GPs urged to contact MPs about assignment of benefit concerns

Jolyon Attwooll

10/10/2023 4:07:43 PM

The RACGP has issued a letter template for members, which includes a request to make verbal consent to bulk bill telehealth a permanent feature.

GP in front of laptop
A templated letter has been prepared for GPs to write to their MP about assignment of benefit changes.

GPs are being urged to express their ‘deep concern and frustration’ about extra bureaucracy introduced to the telehealth bulk billing process by writing to their local MPs.
A newly released template letter is now available through the RACGP’s advocacy resources in response to changes requiring GPs to obtain written consent to bulk bill a patient for a telehealth appointment, or complete a form documenting verbal consent.
It warns that genuine improvements and health system reforms are being undermined by ‘unnecessary, outdated and inefficient bureaucratic requirements’. 
‘These requirements will make it cumbersome and administratively unviable for GPs to bulk bill telehealth appointments and further contribute to declining rates of bulk billing,’ the letter reads.
‘This is a 20th century approach to 21st century healthcare that is inefficient and cumbersome.’
According to the college, the forms introduced by Services Australia that are now required to complete the bulk billing process for telehealth do not integrate with existing practice software.
In its template, the RACGP states that obtaining verbal consent for telehealth should be made permanent, with a digital solution to recording patient consent integrated with existing clinical information systems described as ‘a sensible way forward’.
MPs who receive the correspondence from GPs will be asked to raise the issue directly with the Federal Health and Aged Care Minister Mark Butler to ‘ensure a quick resolution’ and allow continue access to bulk billed telehealth.
RACGP President Dr Nicole Higgins said she hopes as many GPs as possible will join the college’s advocacy efforts.
‘The change to assignment of benefit requirements, which was introduced without any proper consultation, has caused entirely predictable and unnecessary stress – and is already having an effect on patients,’ she told newsGP.
‘I have expressed my views directly to the Minister and it is to his credit that he has responded to address our worries.
‘I encourage my GP colleagues to make it clear just how widespread our concerns are in general practice, and to keep the impetus going for a speedy solution.’
In response to outcry about the changes last week, Minister Butler moved to dampen down the controversy.
‘I have asked my department to provide options to address concerns about the assignment of benefit for Medicare bulk billed claims, including legislative amendments,’ he said.
‘My department has advised me that until these changes are made, there are no plans to pursue any broad punitive actions on this issue, unless it relates to fraudulent claims against Medicare.’
There has not yet been any timeframe put on potential legislative changes, although Minister Butler said the RACGP will be consulted on proposed amendments before any are put in place.
The most recent poll run on the newsGP website showed an overwhelming majority of readers are likely to move to private billing if the extra paperwork requirements remain in place.
Anecdotally many general practices have said they have already cut down on bulk billing telehealth as a result, with some saying they have stopped altogether.
There is no public data yet available to verify the impact.  
Next month will mark the start of a flagship health measure from the 2023–24 Federal Budget, with the introduction of a bulk billing incentive that is triple the current rate.
Weighted in favour of the most remote areas, the incentive is funded by $3.5 billion over five years, with the initiative expressly intended to address the recent decline in bulk billing.
It will apply to all bulk billed level B telehealth consultations lasting 6–20 minutes, while longer consultations will require the patient to be part of MyMedicare.
When telehealth was widely introduced shortly after the onset of the pandemic in Australia in 2020, verbal consent for bulk billed appointments was permitted to be recorded in the patient notes.
However, a critical report by the Australian National Audit Office (ANAO) published in January this year highlighted concerns about that approach’s ‘failure to manage legal risk’.
More information on assignment of benefit and signature requirements can be found on the RACGP website.
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Dr Leo Graham Priest   11/10/2023 11:52:01 AM

How about we e-mail our MPs with a link to a form they have to complete, print out and mail back to us requesting the contents of our correspondence. That may better demonstrate our frustration.