Telehealth to be expanded for all patients

Anastasia Tsirtsakis

24/03/2020 4:06:36 PM

GPs will be able to bulk bill telehealth services for all Australians from next week.

GP on the phone
The Federal Government has heeded the call of thousands of GPs amid the coronavirus pandemic, opening up the telehealth eligibility criteria to all Australians.

GPs will be able to bulk bill phone or video consultations with all patients from next week in a bid to help contain the rapid spread of coronavirus, AAP has reported.

The Federal Government has expanded the eligibility criteria to include all GPs, specialists, and mental health and allied health professionals.

‘This has been one of the most significant changes we’ve seen in Australian general practice in my working lifetime of 35 years,’ Professor Michael Kidd, Principal Medical Adviser to the Department of Health, said. 

The reform follows continued advocacy from the RACGP, and other medical and patient groups, who have been working tirelessly with the Federal Government to co-design the response to the pandemic.

As it stood, the eligibility criteria for bulk-billed telehealth only included suspected or confirmed cases of COVID-19 (coronavirus), and particularly vulnerable cohorts. Anyone between the ages of one and 70 (or one and 50 for Aboriginal and Torres Strait Islander people) had been excluded.

‘The RACGP has said from the start, we need telephone and videoconferencing item numbers for all patients. We need them to continue providing quality care so we can protect patients, GPs, and their teams,’ RACGP President Dr Harry Nespolon told newsGP. ‘We have been working closely with Minister Hunt and the Department of Health to achieve this.

‘We thank the minister and the department for listening to our concerns, and addressing them. There is still work to be done, but we think we can get there within the week.’

Telehealth expansion has been seen elsewhere in the world as confirmed cases soar, with GPs in the UK advised to consult patients remotely where possible. Similarly, in the US President Donald Trump has rolled out telehealth accessibility for all Medicare recipients.  

Locally, Federal Health Minister Greg Hunt praised the opening up of telehealth to all Australians as ‘an extremely important development’.

‘Very important to stress, however, that a very large proportion of GP services of course require face-to-face treatment,’ he said. 

Meanwhile, Private Healthcare Australia chief executive Rachel David said private health funds are working to expand consultations for mental health services. Dr David also called on health funds to give relief to members experiencing financial difficulty as a result of the pandemic.

General practices have been feeling mounting pressure. Rapidly changing medical advice has meant staff members are constantly inundated with requests for information, while personal protection equipment (PPE) shortages have been worsening. 

The Federal Government has said it will continue to work with the RACGP and other peak bodies, with the next stages of the response expected to be confirmed by the end of this week.

The RACGP has more information on coronavirus available on 
its website.

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Dr Manju Salaria   24/03/2020 8:03:50 PM

Thanks a lot. It would be so useful for everybody, patients and doctors as well as the rest of the public.

Dr Stuart Nash   25/03/2020 7:59:22 AM

Why 30th March? Will COVID-19 stop and wait for us all to be ready?
Medicare clearly has some inside knowledge that GPs and our families are immune for the next five days?!
The item number is there, why not start now?

Dr Robert James Douglas   25/03/2020 9:05:51 AM

Why the wait? I've been doing it for ineligible px since last week. Wish I could retrospectively bill.

Dr Ban K. Hameed   25/03/2020 9:12:13 AM

Thank you very much

Dr Benjamin James Weatherhead   25/03/2020 9:15:43 AM

Unfortunately I suspect that, like the other telehealth items, there will be a requirement for universal bulk billing.

A.Prof Christopher David Hogan   25/03/2020 9:27:04 AM

The elephant in the room is the effect of significant unemployment in the community. I am uncertain as to how many patients can afford to pay private fees. How can we structure our practices so that we remain economically viable?

Dr Ghulam Murtaza   25/03/2020 10:36:11 AM

Thank you RACGP... thanks a lot. We don’t have PPE neither masks at all.. Thanks for fighting for us. Love you all. 😊

Dr Daniela Costa   25/03/2020 11:10:25 AM

It would be important to include telephone consultations by GP's providers of FocusPsychological Strategies

Dr Ian Mark Light   25/03/2020 4:49:26 PM

The RACGP has done well and the Government also pressure is lessened .
But with the URTI and LRTI arriving hopefully less because of the “lockdown “ the basic PPE - mask gloves gown head cover goggles and face shield plus rapid tests as the technology is there have to be here by May and their will need to be trial runs and ability with putting on the PPE and taking the PPE off with a “buddie “
Good videos y tube CDC USA .

