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Minister moves to reassure GPs after ‘archaic’ telehealth change


Michelle Wisbey


6/10/2023 4:50:55 PM

Mark Butler has told the RACGP he will update telehealth bulk billing consent rules and that there are ‘no plans to pursue … punitive actions on this issue’.

Mark Butler
Federal Health and Aged Care Minister Mark Butler has asked his department to provide new options for gaining telehealth bulk billing consent. (Image: AAP)

Federal Health and Aged Care Minster Mark Butler has instructed Government health bureaucrats to ‘provide options’ on a contentious Services Australia update which left practice owners drowning in a sea of red tape.
 
That update required GPs to fill in a form documenting patients’ verbal agreement to be bulk billed for telehealth – a complex and ‘old-fashioned’ step backwards.
 
But in a statement to the RACGP on Friday, Minister Butler said those changes will likely be scrapped.
 
‘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.’
 
Last year, the Department of Health and Aged Care (DoH) revealed the practice of requiring consent to bulk bill for telehealth was under review, after it was altered to accommodate the COVID-19 pandemic.
 
But Services Australia now states the preferred method for obtaining patient consent to be bulk billed for telehealth consultations is in writing or via email.
 
Verbal consent remains possible but only by using accompanying forms, meaning that while it was previously possible to document verbal consent in clinical notes, that option is no longer available.
 
The change sparked widespread anger and chaos among GPs, who described it as a breakdown of trust between the medical profession and the Government.
 
RACGP President Dr Nicole Higgins welcomed Friday’s change of heart, but said it showed the DoH had not communicated with, or sought feedback from, key stakeholders.
 
‘What’s really important moving forward is that we’re involved in discussions around what that legislative change should look like and how we modernise the process,’ she told newsGP.
 
‘It needs to be a modern system that’s digitalised and integrated with our medical software, that’s transparent, and that is seamless for both GPs and patients.’
 
Dr Higgins said the Services Australia move was a ‘kick in the guts’, and the last thing needed by already busy GPs.
 
‘We want to be spending time with our patients not filling in more paperwork,’ she said.
 
‘The announcement last week created so much anger among GPs and practices at a time when morale was already low.
 
‘Admin teams and practice managers were angry and confused. It caused chaos as everyone scrambled to become compliant, to do the right thing.’
 
The DoH is yet to reveal a timeframe or any details of potential bulk billing changes.
 
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Dr Linda Charlotte Lombard   6/10/2023 6:35:34 PM

and they want to encourage us to bulkbill..


Dr Dhara Prathmesh Contractor   7/10/2023 8:16:23 AM

Medicare item numbers and General practice rules and regulations seems to be changing monthly basis. Theoretically thrilling drama.
Each time a government changes and advertising polling strategies changes . Political vote pressures , affecting general practices and patient care. Each time new promises… and then new rules to implement and follow. Seems a doctors education and effort to their careers with requirements of 99.95 ATARS have work hard, studied hard, but needs to be doing their jobs as priced by Medicare and governments. Doesn’t happen in any other industries. Why?
General practice respect and goodwill in community rotates around bulk billing. Instead of good clinical care.
Instead of new Medicare item numbers changes advertising- more patient education advertising on their health ( for example cancer screening)will benefit communities better.


Dr Amber Penny Kimmins   7/10/2023 10:01:16 AM

Ridiculous red tape


Dr Conor Calder-Potts   7/10/2023 11:10:21 AM

It’s the typical Department of Health modus operandi. We’ve introduced this new time consuming rule for GPs to comply with. *backlash from GPs*. Minister announces that rule is still in place but they probably won’t enforce it… GPs are perpetually being threatened with a big stick. It makes our job harder and harder to do and primary healthcare becomes ever more bogged down with fear and compliance issues.


Dr Peter Callel James Joseph   7/10/2023 11:48:57 AM

The RACGP needs to be a political advocate for GPs in the absence of any other. The Gorton Scheme led to deliberate de-skilling of undifferentiated doctors from the early 1960s, Then Medicare allowed the bad behaviour of a significant minority to devalue our services and work for a rebate now half of its historical value. A standard consult of $90 would have incurred a patient cost of $13.50 had the compulsory gap been enforced. We would have fee for service instead of contorted service for rebate.
We treat patients and not Medicare, which has almost destroyed our specialty.
The RACGP Vision statement is a start but it politely avoids discussion of how we got here and the difficulty of dealing with a Government wedded to bulk-billing and aware of the fact that like the frog in hot water we have not noticed our progressive demise. The longer we contort ourselves to try to make it work the worse it gets.
Civil disobedience anyone?


Dr Alfred Edward Ledner   7/10/2023 3:51:26 PM

Its dead simple. Just don't Bulk Bill and watch the Minister writhe, cos his department is pretty much independent of his "I have asked my Department to provide options". They will provide more red tape. He has not promised anything and he can't because it needs legislation not the promise of a politician out of control of his public servants.


Dr Boris Mezhov   7/10/2023 5:26:05 PM

Significant proportion of my patients are elderly migrants from pre- digital era, belonging to few migration streams from 1980s and 1990s. Many of them are totally dependent on IT skills of their children and grandchildren. They are still struggling badly with that stupid idea of the previous Government to cancel Brand medications names in an officially declared by Department of Health campaign " To learn more about your medications''. Huge number of that time immigrants request me to write the habitual ''Brand '' name by hand on prescription until now. I would not be very wrong stating that this stupidity triggered massive loss of voices at recent Elections.
On the top of patients mentioned above, our Practice is looking after Ukraine war refugees. Not mentioning English skills, these unfortunate patients frequently do not have PC at home, and in many cases rely on Social Security, on their neighbours , or on their GP help.
Does anyone think of those patients now?


Dr Michael Charles Rice   9/10/2023 10:26:35 AM

Now is the time for some official advice from our Colleges, MDOs and rep bodies.

What's it to be?
- Stick with the Law as explained by Services Australia (https://www.servicesaustralia.gov.au/changes-to-mbs-items-during-coronavirus-covid-19-response?context=20#requirements)
- Something else?

Strategic thinking caps required!


Dr Jennifer May Smith   10/10/2023 5:33:10 PM

So the best they'll do is "we probably won't punish you..." Feeling REALLY reassured...


Dr Christopher Thomas G Collins   14/10/2023 4:03:57 PM

Dear Mr Mark Butler, I am a GP working in Caboolture Qld for 30 years. I am on the cusp of retirement, and there are not enough GPs coming through training programmes or from overseas to fill the places of retiring GPs. General Practices mostly run on a shoestring of profit nowadays because of 30 years of inadequate indexation of medicare rebates. The introduction of Telehealth rebateable consultations might be the only reason that some practices are surviving.
My regular patient population is elderly and many do not have a computer, internet access, nor a mobile phone, and still have just a landline number. Does this mean that every one of my telehealth consultations with them requires a paper form to be mailed to the patient and returned or for them to fill out a paper consent at the practice? This is draconian and unworkable.
Many GPs on the cusp of retirement like me may call this the last straw, after Payroll tax and the doubling of CPD requirements. Retirement now?