From home affairs passenger movement records to pharmaceutical drug sponsor supplied data, here’s a look under DoHDA’s hood.
The Department of Health, Disability and Ageing’s public register of data matching activities reveals that the latest compliance campaign involves identifying PBS claims where the medication was already supplied to patients under a separate arrangement.
According to the public register of data matching activities maintained by the chief executive of Medicare and updated on Wednesday, DoHDA began the 36-month PBS claims campaign in December 2025.
It will use pharmaceutical drug sponsor data including distribution and delivery information, as well as information about the supply of medicines made directly to patients.
This will be compared to Services Australia’s PBS claims information dataset, which includes approved pharmacist information, patient information and prescription/supply information.
In terms of permitted purpose, this campaign aims to identify where a person may have claimed an overpayment or broken a law, rather than investigating whether a person may have engaged in inappropriate practice or educating health practitioners about Medicare requirements.
Perhaps more relevant to GPs are the two other data matching programs currently in place.
The first of these is the ongoing data matching with the Department of Home Affairs to identify instances where a Medicare service was rendered while a patient or practitioner was out of the country.
Related
According to the log, DoHDA’s plan was to run the overseas claiming compliance campaign for two years from August 2024, meaning it will expire in August 2026 unless renewed.
Last year, more than 1100 doctors received “early intervention letters” from the department warning that they may have billed Medicare while overseas.
Unlike the PBS campaign, the home affairs matching campaign was conducted under the legislated permitted purpose of investigating whether a person may have engaged in inappropriate practice or educating health practitioners about Medicare requirements.
The other live data matching campaign is ongoing work to identify potential inappropriate practice, incorrect claiming and fraudulent activity via MBS and PBS claims information.
The example given in the log is using the data to determine eligibility for a benefit under one program, where eligibility for that program is dependent upon services provided under the other program.
Data matching programs which have since expired include collaborations between the Australian Digital Health Agency and Services Australia to identify practices that were ineligible for the eHealth Practice Incentive Program and a one-off exercise to identify potential inappropriate prescribing of PBS-listed psychotropics in residential aged care.
