Fraud prevention and compliance - improve billing practices within public hospitals

This measure will identify and recover Medicare benefits that were incorrectly claimed by health practitioners for services to public patients in public hospitals.

Description of the measure

Services to patients who attend emergency departments of public hospitals are funded by the Australian Government through an arrangement with the states and territories. When these services are also billed to Medicare, health practitioners are 'double dipping'.

The measure is limited to inappropriate billing of diagnostic imaging and pathology services to
non-admitted emergency patients in public hospitals.

This measure began on 1 July 2012 and ends on 30 June 2016. It is being announced in the
2013-14 Budget.

Questions and answers

Who will be affected by this measure?

This measure will affect:

  • public hospitals
  • Local Hospital Networks
  • public hospital practitioners
  • professional bodies representing the practitioners.

When will this measure start and finish?

The measure began on 1 July 2012 and ends on 30 June 2016.

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Page last updated: 9 March 2016

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