Fraud and compliance
The TAC is committed to protecting the funds and other assets placed under its control and protection for the benefit of the people of Victoria. Fraud represents potential risks to these funds and assets.
The TAC will not tolerate fraudulent or corrupt activities against its interests and will vigorously pursue parties engaged in such practices or attempting to do so.
Read the TAC Compliance and Enforcement Policy
How to make a report
Should you wish to make a report of fraudulent behaviour or other breaches of the TAC legislation, please contact the TAC's Fraud and Compliance Group by emailing Fraud_Compliance@tac.vic.gov.au or by calling 1300 654 329.
Fraud and the TAC
Fraud is dishonest activity or potential financial loss to the TAC including theft of moneys or other property by employees or persons external to the TAC. This includes:
- the deliberate falsification, concealment or destruction of documentation
- falsified documentation used or intended for use for a normal business purpose
- the improper use of information or position.
The following are examples of fraudulent behaviour:
- knowingly submitting a false claim
- providing false information
- working whilst on compensation benefits
- altering a medical certificate
- submitting false travel expense claims
- claiming for services which were not given (service providers) and
- providing false invoices, medical certificates.
Actions that may be taken by the TAC
Following an investigation, the TAC may:
- Commence criminal proceedings under relevant provisions of the TA Act or relevant criminal legislation
- Issue a letter of caution to the person
- Determine whether civil action should be taken to recover compensation amounts overpaid
- Refer the matter to the Victoria Police, the Coroner, the Office of Public Prosecutions (OPP) or another body (including professional or trade regulatory bodies such as the Australian Health Practitioner Regulation Agency (AHPRA) and the Legal Services Board) or
- Take no further action.
Any employee found to have engaged in, or concealed any such behaviour, may be disciplined, and their employment may be terminated.
TAC billing review program
The TAC has a Billing Review Program to ensure that payments for services provided to TAC clients are reasonable and appropriate. For more information please refer to:
- Billing Review Program - Information for Medical Practitioners PDF, 0.17MB
- Billing Review Program - Information for Medical Practitioners DOC, 0.75MB
- Billing Review Program - Information for Allied Health Providers PDF, 0.18MB
- Billing Review Program - Information for Allied Health Providers DOC, 0.75MB
- Billing Review Program - Information for Dental Providers PDF, 0.16MB
- Billing Review Program - Information for Dental Providers DOC, 0.82MB
Preventing, Detecting and Investigating Fraud 2020/21
The TAC utilises a comprehensive toolkit of analytical methods, intelligence gathering and reporting techniques to identify potential fraud and claim anomalies.
The TAC has proactive detection capability as part of a continuous monitoring framework that identifies potential fraud, provider misbehaviour and payment anomalies across key control points in the scheme.
In attempting to disrupt fraud and change client/provider behaviour across the scheme the following enforcement action was taken during 2020/21:
- TAC’s Prosecutions & Enforcement Committee have approved fifty (50) criminal briefs of evidence to be dealt with through the Magistrates Court. TAC is alleging fraudulent behaviour against the scheme totalling $2,633,053 and in all cases will be seeking full restitution.
- There are nine (9) cases where arrest warrants are outstanding where TAC is seeking to recover $387,510.
- Thirteen (13) court cases have been finalised with a registered plea of guilty with TAC awarded a total of $293,119 in restitution.
- Cases that have not met the prosecution threshold are dealt with through the TAC’s principal means of achieving a change of behaviour and prompt voluntary compliance. Nineteen (19) warning letters were sent for breaches of the Act relating to fraud and providing false information to the TAC by clients as well as Medical and Service Providers, which include demands for reimbursement.
Throughout the Covid-19 pandemic, the Forensics Group has continued to be pro-active in collaborating with members of the Australian & New Zealand Interagency Fraud Association (ANZIFA) community, sharing information and trends to continue to disrupt fraud across the Insurance sector in both Commonwealth and State Jurisdictions.
During the 2020/21 financial year, the TAC maintained ongoing efforts in the continuous proactive monitoring of service provider billing behaviour, which was supplemented by internal business referrals and information received from the public.
The program focuses on ensuring the invoicing supplied to the TAC by service providers and the subsequent payments made are an accurate reflection of the services that have been provided to TAC clients. In 2020/21 continuous monitoring activities and reviews were undertaken on more than 250 providers across a broad range of disciplines.
