Health Secretary urged to delay telehealth rule changes

Matt Woodley

21/06/2022 4:32:31 PM

Proposed changes to MBS claiming rules should be further deferred, the RACGP has said in a letter to Professor Brendan Murphy.

GP on the phone.
There are concerns that incoming telehealth restrictions will impact patient access to general practice services.

RACGP Vice President Dr Bruce Willett has written to Federal Health Secretary Brendan Murphy, strongly recommending that changes to the 80/20 and 30/20 prescribed pattern of service rules be deferred.
Currently slated to be implemented on 1 July, the 30/20 rule would result in any GP providing more than 30 daily telephone consultations on 20 or more days over a 12-month period being referred to the Professional Services Review (PSR).
Similarly, the updated Medicare compliance rules would also see telephone and video services follow the established 80/20 rule, which deems that a GP or other medical practitioner has engaged in ‘inappropriate practice’ if they render or initiate 80 or more professional attendance services on 20 or more days in a 12-month period.
However, there are concerns these restrictions would be ‘problematic’ and impact patient access to general practice services, particularly in the context of the ongoing COVID-19 pandemic and current high rates of influenza and other respiratory illnesses in the community.
In the letter, Dr Willett wrote that a ‘comprehensive review’ should be undertaken prior to implementing the rules to ensure they are fit for purpose and accurately reflect the new telehealth environment.
‘The high number of COVID-19 cases in the community continues to be a challenge for GPs and the broader health sector,’ he said.
‘The RACGP is concerned that the circumstances have not changed since the decision to defer was made and that the re-introduction of these rules in July 2022 will generate unnecessary anxiety amongst GPs, potentially impacting on patient care.
‘Telehealth consultations, particularly via phone, have been a vital tool in the pandemic response [and] access to telehealth is even more critical during the winter months as the incidence of seasonal illnesses increases.’
The letter goes on to state that many patients still prefer to access care via telehealth due to the high number of COVID cases in the community, which ‘raises further questions’ around the appropriateness of the 30/20 rule.
‘While we acknowledge that the prescribed pattern of service rules are designed to deter misuse and corporate malfeasance, GPs should not be punished, and their wellbeing put at risk when they are doing their best to care for their patients,’ Dr Willett wrote.
‘The RACGP has been told by numerous members that the punitive compliance agenda being pursued by the Federal Government around pandemic management and use of item numbers is a reason for GPs to consider early retirement from the profession, to seek non-clinical roles and/or to reduce their consulting hours.
‘Extending the deferral of these rules provides a timely opportunity to undertake a comprehensive review … to ensure the department’s purpose for having the rules can be achieved while not compromising on GP wellbeing and patient care.’
The RACGP Vice President also called for the rules to be simplified ahead of any extension.
‘Most GPs continue to do the right thing, despite the many changes to telehealth rules and bureaucratic interventions into medical practice,’ he wrote.
‘[But] without having a clear understanding of the need for these rules and how the benchmarks have been determined, GP confidence in the system will be compromised.
‘Unless the rules are simplified and more resources put into education and awareness-raising activities to ensure practitioners fully understand the rules, it will inevitably have an impact on patient care through a reduced medical workforce and increased practitioner stress.’
The expansion of the 80/20 and 30/20 rules has already been delayed once due to high COVID case numbers and there is hope a similar outcome will be reached before the end of the month.
‘The Government announced an extension of the COVID-19 Response funding arrangements following the National Cabinet meeting of 17 June, which we understand includes a deferral of the prescribed pattern of service arrangements for telehealth until 31 December this year,’ Dr Willett said.
‘We strongly urge the department to heed our advice and use this opportune time to defer and review the 80/20 and 30/20 prescribed pattern of service rules as a matter of urgency.’
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Dr M Tran   22/06/2022 8:50:27 AM

I desperately appeal to Health Department to relax the 80/20 and 30/20 rules.
Throughout pandemic, GPs have seen a large numbers of patients. Now GPs have to refuse seeing patients, even refuse Telehealth appointments, just to obey the 80/20 rules.
Limit of 80 patients a day, including Telehealth consultation is ridiculous, out of date, put enormous stress on Doctors and patients.
GPs refuse to see and to talk to patients, patients will call Ambulance and end up in Emergency Department, put more strain on health system.
Media, Politicians always blame on shortage of health care workers, why would they restrict doctors from treating patients?
I started to limit the booking and felt extremely stressed due to patients’ high demand and anger
GPs are always under pressure from both ends: politics and patients.
I am calling for a revise of the 80/20 rule now including Telehealth. This rule really causes more stress to Doctors, patients and health care system.
Sincerely yours,
Dr M Tran

Dr Arshad Hussain Merchant   22/06/2022 2:38:57 PM

GPs have relied too much on Medicare bulk billing, it is time to shift
No one bound us not to practice privately
Telephone appointment without Medicare rebate
You will only be audited if you are going to use the MBS item code
RACGP should endorse the use of non Medicare rebatable practice