking a compliance activity that may affect RACP members.
The department routinely conducts data matching of Medicare Benefits Schedule (MBS) claiming data against a variety of datasets to identify possible incorrect claiming, inappropriate practice and fraud. Further information about data matching for compliance purposes can be found at www.health.gov.au by following the links Home > Resources > Publications > Data matching Notice – Data matching for Medicare compliance purposes.
The department has identified health providers claiming for MBS services, including telehealth services, while they are overseas. Section 10 of the
Health Insurance Act 1973 sets out that Medicare benefits are only payable for professional medical services rendered in Australia, to an eligible person. The department intends to implement an audit program to address this claiming behaviour.