Prosecutions
| Date | Defendant | Court | Judge/ Magistrate | Result |
|---|---|---|---|---|
| 07 Oct 2021 | Ali N | Werribee Online Magistrates' Court | Wardell |
|
| 01 Oct 2021 | Jesse H | Ringwood Online Magistrates' Court | Wighton |
|
| 15 Sep 2021 | Blaze M | Heidelberg Online Magistrates' Court | Altman |
|
| 10 Sep 2021 | Harrison L | Melbourne Magistrates' Court | McKenna |
|
| 20 Aug 2021 | Colin M | Sunshine Magistrates' Court (online) | Masood |
|
| 07 Jul 2021 | Matthew W | Geelong Magistrates' Court | Mellas |
|
| 01 Jul 2021 | Robert E | Werribee Magistrates' Court sitting at Sunshine | Pithouse |
|
| 28 Jun 2021 | Iman B | Heidelberg Magistrates' Court Online | NcNamara |
|
| 28 Jun 2021 | Melody S | Wangaratta Magistrates' Court Online | Martin |
|
| 22 Jun 2021 | Trash H | Mildura Magistrates' Court | La Rosa |
|
| 22 Apr 2021 | Jonathan H | Dandenong Online Magistrates' Court | Connellan |
|
| 12 Apr 2021 | Semon L | Broadmeadows Online Magistrates' Court | Trumble |
|
| 22 Mar 2021 | Lacey B | Wangaratta Online Magistrates' Court | Faram |
|
| 23 Feb 2021 | Jasit A | Sunshine Magistrates' Court | Masood |
|
| 16 Feb 2021 | Navpreet S | Sunshine Online Magistrates' Court | Robinson |
|
| 01 Feb 2021 | Reece H | Hume Online Magistrates' Court | Dunn |
|
| 18 Dec 2020 | Ali A | OMC Broadmeadows Magistrates' Court | Smith |
|
| 14 Dec 2020 | Cameron K | OMC Werribee Magistrates' Court | Pitthouse |
|
| 04 Dec 2020 | Khushminder P | OMC Heidelberg Magistrates' Court | McNamara |
|
| 22 Oct 2020 | Craig S | Heidelberg Magistrates' Court | Ballek |
|
| 08 Oct 2020 | Elizabeth E | Frankston Magistrates' Court | Lethbridge |
|
| 17 Sep 2020 | Abdul M | Frankston Magistrates' Court | Lethbridge |
|
| 12 May 2020 | Magdalena M | Dandenong Magistrates' Court | Connellan |
|
| 05 May 2020 | Mitchell L | Bendigo Magistrates' Court | McRae |
|
| 16 Mar 2020 | Brooke L | Wodonga Magistrates' Court | Dunn |
|
| 19 Dec 2019 | George M | Frankston Magistrates' Court | Gattuso |
|
| 19 Dec 2019 | Fouzia M | Frankston Magistrates' Court | Gattuso |
|
| 19 Dec 2019 | Mustafa Y | Frankston Magistrates' Court | Gattuso |
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| 04 Dec 2019 | Seyed G | Heidelberg Magistrates' Court | Ballek |
|
| 04 Dec 2019 | Vikwesh S | Heidelberg Magistrates' Court | Ballek |
|
| 29 Nov 2019 | Paul D | Ringwood Magistrates' Court | Wighton |
|
| 21 Nov 2019 | Nicholas I | Ringwood Magistrates' Court | Starvaggi |
|
| 14 Nov 2019 | Amy P | Seymour Magistrates' Court | Cottrill |
|
| 23 Oct 2019 | Viney K | Broadmeadows Magistrates' Court | Trumble |
|
| 21 Oct 2019 | Luke A | Broadmeadows Magistrates' Court | Hoare |
|
| 03 Oct 2019 | Alexandria M | Sunshine Magistrates' Court | Pitthouse |
|
| 03 Oct 2019 | Chethuri H | Dandenong Magistrates' Court | McRae |
|
| 04 Sep 2019 | Stephen W | Shepparton Magistrates' Court | Mithen |
|
| 02 Sep 2019 | Ashley C | Latrobe Magistrates' Court | Studham |
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| 15 Aug 2019 | Tobias S | Frankston Magistrates' Court | Gattuso |
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| 18 Jul 2019 | Viorel F | Dandenong Magistrates' Court | Bolster |
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| 16 Jul 2019 | Tina K | Broadmeadows Magistrates' Court | Hoare |
|
| 11 Jul 2019 | Cameron F | Geelong Magistrates' Court | Lesser |
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| 27 Jun 2019 | John S | Ballarat Magistrates' Court | Saines |
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| 06 Jun 2019 | Corina F | Dandenong Magistrates' Court | Spencer |
|
| 06 Jun 2019 | Simone S | Dandenong Magistrates' Court | Spencer |
|
| 05 Jun 2019 | Peter D | Melbourne Magistrates' Court | Fitzgerald |
|
| 03 Jun 2019 | Alexander B | Heidelberg Magistrates' Court | Ballek |
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| 09 Apr 2019 | Emidio M | Geelong Magistrates' Court | Coghlan |
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| 29 Mar 2019 | Rebecca W | Ballarat Magistrates' Court | Jones |
