A bill currently before parliament will shorten the timeframe for making Medicare claims, broaden investigative powers and remove restrictions on PSR information.
The RACGP has found little fault with the latest round of proposed amendments to health legislation, while still noting that compliance processes can be “stressful” for providers.
The Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025 contains a swathe of planned changes, some of which will directly affect GPs.
These include reducing the timeframe to make a bulk-billing claim from two years to one year, allowing information obtained by the Professional Services Review to be used as evidence in other investigations and expanding the powers of Medicare’s Chief Executive.
According to the Bill’s explanatory notes, the current investigative powers are so narrow as to “impede the proper exercise of powers to detect, investigate and refer potential fraud matters”.
The RACGP submission to the Senate Community Affairs Committee inquiry on the bill raised no major red flags on any of the potential changes.
Neither the bill itself nor the explanatory memorandum went into detail on exactly how the PSR evidence sharing would work, but the RACGP appeared to have a clearer picture.
According to the college, the bill would change the circumstances for when information obtained by the PSR can be used as evidence in other investigations, such as those initiated by AHPRA to allow sharing when there is a significant threat to life, health or non-compliance with professional standards.
These provisions, the RACGP said, “appear reasonable”.
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It did, however, request more information on how the expanded Medicare chief executive powers would work.
“The Bill will improve the ability of Medicare’s Chief Executive to obtain information about potential non-compliance and to more readily ascertain amounts that should not have been paid,” the college said.
“It is intended that this information-gathering power could be relied upon in a broader set of circumstances (eg in the early stages of inquiries).
“While the RACGP requests further information about how this expanded power will work in practice, we understand it will not change current compliance timeframes regarding when providers are issued with a notice to produce (i.e. this would not occur before the audit stage).”
The college also noted that the majority of doctors submitted MBS claims either immediately or in the weeks and months following the provision of a service, and would likely be unaffected by the lodgement timeframe being lowered to one year.
The Medicare chief executive and the Health Minister will also have discretion to allow claims to be made outside the timeframe in extenuating circumstances.
