Colleagues,

Further to the email I sent last week updating you on the H1N1 vaccine program rollout, the Department of Health and Ageing has provided further advice about a number of important matters.

Outlined below is the latest detailed advice from the Commonwealth Department of Health and Ageing about:

1. MBS billing for H1N1 vaccination services;
2. the use of consent forms;
3. other administrative matters.

1. MBS billing for Pandemic (H1N1) 2009 Vaccinations provided by Medical Practitioners and Practice Nurses/Registered Aboriginal Health Worker

Location
A medical practitioner may provide vaccinations at a place such as a school hall or community centre as well as at consulting rooms, residential aged care facilities and other specific institutions.

As is normally the case, when providing a professional service under Medicare, a medical practitioner must provide either his or her name and address, or provider number on the account, receipt or bulk billing agreement. Where a service is provided at a venue such as a school or community centre and the medical practitioner chooses to list his or her name and address, the medical practitioner need only provide his or her usual contact address - not the address at which the service is provided.

Medicare Australia has confirmed that providing H1N1 vaccinations under Medicare temporarily from a venue, such as a community hall or school that is not an address associated with a practitioner's Medicare-registered practice location, is acceptable under Medicare Australia's administrative rules. These arrangements will be reviewed on 1 March 2010.

This includes doctors who are accessing Medicare benefits under a location specific section 3GA program placement or section 19AB exemption.

Claiming for GP, Practice Nurse and Aboriginal Health Worker services

In terms of providing Medicare-eligible GP and practice nurse or registered Aboriginal health worker services to the same patient, the usual rules apply.

A vaccination can be provided by a practice nurse (MBS item 10993) or a registered Aboriginal health worker (MBS item 10988), for and on behalf of and under the supervision of a medical practitioner. The patient can receive a service under another Medicare item that is additional to a service under items 10993 or 10988 where the medical practitioner also provides a service to the patient in addition to the immunisation being administered by the practice nurse or registered Aboriginal health worker who performs the immunisation.

2. Consent forms

Consistent with advice to you in my previous email, the Department of Health and Ageing has reconfirmed that filling out the consent forms is not compulsory - they are provided to assist GPs. GPs are able to make their own clinical decision on the means by which they inform their patient of possible side effects etc, which is normal clinical practice. They can do it verbally if they wish. The distribution of the Consent Forms is to assist those doctors who wish to use the forms to inform their patients.

In summary, vaccine providers are advised to have regard to their usual informed consent procedures applicable to the use of vaccines that are registered for use by the TGA. A vaccination consent form can be provided with each dose of vaccine ordered. Please advise your State or Territory health department if you will not be using consent forms or do not require ongoing delivery of consent forms with each order of vaccine placed.

3. Other vaccine administration matters

The Department of Health and Ageing has now posted a list of Q&As for healthcare professionals on the healthemergency.gov.au website which you may find useful.

These Q&As include the following additional advice on other administrative matters:

• There is no Australian Government requirement for private general practitioners to provide records of the number of people vaccinated. However, State or Territory health departments will advise GPs if there are local reporting requirements. Requirements for data recording by other immunisation service providers will be determined by the respective State or Territory health department.
• Practices not providing vaccination services may wish to make arrangements with other practices in their area to provide vaccination to patients. In some areas there may also be public vaccination clinics that people can refer patients to. For information on local clinics contact your local health department.

The Australian Chief Medical Officer, Professor Jim Bishop has confirmed that he will continue to provide advice, updates and information directly to medical professionals and clinicians. The AMA will continue to ensure that we draw our members’ attention to these communications. This advice is also posted on www.healthemergency.gov.au

I trust this information is of assistance to AMA members. I will continue to keep you informed of any major developments regarding this vaccine program as it rolls out.



Yours sincerely


Dr Andrew Pesce
President