The Department of Health conducts program audits to check practices are complying with the PIP eligibility requirements for payments including the Procedural GP Payment.

This may include practice visits or a review of practice documents.

If your practice is unable to provide information to substantiate your eligibility and claims for incentives, Health may recover past PIP payments for up to 6 years.

Evidence of eligibility may include:

  • copies of public liability insurance including amount covered
  • copies of a practitioner’s professional indemnity insurance that shows cover to perform procedural services
  • confirmation of details contained in the annual confirmation statements
  • documents showing the GP’s procedural activity and volume has met the requirements of the relevant payment tier
  • evidence of the GP’s after hours commitments.

Copies of the evidence should be kept on practice files.

If a practitioner leaves a practice and an audit is conducted for the time the practitioner was there, a practice will still need to provide evidence that the professional indemnity insurance was maintained during their employment.

Page last updated: 31 October 2019