Medicare Compliance Lawyer Melbourne

Medicare audits and billing investigations can pose significant financial and reputational risk to medical practitioners and healthcare organisations.

NorthBridge Legal advises doctors, medical practices and healthcare businesses across Victoria on Medicare compliance, audit response strategy and regulatory risk management.

Early legal advice is critical in managing audit exposure, responding to requests for information and protecting professional standing.

If you have received correspondence from Medicare, Services Australia or the Professional Services Review (PSR), seek legal advice before responding.

Medicare Audits & Compliance Reviews

Responding to Medicare Audit Notices

Medical practitioners may be subject to:

  • Medicare compliance audits

  • Requests for information

  • Data analysis reviews

  • Recovery notices

Audit processes can escalate if responses are incomplete or poorly structured.

We advise on:

  • Strategic audit response

  • Risk exposure assessment

  • Documentation preparation

  • Communication strategy

Professional Services Review (PSR)

Professional Services Review Matters

More serious billing concerns may be referred to the Professional Services Review (PSR).

PSR proceedings may involve:

  • Review of claiming patterns

  • Assessment of clinical appropriateness

  • Potential repayment obligations

  • Referral for regulatory action

We provide strategic advice in managing PSR exposure and preparing submissions.

Billing Risk & Compliance Frameworks

Proactive Medicare Compliance

Healthcare businesses can reduce audit exposure by implementing:

  • Billing governance frameworks

  • Internal compliance reviews

  • Staff training

  • Risk monitoring systems

We assist medical practices in developing structured compliance programs to minimise future regulatory exposure.

Interaction with AHPRA & Regulatory Exposure

Medicare investigations may intersect with:

  • AHPRA notifications

  • Mandatory reporting obligations

  • Professional misconduct allegations

Coordinated legal strategy is essential to manage both financial and regulatory risk.

AHPRA Lawyer Melbourne
Mandatory Reporting Lawyer

Common Medicare Risk Areas

Medicare risk frequently arises in:

  • High-volume item claiming

  • Incorrect item numbers

  • Bulk billing compliance

  • Telehealth claims

  • Supervision billing

  • Documentation adequacy

Each matter requires careful factual and legal analysis.

Who We Act For

We advise:

  • General practitioners

  • Specialist practitioners

  • Allied health providers

  • Multi-disciplinary medical practices

  • Healthcare corporate groups

FAQ

What should I do if I receive a Medicare audit letter?

Seek legal advice before responding. Early strategy can reduce escalation risk.

Can Medicare audits lead to AHPRA action?

In certain circumstances, billing concerns may intersect with regulatory issues.

What is the Professional Services Review?

The PSR is a statutory body that reviews potential inappropriate practice in Medicare billing.

Can I challenge a Medicare recovery decision?

Yes. Legal advice should be sought to assess review options.

Medicare compliance issues require strategic legal advice informed by regulatory, commercial and reputational considerations.

NorthBridge Legal advises healthcare professionals and organisations across Melbourne and Victoria on managing audit exposure and strengthening compliance frameworks.