If you suspect someone may be committing fraud against Centrelink, Medicare or Child Support, you can report it.
We understand the majority of people are honest and do the right thing. However, there are a small number of individuals who receive money for which they aren’t eligible, or abuse the services we provide.
Types of fraud
Fraud occurs when someone acts dishonestly with deliberate intent to gain a financial advantage from the health and social welfare systems. Our fraud control processes focus intelligence and investigative activity on the most serious cases of non-compliance, rather than people making honest mistakes.
Welfare fraud may include:
- claiming a welfare benefit using a false identity or in the identity of another person
- providing false or misleading information
- failing to disclose information, for example not disclosing income from paid employment or assets
- not advising living with someone as a member of a couple
- undeclared or undisclosed assets
- continuing to receive welfare benefit after a person has died
- failing to notify of permanent or temporary absences from Australia while in receipt of payments
Health program related fraud may include:
- making Medicare claims for services not provided
- using someone else's Medicare card
- using an invalid concession card
- forging prescriptions for Pharmaceutical Benefits Scheme (PBS) medicines
- making PBS claims for medicines that weren’t provided
- swapping PBS prescription medicines for other pharmacy items or goods
- taking or sending PBS medicine overseas that isn’t for your personal use or the personal use of someone travelling with you
Child support fraud
Child support fraud may include:
- either parent making false or misleading statements, deliberately omitting or under declaring income or assets
- an employer dishonestly advising that a payer isn’t employed by them despite regular payments being deposited into the payer’s account from the employer
- a payee claiming a child is in their care when this isn’t the case
- use of false names or documents such as statutory declarations, payslips or bank statements
- employee and employer collusion – that is where it appears an employee and employer are working together to disrupt, minimise or avoid making child support payments
How to report fraud
If you suspect someone is committing health or social welfare fraud, and you want to report it:
- you don’t have to give us your name if you prefer to remain anonymous
- complete as much of the relevant form as you can
- be specific with your answers, as this is more helpful for our review processes
- don’t worry if you can’t give answers to all the questions
- we will keep everything you tell us confidential
If you want to print the form, keep it safe and private.
Reporting suspected fraud
For health program related fraud you will need to fill out a paper form.
You can also report suspected fraud by calling our fraud tip off line. Before calling, make sure you find somewhere private and safe so the information you provide is confidential. Call 131 524, Monday to Friday, 9.00 am to 4:45 pm AEST excluding South Australian public holidays.
What we do with information about suspected fraud
Specialist officers assess every fraud allegation.
We understand you may want to be informed of the progress and result of information you provided. However, we are unable to release any details about the progress of our activity due to the secrecy provisions in the laws we are bound by including the Privacy Act 1988.
You may not see or be aware of obvious changes to someone’s payments or situation following our investigations. However, it’s important to know all information reported to us about suspected fraud is dealt with appropriately.
There are times where the information you provide does not result in a change in a person’s payment, or any further action is being taken. For example:
- the person you name isn’t receiving a welfare or child support payment
- we are unable to identify the person or health professional, usually due to a lack of detailed information in the allegation
- the information provided may not be relevant to the payment the person is receiving
- the information provided is found not to be consistent with the person’s circumstances
Not all incorrect payments are a result of fraud. Sometimes incorrect payments can result from someone making an accidental oversight, error or misunderstanding when filling out forms or providing us with information. However, where an incorrect payment occurs, it must be repaid.
The matter may be referred to the Commonwealth Director of Public Prosecutions when the investigation identifies sufficient evidence of criminal behaviour.