AMA secures telehealth for COVID patients

AMA lobbying has resulted in a sensible decision by the federal government to extend telehealth access for patients with COVID-19.

Following talks between the AMA and the federal government last week, the AMA has welcomed a decision to exempt COVID-19 positive patients from Medicare’s ‘established relationship rule’.

AMA Vice President Dr Danielle McMullen said the ‘sensible’ decision will support patients who are self-isolating and ensure they do not need to visit a general practice.

When states and territories dropped public health orders last week requiring covid positive patients to self-isolate, many patients with COVID would have been unable to access MBS-funded telehealth services from a GP unless they had attended a face-to-face visit in the last 12 months.

“It’s a ‘no-brainer’ that COVID positive patients need access to their GP via telehealth. This helps limit the spread of COVID in the community and ensures vulnerable patients are not exposed to the virus.

“We’re pleased the Department of Health understood the position COVID-positive patients were put in once mandated isolation times were dropped and responded rapidly to the AMA’s advocacy on behalf of our members and patients,” Dr McMullen said.

While this exemption is due to end on 31 December, the AMA will continue to work with the government to ensure it is in place for as long as it is needed as part of pandemic response arrangements.

The Department of Health’s MBS Reviews Unit has issued the following summary:  

1. effective from Thursday 13th October 2022 until 31 December 2022, an exemption has been implemented for COVID-19 positive patients from the established relationship requirement for telehealth services provided by General Practitioners (GPs) and Other Medical Practitioners (OMPs).  This will enable COVID-19 positive patients to access Medicare rebates for telehealth services with any GP. 
2. A COVID-19 positive patient is defined under these new arrangements as a person who has received a positive COVID-19 test result within the last 7 days, confirmed by either a laboratory testing (PCR) or a COVID-19 rapid antigen self-test (RAT) which has been approved for supply in Australia by the Therapeutic Goods Administration. 
3. More information about this change will be published tomorrow in a Factsheet on the MBS Online website at http://www.mbsonline.gov.au  
4. The determination which puts the exemption in place has been registered on the Federal Register of Legislation and is available at: https://www.legislation.gov.au/Details/F2022L01359
5. For clarity, the level C telehealth item for assessment and consideration of COVID-19 antivirals is excluded from the 1 in 12 rule. That is, there is no requirement for a pre-existing relationship and this item is unaffected by any change in state and territory Public Health Orders.
6. In relation to broader telehealth, it is important to note that the established relationship requirement still does not apply to:
   • children under the age of 12 months; 
   • people who are homeless;
   • patients receiving an urgent after-hours (unsociable hours) service;
   • patients of medical practitioners at an Aboriginal Medical Service or an Aboriginal Community Controlled Health Service; or 
   • people isolating because of a COVID-related State or Territory public health order, or in COVID-19 quarantine because of a State or Territory public health order; or 
   • people living in a flood-affected area, defined as a State or Territory local government area which is currently declared as a natural disaster area due to flood by a State or Territory Government.