Posted on: 10 May 2023

In response to concerns regarding debt recovery from ineligible Medicare claims, the Australian Federal Government has introduced the Shared Debt Recovery Scheme. The established legislation enables the government to hold both medical practices and practitioners accountable for Medicare debts.

The scheme, which was implemented on 1 July 2019, addresses the issue of overpayments made to medical practitioners by Medicare. These overpayments arise from billing for services that are not eligible for reimbursement, such as services that were not provided, were provided to ineligible patients, or were not adequately documented.

Under the scheme, the government can hold both medical practices and practitioners responsible for debts resulting from ineligible claims. This means that if a practitioner is found to have made an ineligible claim, the medical practice they work for could also be held liable for the debt. Conversely, if a medical practice is found to have made an ineligible claim, the individual practitioners who work there could also be held responsible.

The introduction of the Shared Debt Recovery Scheme has been met with mixed responses from the medical community. Some have welcomed the scheme, arguing that it will ensure that practitioners and medical practices are more careful when making Medicare claims, and that it will help to reduce instances of overbilling and fraud.

Others, however, have expressed concerns about the impact of the scheme on medical practices, particularly those in rural and remote areas where it can be difficult to find medical professionals willing to work. They argue that the scheme could discourage practitioners from working in these areas, and could make it more difficult for medical practices to recruit and retain staff.

Despite these concerns, the government has continued to push forward with the implementation of the Shared Debt Recovery Scheme. In addition to holding both medical practices and practitioners accountable for debts resulting from ineligible claims, the scheme also provides an appeals process for those who believe that they have been unfairly targeted.

Overall, the Shared Debt Recovery Scheme represents a significant shift in the way that the government approaches debt recovery from medical practices. While it has been met with some resistance from the medical community, it is clear that the government is committed to ensuring that Medicare funds are used appropriately and that overpayments are recovered. As such, it is likely that the scheme will remain in place for the foreseeable future, and that medical practices and practitioners will need to ensure that they are following Medicare guidelines and regulations to avoid any potential debts resulting from ineligible claims.