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Government matches Medicare, Centrelink data to combat fraud

Government matches Medicare, Centrelink data to combat fraud

Data-matching protocol follows on heels of controversial ‘robodebt’ program

Credit: 74784427 © Robyn Mackenzie Dreamstime.com.jpg

The Department of Human Services is combining data from Centrelink and Medicare in an effort to unearth discrepancies between records held at the two agencies.

Protocols for the program state that it seeks to find differences in the recording of “life events” for individuals that have records with Medicare and Centrelink.

“Where expected life events have not occurred this may highlight high-risk identities and the need for further analysis to determine possible fraudulent behaviour and/or record correctness,” the document states.

Senior lecturer in administrative law at La Trobe, Darren Donovan, was the first to note the publication of the protocol.

Update: The department has indicated that although the publication of the protocol is new, the data-matching process is not. However it is "enhancing the already established data sharing arrangements".

Human Services’ programs “are a target for identity and other employment and income-based welfare fraud,” the document says. “Data-matching multiple records is more likely to identify recipients who are possibly engaged in premeditated fraudulent activities.”

The department said the program’s objectives include ensuring that Centrelink payments are only made to people that are entitled to them. The department aims to “detect and investigate fraud” and “provide net savings by detecting overpayments and recovering debt”.

Human Services has indicated that the program acts as an intelligence tool, and that there is a manual role for trained analysts.

Centrelink has been designated the data-matching agency and obtains the data from Medicare and matches it to its own records. The data of non-welfare-recipients will be destroyed at the end of each data-matching process.

The matching process will involve Medicare Benefits Schedule (MBS) data and welfare payment data, including social security, family assistance, paid parental leave, student assistance and disability services. If anomalies are identified, the department said it may also match an individual’s data against PBS data.

According to figures included in the program outline, during period spanning the 2013 to 2018 financial years, the government realised savings of raised debts of $4.7 million and achieved savings of $5.1 million from using Medicare data to detect identity fraud.

The department said that “sophisticated record matching techniques” are used to ensure that the correct individuals are identified and that when “administrative action is proposed” there will be additional checks.

Administrative action for matters that don't meet the criteria for fraud could include “the reduction, suspension or cancellation of benefits” as well as actions “to recover any overpaid amounts”.

The program follows on the heels of Centrelink’s controversial Online Compliance Intervention (OCI), which sought to recover alleged over-payment of welfare benefits. The OCI program, dubbed ‘robodebt’ by its critics, involved Centrelink matching Australian Taxation Office data to its own records of income declared by welfare payment recipients.

For the purposes of the OCI, the ATO annual income data was treated by Centrelink as if it was earned at an even rate throughout the year, leading the welfare agency to in some cases issue notices to its clients asking them to prove that they are not guilty of underreporting income while receiving social security payments.

A 2017 parliamentary inquiry expressed concern that Centrelink “placed the onus on the individual to demonstrate that a purported debt does not exist” and that “challenging these purported debts has taken considerable effort on behalf of those individuals”. 

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Tags centrelinkDepartment of Human Servicesrobo-debt

More about Australian Taxation OfficeCentrelinkDepartment of Human ServicesMBS

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