Joint call for temporary lift to 30/20 telehealth rule

The 30/20 rule must have its threshold expanded to 50 days if fuel shortages deteriorate, the RACGP and Australian Medical Association (AMA) have urged.
 
In a letter to Federal Health and Ageing Minister Mark Butler, the organisations have banded together to call for contingency measures, allowing health practitioners to rely on telehealth consultations more than under current settings.
 
According to the MBS prescribed pattern of service rule, widely known as the 30/20 rule, if GPs carry out 30 or more daily telehealth consultations on 20 or more days within 12 months, they are referred to the Professional Services Review.
 
In the letter, the RACGP and the AMA advised keeping the current limit of 30 daily consultations per day but expanding the threshold to 50 days during any time when Level 3 of the National Fuel Security Plan is in place.
 
The current status is Level 2, but there have been rising concerns about instability and conflict in the Middle East in recent weeks.
 
RACGP President Dr Michael Wright said the letter is designed to prompt change that would give GPs more certainty should the situation worsen.
 
‘We’ve seen fuel prices going up and ongoing conflict in the Middle East with no clear end in sight,’ he told newsGP.  
 
‘And we know with that GPs are likely to be providing more care remotely.
 
‘The RACGP and the AMA are working together to get a sensible lifting of this number so that GPs who are appropriately providing care remotely, particularly with increasing fuel costs, aren’t going to be subject to Medicare compliance.’
 
In reponse to the letter, a Health, Disability and Ageing Department spokesperson said it ‘acknowledges the challenges of fuel pricing and supply for some individuals and communities’.
 
‘The Australian Government continues to monitor the Middle East conflict with respect to fuel disruption and its potential impacts on the health system,’ they told newsGP.
 
‘As circumstances change and evolve, the department will provide advice to Government.
 
‘The Government and department will continue to work with industry and community, including the healthcare sector, as the circumstances change and evolve as part of its National Fuel Security Plan.’

It follows advice issued in May by the Australian Health Practitioner Regulation Agency (AHPRA) encouraging health practitioners ‘to consider whether telehealth is an appropriate alternative to in-person consultations during the global fuel crisis’.
 
‘With Australians being urged to conserve fuel, practitioners can play a role in supporting patients and the healthcare system to avoid unnecessary travel – but only when it is safe to do so,’ AHPRA stated.
 
‘This may include opting for telehealth instead of in-person appointments, and replacing regular home visits with telehealth check-ins, where clinically appropriate.’
 
When fuel prices rose sharply earlier this year, Chair of RACGP Specific Interests Poverty and Health Dr Tim Senior said telehealth becomes more popular with patients who are on tighter budgets.
 
‘People have already been stretched by the cost-of-living crisis and will be watching household bills and costs really closely – any travel that’s avoidable will go early and that’ll happen more among people in families who have less income,’ he told newsGP.
 
Dr Wright hopes the Federal Government will respond positively in advance of any change in the status of Australia’s National Fuel Security Plan.
 
‘We’ve asked if we do get to Level 3 restrictions for this to be automatically introduced,’ he said.
 
‘As GPs, there’s a lot of care that we can provide remotely for our patients, particularly for people who we know well – so this change will make sure that is able to continue without anyone falling foul of Medicare’s compliance mechanisms.’
 
For AMA President Dr Danielle McMullen, changing the 30/20 rule to 30/50 during a Level 3 situation would be a ‘sensible, temporary contingency measure’.
 
‘Preparing those arrangements now will ensure the health system can respond quickly if circumstances deteriorate,’ she said.
 
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30/20 fuel crisis Medicare rule telehealth