External

4.To ensure Comcare meets CLEB's requirements, all allegations should be documented in the manner outlined in this Operational Advice.  This documentation will include:

  • what the person making the allegation alleges, using the exact words whenever possible;

  • what actions the Investigator took as a result of the allegation;

  • planned actions for either following up on the allegation; or

  • if it is decided not to initiate an investigation, the reason for taking this decision.

5.On receipt, each allegation should be preliminary assessed.  This provides a methodical approach to determining initial actions to undertake as a result of the allegation. It is also an assessment of the value of the information received.  In practical terms, the following questions must be asked:

  • is it likely that an offence has been committed against a Comcare program?

  • could the allegation have happened the way it is alleged or is it too unrealistic to be believed?

and/or

  • is the allegation likely to be true?

6.The assessment will be conducted after obtaining any readily accessible evidentiary information from within Comcare, such as a PRACSYS or file review and/or interviews of claims personnel.

7.During the assessment , the Investigator must be conscious of the ramifications of any actions undertaken and especially that the actions do not alert the person under investigation.

8.The assessment of the allegation  should be based on:

  • nature of the alleged offence

  • seriousness of the alleged offence

  • resource availability including other investigations already commenced

  • the effects of the alleged offence on the program

  • legislative requirements

  • the threat to Comcare's systems

  • the level of criminality

  • scope and size of the investigation

  • ability to deal with an investigation into such an alleged offence

  • capacity of Comcare to undertake the investigation

  • political or public sensitivity

Note that the above matters are in no particular order or priority.

9.At any time during the assessment or investigation, the Investigator is encouraged to consult with:  the Manager, Fraud Prevention Group; local Australian Federal Police (AFP) contacts or Legal Services Group (LSG).

10.Initial approaches to the Office of Director of Public Prosecution (DPP)and Comcare's Legal Panel should only be made after seeking advice from Legal Services Group.  Any subsequent contact with DPP should be briefed to LSG as appropriate.