Payment recovery for Practice Incentives Program (PIP) and Workforce Incentive Program (WIP) - Practice Stream 012-10010100

Table 1

Table 2

The debtor should contact PIP for any questions about the calculation of a debt. Program Management will provide advice in response to individual enquiries about the calculation of a debt on a case-by-case basis.

The debtor should contact Medicare Debt Recovery for any questions on how to repay the debt.

Enquiries during the recovery process on the:

• Recovery process, Payment incentive recoveries will give a response
• Overpayment or the program/s, Payment incentive recoveries will give a response to Medicare Debt Recovery. Medicare Debt Recovery will then give a response to the debtor

A response must be given to the debtor within 5 working days.

‘Warm transfer’ calls to Medicare Debt Recovery. If the number is busy, give the correct number to the debtor and ask to call at a later time.

An overpayment can be appealed. The debtor can find more information on the overpayment letter.

The Department of Health and Aged Care (DoHAC) conducts audit and compliance activity for the PIP and WIP - Practice Stream, and recovers funds where overpayments are identified. Since 2018, DoHAC has undertaken voluntary compliance activity and recovered funds for PIP After Hours Incentive, Procedural GP Payment, and the WIP - Practice Stream.

To check if a practice is subject to any recovery activity by DoHAC for these Incentives, a Recoveries Officer must email Program Management and confirm:

• Which incentive the recovery is for
• How Services Australia was notified
• The impacted payment quarters and amount of the recovery
• The date the practice became ineligible for the incentive or payment tier/level
• If the practice was eligible for a lower payment tier/level

For Procedural GP Payment, the names of the GPs.

Requests from practices to voluntarily repay funds for incentives other than After Hours Incentive, Procedural GP Payment, or WIP - Practice Stream do not need to be escalated for a compliance check.

Do not disclose practice or payment information to a third party.

Program Management (Policy team) will confirm if:

• the practice was subject to any audit or compliance activity in the period of the overpayment
• a debt recovery has been raised by DoHAC for the same period
• any further action is needed

eHealth compliance

DoHAC manage eHealth Incentive compliance.

A practice must contact DoHAC for all eHealth Incentive compliance questions.

DoHAC’s return email and postal address is on the compliance correspondence from DoHAC.

A Practice must quote the reference number on the compliance correspondence in their response.

Practice Incentives Overpayment information and summary sheet (IP032)

Recovery of PIP payments (z1844) letter

Recovery of WIP - Practice Stream and PNIP payments (z1669) letter

Incentive programs processing team

Payment incentive recoveries

Debt and Compensation Program (DCP) Branch and Payment Assurance Operations (PAO) contacts > Medicare Debt Recovery

Practice Incentives Program (PIP)

Workforce Incentive Program contacts