Medicare Participation Review Committee
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.
Type of Body
E. Statutory Office Holder Offices and Committees
Established By / Under
Act / Regulation
Established By/Under More info
Health Insurance Act 1973
Max No. of Board/Committee Members
Annual Report Prepared and tabled?
22 February 1986