UPDATE: AMA receives key assurances on telehealth red tape

UPDATE 4.30PM FRIDAY, 6 OCTOBER 2023

The following statement from Health Minister Mark Butler has been issued today (6/10/2023) following a meeting with the AMA Vice President about telehealth red tape.

"I have asked my department to provide options to address concerns about the assignment of benefit for Medicare bulk billed claims, including legislative amendments. My department has advised me that until these changes are made, there are no plans to pursue any broad punitive actions on this issue unless it relates to fraudulent claims against Medicare."

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The following was published in AMA Rounds at 7AM Friday, 6 October.

The Health Insurance Act (1973) showed its age this week, after fresh advice was published by Services Australia in relation to verbal assignment of benefit arrangements for telehealth services. The Health Insurance Act provides the legal basis for the payment of Medicare rebates, including the assignment of benefits by a patient.

Throughout COVID-19, the Department of Health and Services Australia have taken a largely common sense approach to this, allowing verbal consent for telehealth consultations to be documented in a patient’s clinical notes. However, an Australian National Audit Office review earlier this year raised concerns that this practical approach did not meet the technical requirements of the Health Insurance Act.

While verbal consent is still permissible under the revised advice, it comes with extra red tape. To make matters more complex, Services Australia has published inconsistent advice on different parts of its website. The AMA has been advised by the Department of Health & Aged Care that the most current  and relevant advice can be found here.

In short, verbal assignment is still possible, but there is a requirement to explain to the patient how you’ll fill in the patient signature field in the approved form and confirm that the patient agrees. If the patient agrees, you need to type patient verbally agreed in the patient signature field. The completed form then needs to be sent by email or text to the patient.

A more detailed set of FAQs is available at MBS online.

While the AMA understands the reasons for the updated advice being issued, it is clear that it is a red tape nightmare that needs to be fixed. To this end our advocacy with the Minister for Health and Aged Care along with his Department has already secured progress in a number of areas including:

• The Department will move to quickly consult on required changes to the Health Insurance Act, with the Government committed to progressing legislative amendments to ensure that assignment of benefits rules are updated to reflect modern practice, while also protecting the integrity of Medicare.
• A commitment that no retrospective compliance activities will be completed by the Department.
• Recognition of the need for digital solutions to be able to record consent with minimal red tape as part of normal workflows.

The AMA will keep members informed about work in this area, recognising the potential for the current interpretation to impact on access to care for patients and add unnecessary complexity to the day to day work of doctors.