We are responsible for protecting the integrity of the health programmes by ensuring only eligible services are paid for. To protect taxpayer dollars, we are committed to ensuring that the right person, doctor, specialist, pharmacist or patient, receives the right payment at the right time.
Health provider related tip-offsThe Australian Government Department of Health is committed to preventing the occurrence of fraud against health related programmes.
The department receives health provider fraud tip-offs through tip-off form submissions and the 1800 314 808 Provider Benefits Integrity Hotline.
Who are health providers?Health providers are:
- professionals, which include but are not limited to, doctors, pharmacists, and dentists
- organisations which include medical practices, hospitals and administrative staff.
What are health related programmes?Health related programmes include:
- Medicare – which provides access to medical and hospital services for eligible patients through the payment of benefits for eligible services.
- Pharmaceutical Benefits Scheme (PBS) – which provides Government subsidises on eligible medicines to reduce the cost to eligible patients.
- Child Dental Benefits Schedule (CDBS) – which provides access to benefits for basic dental services for eligible children aged 2-17 years.
- Health related incentive programmes, including the Practice Incentive Programme, Mental Health Nurse Incentive Programme, and Practice Nurse Incentive Program, among others.
What is health provider fraud?Fraud against the Australian Government is defined as 'dishonestly obtaining a benefit, or causing a loss, by deception or other means'. Health provider fraud relates to the actions of a health provider against the Government’s health related programmes.
What types of tip-offs can I submit?Anyone can submit a tip-off to the Department about the actions of a health provider. If you observe suspected fraud or are concerned about suspicious actions by a health provider against a health related programme, it is important that you notify the Department of your tip-off information.
A tip-off may relate to concerns that include suspicions of:
- incorrect and/or inappropriate billing.
You do not need to provide us with your personal details when submitting a tip-off. You can use a made up name or remain anonymous.
How do I submit a tip-off?If you have concerns relating to a health provider you can submit the details to the Department online by
completing the tip-off form.
Alternatively, you can call 1800 314 808 between the hours of 9am to 5pm AEST to provide the details to the Provider Benefits Integrity Hotline.
For concerns regarding the administration of other Departmental programmes, refer to the Reporting suspected
For health programme concerns relating to the actions of a member of the public, call the Department of Human
Services (DHS) on 131 524 or alternatively go to the DHS website Reporting fraud page.