AMA submission to the Senate Community Affairs Committee Inquiry into Compliance Audits on Medicare Benefits

30 Apr 2009

The Increased MBS Compliance Audits Initiative announced in the 2008-09 Federal Budget contains measures to further protect the integrity of Medicare by:

  •    increasing the number of audits conducted from 500 to 2,500 per year (at a cost of $76.9m);
  •    expanding the audit program to allied health providers and to better cover specialists;
  •    accessing medical records to administratively verify Medicare billing; and
  •    introducing additional financial penalties for incorrect billing for incorrect claims exceeding $2,500.

Medicare Australia commenced the first and second measures on 1 January 2009.  On 9 April 2009 the government released an exposure draft of the the Health Insurance Amendment (Compliance) Bill 2009 to give effect to the third and fourth measures.

The Senate Community Affairs Committee is undertaking an inquiry into compliance audits on Medicare benefits. The Committee will report to the Senate by 15 May 2009.  Further information about the inquiry can be found at

The AMA submission to the inquiry highlights the AMA's fundamental concerns about how the government’s proposal will compromise the central ethic in medical practice which preserves the privacy of the doctor-patient relationship. The submission also raises concerns about the unnecessary additional red tape burden that the audits and the requirement to produce information impose on doctors.  It highlights the lack of procedural fairness in the application of the proposed financial penalty regime.