Notice of Medicare compliance activity - claiming MBS services while overseas

The Department of Health and Aged Care (the department) is responsible for ensuring the integrity of Australian Government health program payments.

We are undertaking a compliance activity that may affect some of your members. We have identified providers claiming for Medicare Benefits Schedule (MBS) services while overseas. This type of claiming breaches Section 10 of the Health Insurance Act 1973. The Act states that Medicare benefits are only payable for professional medical services provided in Australia, to an eligible person.  

This activity involves data matching Department of Home Affairs movement records to MBS claiming data. Read more about data matching.

the Department will be sending letters asking recipients to review their claiming as well as undertaking audits. Read more about the MBS audit process.

Yours sincerely,

Chris Lake

Acting Assistant Secretary

Compliance Risk and Provider Engagement Branch

Benefits Integrity Division