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RACGP ‘working to find a way forward’ amid assignment of benefit concerns
The college says it is in constant communication with the Department to resolve GPs’ concerns with the upcoming changes.
‘We have shared those concerns of the membership with policymakers, and we are working to find a way forward.’
Incoming changes to the way Medicare benefits are assigned to patients are continuing to cause concern for many GPs, particularly compliance in residential aged care settings.
In response, the RACGP says it appreciates GPs’ ‘significant concerns’ and is continuing to actively lobby the Federal Government for a practical solution ahead of next month’s start date.
From 1 July, a changed assignment of benefit process will commence for Medicare bulk-billed services, impacting the way patients assign their Medicare benefit to a provider in exchange for not incurring any out-of-pocket costs.
Next month’s changes include the need for an electronic or physical signature to be collected from the patient, or responsible person, as part of the assignment of benefit, and a requirement for practitioners to keep that completed agreement for two years.
Consent can be obtained before or after a service is rendered (pre- and post-assignment) but must be prior to a claim being submitted. It is also required for every individual bulk-billed service (known as episodic assignment).
When a patient is unable to sign an assignment of benefit agreement, such as those in aged care settings, an assignor (namely a parent, partner, carer, relative, person with power of attorney or friend) could be asked to sign the agreement on their behalf.
However, many GPs remain worried they won’t be able to bulk bill these patients in situations where a compliant representative is unable to sign on their behalf.
RACGP President Dr Michael Wright said the college is in ‘constant communication’ with the Department of Health, Disability and Ageing (DoHDA) ‘trying to fix this problem and to find a way forward that’s fit for purpose’.
‘We’ve heard the concerns from members saying that these changes will not be fit for purpose and will drive GPs away from providing care for nursing home patients – those have been made and heard loud and clearly,’ he told newsGP.
‘We’re very concerned that GPs feel, due to concerns of potentially being non-compliant with Medicare, that they will either stop visiting nursing homes or shift to private billing.
‘We have shared those concerns of the membership with policymakers, and we are working to find a way forward.’
However, Dr Wright said DoHDA recognises ‘there’s a real problem here’.
‘This transition risks having major impacts on access to care for patients in residential aged care facilities,’ he said.
‘There are also major changes to the workflow of general practice that have to be thought about before changes are implemented.’
A spokesperson for the DoHDA said ‘the Department appreciates that moving toward a compliant workflow will be a transition for the sector’ and it is taking stakeholders’ concerns on board.
‘The focus is to ensure providers understand the options for patient assignment of benefit,’ a spokesperson told newsGP.
‘It has been a longstanding requirement under the Health Insurance Act 1973 that for bulk billing to occur, a patient (or another person on behalf of a patient as appropriate) must assign their Medicare benefit to the provider in exchange for not incurring any out-of-pocket costs.
‘The Department is continuing to explore issues raised by stakeholders and possible solutions that could support practices to adopt compliant solutions.’
These AoB requirements, the Department adds, are designed to safeguard vulnerable patients’ rights, ensuring decisions are made in their best interests while maintaining appropriate privacy protections.
‘These settings are also broadly consistent with existing requirements and strike a balance between enabling access to care, protecting patient autonomy, and ensuring GPs can bill.’
To prepare for the updated requirements, practices are urged to:
- consider when and how patients assign their benefit. This could be during booking, check-in, the consultation itself, or post-visit (using paper or electronic methods such as SMS or email).
- ensure patient contact details are up to date and understanding preferred communication channels. Existing check-in and registration processes can support this.
While a specific form is no longer required, Services Australia will make template forms available. Providers can also design their own, provided all required information is included.
In other steps, practices can engage with their software vendors to understand compliant electronic assignment options that can streamline administrative processes as well as visit the Government’s
Frequently Asked Questions, with further supporting information to be available soon.
The spokesperson added that the Department is working to finalise regulations to support enduring assignment of benefit for patients who are registered in MyMedicare or receive services from an Aboriginal Community Controlled Health Organisation or Aboriginal Medical Service.
‘Enduring assignment of benefit will require an agreement to be signed once (by a patient or their assignor), for ongoing and future services from a preferred clinic/practice,’ they said.
To help GPs navigate the new rules, the RACGP has set up a
webpage with information and resources.
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