A new Department of Health, Disability and Ageing consultation suggests mandating that all medical referrals contain a pointer to the Medical Costs Finder website.
The Department of Health, Disability and Ageing is looking to go where no federal health administration has ever gone before: GP referrals.
A new consultation document proposes that the government mandate that all referrals between GP and non-GP specialists “contain standard information about how referrals operate and where consumers can obtain more details, including about non-GP specialist fees (with a link to the [Medical Costs Finder] website) and informed financial consent rights”.
This could appear, the department suggests, as a disclaimer at the bottom of referral letters.
Under the same set of proposals, GPs would also be mandated to provide patients with a copy of the referral and any non-GP specialist reports on their condition either as a hard copy, through email or via My Health Record.
Although there are already similar requirements in place for pathology requests featuring a pathology provider’s brand name, referrals have traditionally been left (mostly) untouched by the department.
Technically, the only hard rules under Medicare when making a referral is that it must include relevant clinical and identifying information about the patient and their condition, a date and a signature from the referring doctor.
The only other hard rules are that GP referrals are valid for 12 months from the date that the patient first sees the non-GP specialist, that non-GP specialist to non-GP specialist referrals last three months, that referrals are only valid for one course of treatment and that public hospitals cannot make a named referral a prerequisite for access to outpatient services.
Typically, local health districts and hospitals will have their own guidelines for what counts as a referral that can be accepted – this is where the specific requirements for three patient identifiers and practice contact details may come in.
Jessica White, the chief technology officer at GP software vendor Best Practice, told The Medical Republic that referral management was “significantly more complex” than just understanding the cost of a service.
“General practitioners and other clinical providers refer patients to specific specialists based primarily on clinical relevance, areas of expertise, patient needs, geographic location, known care pathways, wait times, and continuity of care considerations,” she said.
“While empowering patients with a clearer understanding of potential out-of-pocket costs has merit, it is unclear whether embedding tools such as Medical Costs Finder directly into clinical referral workflows is appropriate or beneficial.”
Ms White pointed out that introducing cost comparison tools into the referral process risked shifting focus toward perceived price differences rather than clinical suitability.
More broadly, she said, there were challenges in that referral management across the healthcare system is highly inconsistent.
While some hospitals and clinics still rely on fax or post, others have electronic solutions in place.
“Patients may not consistently receive copies of their referrals, and digital integration across systems remains limited,” Ms White said.
“In this context, embedding additional digital links into an already fragmented process is unlikely to deliver meaningful transparency or efficiency gains.”
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A more impactful focus, she said, may start with standardising referral workflows across the health ecosystem; steps like consistent referral formats, interoperable referral standards and structured pathways.
“Addressing these foundational challenges would reduce existing inefficiencies and create a stronger platform upon which future innovations — including cost transparency tools — could be meaningfully integrated,” the Best Practice CTO said.
“The Sparked initiative is critical in addressing some of these issues, but we must focus on implementation above and beyond standards.”
The news is not all bad.
According to the departmental consultation paper, mandating the inclusion of additional information regarding the Medical Costs Finder and forcing uploads to My Health Record could potentially “reduce the need for strict referral validity periods” because it enforces a minimum level of communication between GPs and non-GP specialists.
DoHDA is also seeking views on whether it should revise the default period for GP-to-non-GP specialist referrals upward to two years, three years or indefinite.
“If referral lengths are extended, there are levers available to ensure the GP gatekeeper role is preserved,” the consultation paper reads.
“For instance, the government could add requirements for non-GP specialists to notify a patient’s GP/referring medical practitioner when there is a change in treatment or medication.”
Practising paediatric respiratory physician Associate Professor Vikram Palit, who is also CEO of referral management software vendor Consultmed, said the three-month time intervals for non-GP specialist-to-specialist referrals was a constant pain point.
“The idea behind that, I think, was that the GP is the gatekeeper and overall care coordinator, and so should always be up to date,” he told TMR.
“If the patient needs another specialist referral becasue their condition has changed or there is a new issue, then ideally that extra three months specialist referral then goes back to the GP, and the GP knows what’s going on. Or the GP does the new specialist referral.
“But this is a highly administrative process. Technology exists now to notify GPs if there is a change in the patient’s status.”
Like Ms White, Professor Palit called for a deeper look at the referral system.
“The big question mark here is: does everything need to be a referral? And the answer is no,” he said.
“This is where the Advice and Guidance, or eConsult model plays an important role and is now emerging across many health systems. Instead of patients being referred directly to a specialist, the GP can first seek targeted clinical advice and guidance.”
Models like this are used in some rural and remote settings, and it was also suggested in the Grattan Institute’s 2025 report on non-GP specialist fees.
“The evidence demonstrates that this approach significantly reduces unnecessary hospital outpatient presentations,” Professor Palit said.
“If the government is focused on specialist fees, the implication for patients is clear: many may not need to see a specialist at all and can instead be safely managed in the community with specialist advice.”
In up to 30% of cases, he said, patients could avoid a specialist consult if the GP received advice through the eConsult model.
The third change that the department is mulling is whether referrals should be valid for multiple practitioners in instances where patients want a second opinion.
“Given that the second non-GP specialist would be required to treat the patient as if this was their first attendance, a modification to allow the claiming of initial attendance items in such a situation may be reasonable,” the consultation said.
“This would allow patients to seek second opinions without the inconvenience and potential financial costs associated with acquiring a new referral, and without disadvantaging the new non-GP specialist by preventing them from claiming an initial attendance item.”
The referral consultation comes just as reforms to the Medical Costs Finder website were introduced to parliament. If passed, the government will have the power to publish details about what individual specialists charge for particular services.
This information is already collected by Medicare, hospitals and insurers, just not published.
