DoH confirms personal attendance not needed to claim MBS COVID vaccine numbers

Matt Woodley

25/02/2021 3:04:09 PM

The RACGP had strongly advocated that such a requirement would severely hamper general practice’s involvement in the rollout.

Nurse providing a vaccine.
COVID vaccines will be able to be administered by a GP or suitably qualified healthcare professional who has completed the mandatory training.

GPs will not be required to personally attend to each vaccine distributed as part of the coronavirus vaccine rollout, according to a new Federal Government fact sheet.
Concerns had previously been raised by RACGP President Dr Karen Price that such a requirement would kill GP involvement in the program ‘dead in the water’.
However, the latest information, published ahead of the 16 new Medicare Benefits Schedule (MBS) item numbers going live in March, indicates that the patient must only receive a face-to-face attendance by a GP or ‘suitably qualified health professional’.
Under these arrangements, a vaccination may be provided by an endorsed enrolled nurse employed by a general practice, provided they are under the supervision of a registered nurse and have completed the mandatory COVID-19 vaccine training.
The fact sheet states that while a GP must accept ‘full responsibility for the service’, they need only be present ‘at the location at which the vaccine suitability assessment service is undertaken’ and where the vaccine is administered.
Dr Price told newsGP she is relieved to have clarity from the Department of Health (DoH).
‘The college had been very clear during negotiations that requiring a GP to be present and administer every single vaccine would not be feasible, so I am grateful that the department has heard our concerns,’ she said.
‘Our highly trained practice nurses are more than capable of working in partnership with GPs to administer these vaccines and be alert to any potential clinical issues that may arise – as evidenced by the unfortunate situation that occurred recently in Queensland.
‘With this stumbling block now cleared, general practices can concentrate on ensuring everything is in readiness for next month’s life-saving rollout of COVID vaccines.’
Once the MBS items go live next month, details of the item descriptors and an explanatory note will be available on MBS Online. GPs will be able to find this information by searching for ‘COVID-19 vaccine suitability assessment’.
In order for someone to receive a vaccine, a GP or suitably qualified health professional will be expected to use their clinical judgement to determine if they meet the eligibility criteria.
The vaccine suitability assessment service is free to patients and the MBS items must be bulk billed. Patients are expected to receive an MBS vaccine suitability assessment service at the time they are given each of the two Oxford University/AstraZeneca vaccines doses.
However, in certain circumstances, a GP may have to bill Medicare for more than two MBS COVID-19 vaccine suitability assessment services for the same patient.
‘For instance, a patient who is assessed as suitable to receive a COVID-19 vaccine, but who continues to have concerns about the vaccine and wants time to consider if they should receive it, may receive a suitability assessment service without choosing to have a vaccination,’ it states.
‘In this situation, even though the patient has not received a vaccination, the appropriate MBS COIVD-19 suitability assessment item may be billed.
‘If the patient returns at a later date, having decided that they do wish to receive a vaccination, a further suitability assessment would need to be undertaken, and billed to Medicare using the relevant item number.’
While rebates for the new vaccine suitability assessment services will be paid at 85% of the new item fees, these fee amounts have been increased so that they are at the same level as the rebates detailed in the Expression of Interest (EOI) documentation.
The Government has advised that more than 4600 general practices have had their EOIs accepted, and the DoH is in the process of advising successful applicants.
Dr Price said the strong response shows GPs ‘overwhelmingly’ want to be able to vaccinate their patients.
‘We want to see every practice that wants to provide these vaccinations to be able to do so,’ she said.
‘We need to get to the point where COVID-19 vaccinations are part of usual patient care as soon as we can.
‘However, we appreciate that not all practices can be involved in the first stages of the rollout as supply of the Oxford University/AstraZeneca vaccine will be limited. The 4600 practices approved to participate in the rollout will come on in phases.’
Dr Price also acknowledged that while many patients will want to get the vaccine from their usual GP, it may not always be possible – particularly during the early stages of the rollout.
‘There is high demand for the vaccine, and we need to get it out quickly. I implore patients to please be patient and understanding – and if you do have questions or concerns, call your GP,’ she said.
‘I want to reassure GPs that practices participating in the rollout will be receiving information and guidance to support them in delivering the vaccine and the logistics that will entail. 
‘I know practices will be gearing up and making all the necessary preparations to help in this mammoth effort, including completing the mandatory training modules.
‘I have great confidence that our GPs are up to this task, and I want to thank them for their efforts because I know many are going above and beyond to make this happen for their patients.’
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Dr Daniel Thomas Byrne   26/02/2021 7:11:32 AM

Common sense prevails. Well done Karen.
Personally I think every approved practice who is ready to go should get a vaccine delivery (even if small numbers initially) rather than a few practices getting a large delivery. Otherwise you are risking panic and “vaccine envy” in the community. Patients want “their practice” to give them their immunisation.

Thinus van Rensburg   26/02/2021 8:32:57 AM

I'm curious how the liability issue would work with this in the 1b phase.
The assumption is that the practices doing this stage would be doing vaccination on a significant number of patient that are unknown to the Clinic. These would all be elderly or have complex health issues.

Their vaccination is billed under a Dr but that Dr may never cast an eye on this category of patient and perhaps not even on the file as they would be 100% reliant on the Nursing team to do the right thing.

S where does this leave one in the unlikley event of an adverse reaction. The attendance was billed to the Dr's provider Number but all clinical attendance, and potential mistakes, were done by a clinical person employed by the Clinic.

This is not so much an issue if the patient is known to the Clinic but all those strangers just coming in for their vaccination creates another dimension - curious to known what the MDOs advice would be on this

Dr Gerald Raymond Segal   26/02/2021 8:50:27 PM

Sorry Karen this "clarification" from the DOH does not really help. It means a doctor MUST always be around. What happens when our Practice team immunises in a Council Hall? Must we send a doctor there? What if we do night sessions? Does a doctor need to stay back after a busy day?
These are real world concerns. We are going to be immunising all this year as well as trying to do our usual work. If we have to be around for EVERY session, no matter what the location, we are all going to very soon be totally exhausted.
Gerald Segal

Dr Philip William Ousby   6/03/2021 9:35:19 AM

This is helpful but what is needed is that Registered Nurses with a Vaccination Certificates, not just the current Covid update, should be able to vaccinate by themselves at times when a Doctor is not there. They do this all the time for other vaccines e.g. at high school immunisation clinics and other situations. This would really make a difference as we could simply provide a location for vaccination to take place. Covid vaccine has proven to be as a safe as other vaccines and probably better tolerated than a vaccine like Bexsero. Admin would need to assist the nurse. How can this entirely logical, entirely safe situation not be allowed.