Shared Debt Recovery Scheme - public consultation

Overview

The Department of Health (the Department) has a responsibility to protect the integrity of Australia's health payments system through prevention, identification and treatment of incorrect claiming, inappropriate practice and fraud by health care providers and suppliers.

In the 2017-18 Budget, the Government announced that it would be introducing legislation to improve Medicare compliance. When the announcement was made only 20 per cent of Medicare debts raised were being recovered. While the debt recovery rate is now around 40 per cent, stronger powers were needed so that the Government could recover more of the funds overpaid due to incorrect claiming, inappropriate practice and fraud. In addition, different practitioners were subject to different rules for record keeping and different compliance arrangements.

The legislative changes introduced to support the 2017-18 measure include:

• strengthened debt recovery powers, including compulsory setoffs and garnishee notices;
• standardised administrative arrangements across the three Acts governing the provision of Medicare and dental benefits and the supply of pharmaceutical benefits; and
• the introduction of the Shared Debt Recovery Scheme (the Scheme) to address organisational billing of Medicare services.

On 1 July 2018, the Health Insurance Legislation Amendment (Improved Medicare Compliance and Other Measures) Act 2018 (‘the Improved Medicare Compliance Act’) came in to force and gave effect to the first two changes.

The amendments to the Health Insurance Act 1973 (the Act) that introduce the Scheme is anticipated to take effect on 1 July 2019. 

The Scheme and its operation are described in detail in the full consultation paper available below.

Why your views matter

The Department acknowledges that organisations and health practitioners impacted by the Scheme are diverse and operate under various employment agreements, contractual arrangements and business models in distinct environments.

The purpose of this paper is to seek input from organisations, health practitioners and the public to inform the drafting of a legislative instrument which will govern elements of the operation of the Scheme. 

Individual practitioners, organisations as well as the public are invited to respond to this consultation.

The online submission process will close on Thursday 31 January 2019 at 5pm.

If you have any questions about the Scheme, please refer to the "frequently asked questions" (FAQ) document in the Related Documents section below or send us an email at hc.consultation@health.gov.au.

The FAQ document will be updated with more questions provided from stakeholders during the consultation. 

What happens next

Input from this consultation will inform the drafting of a legislative instrument which will govern elements of the operation of the Shared Debt Recovery Scheme.