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Report Fraud

Each year millions of dollars of taxpayers' money is lost due to fraud against health and welfare services and payments.

The Australian Government Services Fraud Tip-off Line provides people with a place to report suspected fraud against Centrelink, Medicare, the Pharmaceutical Benefits Scheme or the Child Support Agency.

Most people are honest and use government services fairly, but if you have information about someone misusing these services, please contact us.

You can remain anonymous, and the information you provide will assist in ensuring the services support those who really need them.

Call the Australian Government Services Fraud Tip-off Line on 131 524*.

What is fraud?

Fraud is dishonestly obtaining a benefit by deception or other means.

Examples of suspected fraud against Medicare Australia programs

  • making Medicare claims for services that were not provided
  • using someone else's Medicare card
  • using an invalid concession card
  • forging prescriptions for PBS medicines
  • making PBS claims for medicines that were not provided
  • swapping PBS prescription medicines for other pharmacy items or goods
  • taking or sending PBS medicine overseas that is not for your personal use or the personal use of someone travelling with you.

How to report suspected fraud against Medicare Australia programs

You can report suspected fraud by:

or fax to: 02 9895 3325

You are under no obligation to provide your name when giving us information.

How to report suspected Diagnostic Imaging (DI) or Pathology prohibited practice

This form is approved by Medicare Australia as a means to satisfy legal reporting requirements in Part IIBA of the Health Insurance Act 1973, which may protect persons from criminal prosecution or being subject to civil action under that Act.

You should complete this report form if you are a requestor or provider of DI or pathology services and you have knowledge of any of the following prohibited conduct.

  • You are a requestor who knows that a person connected to you asked for or accepted a benefit from a provider or a person connected to a provider, and the benefit would be likely to induce requests for services – see subsection 23DZZIK(3).
  • You are a provider who knows that a person connected to you offered or provided a benefit to a requestor or a person connected to a requestor, and the benefit would be likely to induce requests for services – see subsection 23DZZIL(3).
  • You are a provider who knows that a person connected to you threatened a requestor or a person connected with a requestor, and the threat would be likely to induce requests for services – see subsection 23DZZIM(3).
  • You are a requestor who knows that another person accepted a benefit from a third person with the intention of inducing the requestor to request services from a particular provider, where the benefit is intended to induce requests for services – see subsection 23DZZIQ(7).
  • You are a provider who knows that another person offered or provided a benefit to a third person with the intention of inducing the requestor to request services from a particular provider, where the benefit is intended to induce requests for services – see subsection 23DZZIR(5).
  • You are a provider who knows that another person threatened a third person with the intention of inducing the requestor to request services from a particular provider, where the threat is intended to induce requests for services – see subsection 23DZZIS(5).

If the report you wish to make does not relate to one of the above points you should complete the ‘Reporting Suspected Fraud’ form.

You can report suspected Diagnostic Imaging or Pathology prohibited practice by:

Assistance
If you need assistance completing this form call Medicare Australia on 131 524*.

Lodgement
Send completed and signed forms to:

  • Compliance and General Programs Division
    Compliance Operations
    PO Box 9822
    Sydney NSW 2001

or fax to: 02 9895 3325

General enquiries
For all general enquiries about the new diagnostic imaging and pathology legislation please contact:

Hotline: 132 150*
Email: legislativeamendments@health.gov.auEmail
Website: www.health.gov.au/legislativeamendmentsExternal link

* Call charges apply

Other fraud reporting channels available

Centrelink: If you suspect fraud is being committed against any Centrelink programs go to CentrelinkExternal link.

Child Support Agency: If you suspect fraud is being committed in relation to child support go to Child Support AgencyExternal link.

Privacy note

The information you provide may be used to identify suspected fraud. Medicare Australia may need to contact medical practitioners, pharmacists, health care workers or consumers for clarification of this information. Some information obtained may be released to the Department of Health and Ageing, Centrelink, the Department of Veterans' Affairs, the Department of Immigration and Multicultural and Indigenous Affairs or as authorised/required by law for compliance purposes. The collection of the information on this form is authorised by the Health Insurance Act 1973, National Health Act 1953 and under Regulations 3 and 3E of the Medicare Australia regulations 1975.

Freedom of information

It is Medicare Australia’s policy to keep your identity confidential. However, Medicare Australia is subject to the Freedom Of Information Act 1982 and any individual may seek access to documents held by Medicare Australia. Therefore it is possible that the information you provide may be released.

Our site has more information about our freedom of information and privacy and security policies.

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Last updated: 8 February, 2010