AMA urges Government to address compliance confusion

20 Feb 2020

The AMA is calling on the Government to urgently address confusion created by Medicare compliance activities and better support GPs to care for patients holistically, including clarifying legitimate circumstances where GPs can treat and subsequently appropriately co-claim patients who are seeking both mental and physical health care.

AMA President, Dr Tony Bartone, has said that recent Department of Health compliance letters and the Medicare system fail to adequately recognise the needs of patients with mental health problems, especially as these patients often suffer from physical complaints as well.

“The AMA supports the need for compliance activities, however these recent letters from the Government to the medical profession have been left wanting,” Dr Bartone said.

“It is perfectly legitimate to co-claim Medicare items when treating a patient with separate mental and physical health problems, but the Department has chosen to target (write to) a small number of GPs who do this more than other GPs.”

Dr Bartone has emphasised that GPs are skilled to provide holistic care for patients, and that patients don’t present to GPs in pieces with mental health problems one day and physical another. They come to their GP as a whole person, and are treated by their GPs as such.

“The letters show that there is a lot of confusion about the proper and clear interpretation of the relevant Medicare item numbers and the Government needs to act to address this,” Dr Bartone said.

“Medicare needs to support efficiency in the provision of health services and to understand the complexity of conditions that patients present with.

“The language in the Medicare Benefits Schedule needs to change so that it embraces the whole of patient approach to care that GPs take, and removes any confusion caused by the wording of existing Medicare item numbers.”

The AMA made a recent submission to the Australian National Audit Office about the Department of Health’s approach to health provider compliance. The submission is available here.

The AMA has met with the Department of Health about the letters and they have given reassurances that they will work with the AMA to try and address the concerns that have been raised.

Read the full media release here.