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RACGP works to change telehealth MBS compliance approach


Michael Wright


9/03/2021 4:26:41 PM

The campaign is due to begin within weeks, but the college has strongly recommended that it be shelved.

Doctor on the phone to a patient.
The majority of breaches appear to be related to the requirement for a GP to have seen the patient in the past 12 months.

This article was updated on 12 March to clarify the nature of the compliance campaign.

Earlier this year, the Department of Health (DoH) advised the RACGP that it was likely undertake a telehealth compliance campaign in March or April, after identifying almost 30,000 GPs who had potentially breached telehealth Medicare Benefits Schedule (MBS) rules.
 
The RACGP understands that the majority of breaches appear to be around the requirement to have seen the patient in the past 12 months. However, following RACGP recommendations, the campaign has been changed, and the vast majority of GPs will no longer receive a letter.

During March and April, many GPs will be focusing heavily on the COVID-19 vaccine rollout – the most important public health initiative in decades – and so we feel that broad-based compliance activity during this period would be inappropriate, as would GPs receiving a letter for a handful of telehealth items that may have been billed incorrectly.
 
Timing issues notwithstanding, we also believe that the rules surrounding exemptions to the existing relationship requirements have been unclear.
 
For example, one of the exemptions is for patients located in a ‘COVID-19 impacted area’, but this exemption has been constantly changing due to ongoing outbreaks of the virus in different states and communities, leading to intermittent restrictions, lockdowns and border closures.
 
College representatives met with DoH officials last week to convey our concerns about any potential compliance campaign, and we will update members as more information becomes available.
 
Aside from working to oppose the telehealth compliance campaign, RACGP President Dr Karen Price and I recently attended a roundtable to discuss recommendations stemming from the MBS Review Taskforce released publicly last December.
 
During the meeting, we stressed the RACGP’s support of recommendations that align with our Vision for general practice and a sustainable healthcare system, while strongly rejecting the proposal to put a floor of six minutes on Level B consultations.
 
Any changes arising from the MBS Review must not remove support through the MBS from general practice, especially at a time when more funding is needed to ensure patients can access care.
 
To support our argument, Dr Price and I sought clarification regarding evidence that had led to some of the recommendations, such as the suggestion that video consultations are higher quality than telephone consultations – a statement for which the RACGP has not found any evidence.
 
And, like the proposed telehealth compliance campaign, there are added concerns around the increased pressure of implementing recommendations alongside the COVID-19 vaccine rollout.
 
Aged care roundtable
Dr Price also recently attended an aged care roundtable hosted by the Federal Health Minister Greg Hunt, and the Minister for Senior Australians and Aged Care Services Richard Colbeck.
 
At the meeting, Dr Price laid out the RACGP’s aged care priorities, including recommendations that:

  • GPs be involved in designing reforms in the aged care sector
  • there is a need to redesign the proposed primary care model for people receiving aged care services
  • GPs be supported to continue to prescribe antipsychotics to patients in residential aged care facilities (RACFs) where clinically appropriate
  • systems (funding and technology) be put in place to ensure GPs are supported to provide care to RACFs
  • MBS items be introduced to support GP consultations via telehealth without the patient being present
  • a workforce model, similar to the Prevocational General Practice Placements Program, be introduced to support and provide early exposure to aged care workforce settings.
Even though the aged care royal commission recommended pushing ahead with some problematic reforms, like the new primary care model and restrictions on antipsychotic prescribing, we will continue to highlight our concerns to the Federal Government as it considers its response to the recommendations.
 
COVID vaccine implementation
RACGP representatives continue to raise with the DoH and Ministerial representatives the willingness within the general practice sector to deliver the COVID-19 vaccination program, while highlighting that the lack of information about its rollout is affecting GP and patient confidence in the program.
 
Finally, RACGP advocacy on the mandatory training required for delivery of the Oxford University/AstraZeneca vaccine continues. We have called for a shorter and more targeted education module designed for general practice, and there are positive signs a new, tailored module will be online soon.
 
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A.Prof Joel Rhee   10/03/2021 10:49:17 AM

Thank you Drs Price and Wright for your representation on behalf of the college fellows and members. GPs are the medical specialists in primary care and it makes sense that their expertise is utilised in the upcoming reform of the aged care system.


Dr David Adam   12/03/2021 1:11:35 AM

That's just about all GPs, then?


Dr Peter William Rankin   13/03/2021 9:16:14 PM

This is a perfectly reasonable and responsible initiative by the DoH especially as this restriction was asked for by the RACGP in particular in response to the initiative by some pharmacies to institute “dial a drug”. Telehealth has no chance of being a permanent feature if the abuse carried out by some entrepreneurial corporates was allowed to continue unchecked. The predictable outrage that occurs whenever DoH does something perfectly reasonable like this is farcical. It’s our taxes that are being wasted. Would we rather DoH did nothing and just wait for the newspaper headlines in months to come as stories emerge of doctors exploiting the pandemic for financial gain tarnish the whole profession?