Important changes were introduced on 1 July 2018 to help the department ensure that Medicare is serving the needs of Australian patients. These changes amended various sections of the Health Insurance Act 1973 (HIA), Dental Benefits Act 2008 and National Health Act 1953.

From 1 July 2018 the key changes to the HIA include:

• A new requirement to keep records for a minimum of two years including referrals and documents created as a condition of claiming an MBS item.


• The department can issue a Notice to Produce as part of a compliance activity, which requires you to produce documents relating to items claimed. Before issuing the notice, the department must first provide an opportunity for you to respond to compliance concerns and provide substantiation of claims.


• Financial administrative penalties can be applied to a debt of more than $2500 if substantiating documents are not provided, or not provided within the required timeframe.


• Improved debt recovery mechanisms that allow the department to offset or deduct a debt owed from amounts payable to the debtor or to garnishee debts from a debtor’s bank account.


• From 1 July 2019 the Shared Debt Recovery Scheme will commence and will allow the department to hold an employing organisation responsible for a portion of debts incurred as a result of incorrect Medicare claiming. The one-year delay in the scheme’s introduction allows for consultation with peak bodies to generate regulations under which the scheme will operate.


• To assist in this, information about a health professional’s employer or contracting organisation will now be required when applying for a provider number.

For more information visit health.gov.au/health-compliance or email compliance.stakeholder@health.gov.au.