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| 25 Mar 2019 | Ricky B | Shepparton Magistrates' Court | Farram |
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| 29 Jan 2019 | Mohamed N | Heidelberg Magistrates' Court | Warda |
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| 08 Jan 2019 | Adrian K | Geelong Magistrates' Court | Raleigh |
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| 20 Dec 2018 | Leon J | Melbourne Magistrates' Court | Bott |
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| 12 Dec 2018 | Raymond R | Bendigo Magistrates' Court | Southey |
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| 29 Nov 2018 | Brendan B | Sunshine Magistrates' Court | Burns |
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| 15 Nov 2018 | Emily G | Ringwood Magistrates' Court | Bolster |
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| 01 Nov 2018 | Joel S | Dandenong Magistrates' Court | McCrae |
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| 17 Oct 2018 | Lovnish M | Broadmeadows Magistrates' Court | Grinberg |
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| 18 Sep 2018 | Andrew T | Moorabbin Justice Centre | Barrett |
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| 05 Sep 2018 | Douglas G | Dandenong Magistrates’ Court | Bazzani |
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| 16 Aug 2018 | Sophea M | Dandenong Magistrates’ Court | Wardell |
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| 28 Jun 2018 | Abu A | Broadmeadows Magistrates’ Court | Grinberg |
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| 25 Jun 2018 | Victoria U | Werribee Magistrates’ Court | Burns |
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| 16 Apr 2018 | Karlie C | Broadmeadows Magistrates’ Court | Burchill |
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| 03 Apr 2018 | Ljupce K | Heidelberg Magistrates’ Court | O'Callaghan |
|
| 21 Mar 2018 | Muhammad Y | Melbourne County Court | Higham | The appeal was heard on 21/03/2018 and His Honour Judge Higham at the Melbourne County Court on the two charges as previously appealed to a 12 month Community Corrections Order, with conditions that the accused be under the supervision of the Office of Corrections for the entire time and that the accused perform 100 hours of unpaid community work. The judge also ordered that the accused pay the TAC compensation in the amount of $44,529.98 |
| 15 Feb 2018 | Lazar K | Ringwood Magistrates’ Court | McNamara |
|
| 06 Feb 2018 | Peter B | Werribee Magistrates’ Court | Burns |
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| 15 Dec 2017 | Muhammad Y | Broadmeadows Magistrates’ Court | Fallah |
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| 07 Dec 2017 | Marcus F | Melbourne Magistrates’ Court | Bourke |
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| 01 Nov 2017 | Anthony L | Neighbourhood Justice Centre Collingwood |
|
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| 27 Sep 2017 | Catherine P | Assessment & Referral Court at the Melbourne Magistrates’ Court | Collins |
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| 31 Aug 2017 | Ekrem K | Broadmeadows Magistrates’ Court | Grinberg |
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| 17 Aug 2017 | Phillip S | Ringwood Magistrates’ Court | Sargent |
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| 17 Jul 2017 | Alex N | Melbourne Magistrates’ Court | Holzer |
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| 28 Jun 2017 | Mark P | Heidelberg Magistrates’ Court | Alger |
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| 02 Jun 2017 | Agostino V | Sunshine Magistrates’ Court | Pitthouse |
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| 27 Apr 2017 | Molood M | Dandenong Magistrates’ Court | Connellan |
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| 05 Apr 2017 | Jade S | Sunshine Magistrates’ Court | Fitzgerald |
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| 16 Mar 2017 | Paul H | Geelong Magistrates’ Court | Coghlan |
Appeal Hearing date 4 April 2017 at Geelong Country Court:
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