Health dept officials reveal options for fixing the assignment of benefit shemozzle
Health department officials are working out how to make its assignment of benefit changes easier, three months into a transition period that followed a botched rollout.
Among the options, the Department of Health, Disability and Ageing is assessing whether, legally, a patient can assign benefit to all practitioners at a clinic, rather than only the doctor they are seeing.
Officials gave the update at a webinar last month.
Sweeping reforms due on 1 July would have required practices to get written consent for each bulk-billed consultation so the Medicare rebate could go to the practitioner, and to keep each agreement for two years. The idea was to mitigate the risk of Medicare fraud.
The demands caused outcry, with warnings of extra administration, especially for GPs in aged care who would have to chase family members to authorise bulk-billing for patients with cognitive impairment.
Less than two weeks before the start date, the government agreed to a 12-month transition period in which practices can obtain consent verbally.
It also brought forward the option of obtaining enduring consent, removing the need for agreement at every consult.
However, enduring consent is only available to patients registered with a practice through MyMedicare, patients of Aboriginal Medical Services or Aboriginal Community Controlled Health Organisations and aged care residents.
What happens when the transition period ends in June next year remains to be seen.
At the webinar, Medical Benefits and Digital Health Division telehealth director Roland Balodis said the department was open to stakeholder suggestions for further simplification.
He said the issues were legally complex but that the department would provide legal advice to the government later this year.
He admitted the wording of current legislation made it tricky for enduring consent to cover multiple practitioners, especially independent contractors.
“We do appreciate that it could be administratively simpler to have one signature for all of the professionals for a common set of services,” he said.
“But we also don’t want to have a situation where such agreements could become invalidated as soon as the practice roster changed,” he said, pointing to hundreds of agreements which could potentially be undone overnight, for instance, if another doctor joins the practice.
Mr Balodis also said the department was figuring out the technicalities of how to allow other practices to obtain enduring consent outside of MyMedicare, Aboriginal Medical Services and aged care facilities.
He said the challenge was that technology for registration relies heavily on a program from Services Australia that is linked to specific primary care systems like MyMedicare.
Mr Balodis also clarified what he said were some common questions about how assignment currently works.
He said many practices were not aware that they do not need to list each individual MBS item in an agreement and also pointed out that enduring benefit coverage does end for aged care residents if they return to living in the community.
