Upcoming MBS compliance activities - Urology

The Department of Health, Disability and Ageing has identified a compliance concern relating to the claiming of MBS services rendered while the provider is overseas. The Department has provided USANZ with information and advice regarding this issue, to be shared with our Members. 

Section 10 of the Health Insurance Act 1973 requires both the patient and provider to be in Australia for a service to be eligible for Medicare. The Department provided information outlining the identified potential non-compliance relevant to USANZ Member. Please download the PDF.

The Department is focused on supporting providers to understand their obligations when claiming Medicare benefits. However, providers may be elscalated to enforcement activity, such as an autdit, where claiming data suggests routine claiming of concern.

This issue is part of the Department's 2025 Health Provider Compliance Priorities and impacts a variety of provider groups and specialties.