Dr Hassib Faraj   25/03/2020 8:57:44 PM

Better late than never, I do believe our RACGP DID ACT VERY LATE, WE’ve been working by ourselves our measures since early February to avoid the spread of the virus to our patients and ourselves. Still very unknown the cases when you are obliged to open the door for a suspected cases to listen to their chests, examine their throats without having a PPE.?it is good advance but still a lot hidden , not very clear. I do believe that all patients suffering from respiratory viral inf should attend a respiratory designed clinic well equipped with PPE. DOCTORS AND NURSES. SO TAKE A LOT OF BURDEN FROM UNPROTECTED Vulnerable doctors. And this should be done ASAP. INFORM THE DOCTORS ABOUT ALL RESPIRATORY CLINIC IN ALL SUBURBS. THANKS

Dr Helena Spencer   25/03/2020 10:00:23 PM

It would be great to do Mental Health Care Plans under a telehealth number - patients are already ramping up with psychological distress (teachers who cant sleep from anxiety etc) and we haven't reached a total lock down yet. Psychologists are going to be an important part of keeping Australians mentally healthy and capable of riding this out .

Dr Mohammad Anowar Hossain   25/03/2020 11:44:59 PM

I am working as a GP with ABN. It means no work no money. If I get sick with COVID 19 what is the financial security for me and my family?
I think this is the question for most of my fellow GPs in RACGP family.

Dr Catherine Alexandra Lee   26/03/2020 8:07:45 PM

Please just let us use the standard item numbers when we consult via telehealth. Our brains are completely full at the moment.
Please allow us to determine who we bulk bill and who we charge a gap.

Dr Hema Irene John   27/03/2020 11:31:43 PM

Can we use the usual MBS item numbers for telehealth consults from 30 March 2020

Dr Nicholas A. Cooper   28/03/2020 7:00:52 AM

From the AVANT site A: The advice from the Department of Health is that patients are still required to consent to their telehealth service being bulk-billed, as per normal practice for bulk-billed services.

This means the patient's signature is still needed on the General, Specialist and Diagnostic (assignment of benefit) form (DB4). You can get this form through Medicare Bulk Bill Webclaims using HPOS

This is going to make the whole process very clunky. Surely MBS can accept verbal consent

Dr Duncan MacWalter   28/03/2020 7:51:35 AM

1. Why is there no official communication from MBS about this (as of 6:50am 28/03/20), to allow proper planning for Monday.

2. Why have we had a week where some patients were eligible for a rebate based on age/health/ethnicity of the doctor?

Dr Oliver Frank   28/03/2020 8:28:50 AM

The Minister said: "Very important to stress, however, that a very large proportion of GP services of course require face-to-face treatment."

For now at least, I am finding that I can provide care from home to most of my existing patients using telephone consultations. The biggest immediate need is now is for the Minister to allow dispensing of 'unsigned' prescriptions from the Electronic Transfer of Prescriptions repository that has all of the details needed and that pharmacists have been accessing for years to save re-typing the details into their dispensing systems, and that also reduces the risk of error. This would eliminate the need for anybody to have or to handle a printed prescription.

Dr Bruce Vernon Mugford   28/03/2020 9:13:58 AM

Forcing bulk billing is driving clinics to the wall. Private billing + extended primary care services make general practice sustainable. Patients also too scared to come to clinics so numbers down.
Rebate MUST be increased to same as other specialists or introduce co-payment.

Dr Michelle Anne Ledbury   28/03/2020 9:32:24 AM

We should
Still be able to charge a gap with private patients, there is no reason why not and can be at the discretion of the dr depending on the situation.m of the patient. Else practices taking more than a 50% pay cut. I realise we are in a luck position to have a job, but we are also taking lots of medicolegal risk being on the phone and practices still need to financially survive.

Dr Kate Elizabeth Schilling   29/03/2020 2:56:28 PM

Well, thanks for writing another piece giving confusing information.
You have written: “The package includes opening up telehealth and telephone Medicare Benefits Schedule (MBS) items to all Australians, doubling the bulk-billing incentive for GPs, and the introduction of a new incentive payment to help general practices stay open to provide face-to-face services for patients with conditions that cannot be treated via telehealth.”
Sounds great, but can be easily misunderstood to mean that all GPs can now use Telehealth MBS items for all patients. In a time like this, GPs are already overloaded with a barrage of confusing news, and if the interpretation of the MBS item numbers were not complicated enough, now we have another article written obscuring it even more.
MBS Online: The Australian Government is enabling vulnerable GPs and other vulnerable health professionals who are authorized to use telehealth item numbers, to use telehealth for all consultations with all their patients.
This includes health care providers who are:
o Aged at least 70 years old.
o Indigenous and aged at least 50 years old.
o Pregnant.
o A parent of a child under 12 months.
o Immune compromised.
o Have a chronic medical condition that results in increased risk from coronavirus infection.
It would be nice if you could write articles that help to dispel confusion rather than add to it.