Comcare - Australian Government
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Fraud Control

Comcare is fully committed to complying with the Commonwealth Fraud Control Guidelines 2011 (Fraud Control Guidelines) to minimise the incidence of fraud through the development, implementation and regular review of a range of fraud prevention and detection strategies.

To do this Comcare:

  • implements a fraud control plan
  • maintains and improves awareness of fraud
  • develops, documents and reviews its own fraud control procedures and policies in alignment with the current Government policies
  • encourages professional and ethical conduct by its employees and providers
  • performs fraud detection activities
  • investigates and applies appropriate responses to instances of fraud against Comcare and its programs
  • maintains, supports and fully respects personal information in accordance with the Privacy Act 1988 (Privacy Act)
  • seeks to recover losses due to fraud and take appropriate action against offenders
  • monitors, reviews and continually improves performance.

All managers are accountable for the implementation and management of fraud control measures in their areas of responsibility. All employees are responsible for reporting suspected fraudulent activities.

Comcare updated its fraud control plan in 2010–11 following a restructure of the organisation to better align functions to meet the needs of the 2015 Plan. The fraud control plan describes Comcare’s approach to preventing or detecting and responding to incidents of serious non-compliance and fraud.

Comcare established a fraud detection program in 2010–11. Comcare also continued to seek guidance from other organisations to assist in prioritising risks, identifying how the risks may eventuate and designing an appropriate detection action plan. The focus in 2010–11 was on identifying:

  • instances where injured workers may not have informed Comcare of income received from other sources
  • the misuse of home help benefits
  • access by injured workers to superannuation without advising Comcare
  • duplicate payment of incapacity payments where an injured worker has multiple claims
  • internal misappropriation of funds.

The Fraud Detection Unit (FDU) is responsible for preparing intelligence reports for follow-up by the Fraud Response Unit (FRU). Comcare’s FRU manages the investigation of suspected cases of fraudulent activity in accordance with relevant legislation, policies, procedures and guidelines. Comcare’s FRU investigators are authorised by the CEO to undertake investigations of all allegations of fraud affecting Comcare. Members of the FRU possess the required training competencies. FRU updated investigation policies and procedures following the publication of the Fraud Control Guidelines and ANAO audits of other agencies’ investigations. The FRU improved internal collaboration with teams in the Recovery and Support Group and with external parties such as the Australian Taxation Office and the Australian Federal Police to pursue outcomes of investigations.

In 2010–11 two briefs of evidence were referred to the Commonwealth Director of Public Prosecutions. A brief referred in 2009–10 was decided during 2010–11 which resulted in a criminal conviction, a sentence of imprisonment for nine months and court order to the defendant to repay the Commonwealth for the losses incurred.

Comcare’s fraud units work with relevant business units to identify internal control weaknesses and to implement system or process improvements to reduce the risk of re-occurrence of non-compliance.