GPs included in proposed new medical fee laws

Fees and bulk-billing rates could be listed by default on a revamped Medical Costs Finder website by the end of the year, according to proposed new laws – which also includes several specific references to general practice.
 
The detail was unveiled as part of the Improving Choice and Transparency for Private Health Consumers Bill, which was introduced into Federal Parliament last week.
 
‘While the focus is on the charging practices of non-GP specialists, GPs and their billing could also be published on the website in the future,’ Federal Health and Ageing Minister Mark Butler said.
 
While the proposed legislation has been presented largely as a crackdown against rising non-GP specialist fees and private health insurance costs, it very specifically includes general practice within its remit.
 
‘While the focus is on the charging practices of specialists, the Department may also publish information about GPs and other medical practitioners and their charging practices,’ states an explanatory memo to the Bill.
 
‘GPs would be particularly relevant to publish as they are often the first step of a patient journey for specialist treatment.’
 
It also says the proposed data on the Medical Costs Finder could be published at the end of this year or early 2027, if the Bill passes Parliament, and that it could also show details about the level of bulk billing carried out by GPs.
 
RACGP President Dr Michael Wright said he welcomes greater transparency on costs, but points out existing RACGP standards for general practices already cover this.
 
‘Within the standards, we encourage practices to be clear about what the patient fees are going to be,’ he told newsGP.
 
‘It’s not difficult to find out what a practice might charge.’
 
Bulk-billing rates are also covered by the legislation under consideration.
 
‘The proposed amendments to the [Health Insurance] Act and [Private Health Insurance] Act also include the publication of the bulk-billing rates by GPs and medical practitioners, which particularly address affordability concerns for lower income people,’ the accompanying memo states.   
 
But with the national GP bulk-billing rate currently sitting at more than 80%, it is another area where Dr Wright queried the purpose of any future version of the Medical Costs Finder including GP data.
 
‘It doesn’t seem very useful to focus on GP fees for something like this – it wouldn’t seem like an area that needs to be prioritised,’ he said.
 
Currently the website sets out typical costs for various item numbers, but does not list specific general practices, with treatment locations listed as generic ‘out-of-hospital’.
 
Minister Butler has long flagged a crackdown on non-GP specialist fees.
 
In a pledge before last year’s Federal Election, he promised an upgrade to the Medical Costs Finder, which was set up to provide transparency on the costs of specialist consultations and services.

The service was introduced in 2019, with sign-up currently voluntary, and uptake so far described as ‘disappointing’.
 
Only 1–2% of specialists and 10% of private health insurers were taking part as of December 2025, the Government said.
 
According to legislators, the revised tool would draw on existing Medicare, hospital and insurer billing data, and also publish specialists’ use of gap cover arrangements with insurers to reduce out-of-pocket costs along with individual fees.
 
It would also include fees for common GP telehealth items and allow medical practitioners to show voluntarily whether they offer telehealth, a measure the Government says ‘would also help Australians living in more regional or rural areas’ if the legislation goes ahead in its current form.
 
A drive to allow fee comparison is also cited several times in the explanatory memo.
 
Under the proposals, the Department of Health, Disability and Ageing (DoHDA) would publish an explanation about its approach for calculating the figures, with the legislation noting that the ‘relevant medical practitioner, hospital and insurer may find differences between the published figure on the Medical Costs Finder and their own data’.
 
The legislation says DoHDA will set up an internal review process for medical practitioners, hospitals and insurers ‘to enquire or request a review of the information published about them’ – a proposal that concerns Dr Wright.
 
‘They need to do more than just having an internal review, they really need to work with important stakeholders like the college to make sure that the information they’re using and its interpretation is valid,’ he said.
 
‘We definitely need further consultation to understand what the implications of these changes might be.’
 
The legislation could allow additional information to be published if it later becomes available.
 
‘For example, if a national dataset relating to quality indicators of medical practitioners became established later, this could be a valuable complement to the existing information about medical practitioners’ charging practices,’ the memo states.
 
It also gives an extended example of how the Medical Costs Finder might work using a fictitious example of a GP consult.
 
Here, a GP is talking to a patient about a possible colonoscopy, and together the GP and patient use the website to find the fees and out-of-pocket costs of a nearby gastroenterologist.
 
The example reflects the proposals of a recent consultation paper, which suggests mandating GP referrals to include standardised information from the Medical Costs Finder. 
 
The Federal Government set aside $7 million in the 2025–26 Budget to upgrade the website.
 
A second part of the new Bill seeks to force private health insurers to seek ministerial approval of new products to prevent the practice of so-called ‘phoenixing’, where one old product is replaced by a similar but more expensive new one.
 
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