DoHAC top brass told senate estimates that public tip-offs about practices which charge an illegal out-of-pocket cost while bulk billing continue to trickle in.
The Department of Health and Aged Care currently has 12 open cases relating to healthcare providers who charge additional fees when bulk billing, relying mostly on tip-offs from members of the public.
Under Section 20A(1) of the Health Insurance Act 1973, when a practitioner agrees to bulk bill a patient they are accepting the assignment of benefit as their full payment.
Raising any additional fees – say, an administration or practice subscription fee – alongside the patient’s rebate is illegal.
Speaking at the Community Affairs Committee Senate Estimates hearing today, Independent ACT senator David Pocock questioned DoHAC benefits integrity first assistant secretary Matthew Williams on how the department was monitoring the practice.
Between January 2023 and January 2025, Mr Williams said, DoHAC had received 109 tip-offs from the public relating to out-of-pocket charges for bulk billed services.
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“Most of our intelligence on these issues is based on tip-offs from the public,” he told the committee.
So far, 69 of the 109 tip-offs have been investigated, with 12 in progress.
Senator Pocock said he had heard from a constituent whose father had recently been to a non-GP specialist and been charged an administrative fee while ostensibly being bulk billed, and questioned whether the practice was so common as to potentially undermine the integrity of Medicare bulk billing statistics.
“How do we trust the bulk billing statistics, if this is happening?” the senator said.
“Have you looked at what this could do to those stats … it seems like there’s a bunch of providers who are double dipping.”
Mr Williams said the department was working closely with the sector and would be undertaking “an explicit campaign … in compliance on this issue”.
Often, he said, a high-level intervention is enough to change behaviour.
“[These double fees] can sometimes be inadvertent business practices, so we can engage with [clinics] with an education campaign,” Mr Williams said.
“They can sometimes be business practices that have some intent on a nefarious undertaking, and … we could either treat it through a statutory audit or an investigation and or other compliance measures.
“Each of those compliance measures has a very different outcome and timeframe.”
