Medicare Compliance: What providers need to know

Australian Medical Association/AusMed

Have you been contacted by the Department of Health or Medicare about your MBS billing? Here’s what you need to know.

The Department of Health is responsible for protecting the integrity of Medicare payments to health care providers. More than $36 billion is paid each year to more than 140,000 providers and 6,700 suppliers through the Medicare Benefits Schedule (MBS), the Pharmaceutical Benefits Scheme (PBS), the Child Dental Benefits Scheme (CDBS), Practice Incentive Program (PIP) and other incentive payments. It is estimated that two to five per cent of claiming may be non-compliant.

The Department aims to support compliance and prevent non-compliance wherever possible through:

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