The Chief Executive Medicare must refer a practitioner to the Chairperson of Medicare Participation Committees if the practitioner has been convicted of a relevant offence (essentially fraud on the Commonwealth involving Medicare benefits). The Chairperson must establish a Committee comprising 'peers' of the practitioner under review, choosing one from a list nominated by the Minister and one from a list nominated by a peak body (currently the Australian Medical Association, the Australian Dental Association or Optometry Australia). An Approved Pathology Provider or an Approved Pathology Authority may be referred to the Chairperson of Medicare Participation Review Committees if the Minister has reasonable grounds for believing that they have breached their pathology undertaking and they fail to satisfy the Minister that no further action should be taken. A Committee can: take no further action or; counsel; reprimand; and/or partially or fully disqualify a practitioner from billing Medicare for a period of up to 5 years. In the case of APP or APP, a Committee can also order repayment of Medicare benefits when the APP or APA was in breach of their undertaking.

Further information

  • Type of Body

    E. Statutory Office Holder Offices and Committees

  • Established By / Under

    Act / Regulation

  • Established By/Under More info

    Health Insurance Act 1973

  • Paid Members?


  • Max No. of Board/Committee Members


  • Annual Report Prepared and tabled?


  • Classification

    B. Secondary

  • Function Categorization


  • Creation Date

    22 February 1986

Current board appointments

Position Appointee Start Date End Date
Chair VACANT    
Chair Mr. Stephen Moloney 10 September 2021 9 September 2026
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