The government has given itself another six months to work up and implement a Medicare assignment of benefits process that does not involve email back-and-forth.
Promised updates to the way patients give their consent to be bulk billed now won’t be available until July 2026, more than three years after the Australian National Audit Office originally raised red flags on verbal consent.
As part of an omnibus health legislation amendment bill passed in late October, the government postponed the commencement of the previously-passed assignment of benefits act from 9 January 2026 to 1 July 2026.
According to the bill’s explanatory memorandum, the changes were to “support stakeholders’ transition to new assignment requirements and maintain the integrity of Medicare payments”.
When it does come into effect, the act will remove the need for GPs to fill out and co-sign an approved form when bulk billing, and enable the assignment of benefits (i.e., the patient’s consent to be bulk billed) to be agreed upon before or after a consult.
It will also allow the all-new power for patients to agree to an “enduring” assignment of benefits, wherein their consent to be bulk billed at one consult can be reapplied to future services.
This debacle – and debacle it was – had its origins in the covid pandemic, when public demand for telehealth skyrocketed.
At the time, Services Australia made a temporary exception to the requirement for written bulk billing consent under subsection 20B paragraph 3c of the Health Insurance Act 1973 to allow GPs to collect verbal consent from patients instead.
Enter the Australian National Audit Office, which released a blisteringly snippy report in January 2023 finding that Department of Health, Disability and Ageing officials had failed to properly assess the legal implications of verbal consent before putting it in place.
The main concern was that, without written acknowledgement from the patient of the bulk billed consult having taken place, GPs could potentially bill for services that had not happened; Medicare could be defrauded, $38 at a time.
Related
The department’s reaction to the ANAO report came in September 2023, when it made the snap announcement that verbal consent only was no longer allowed.
Instead, doctors would have to complete an online form to send the patient, send the patient an email with the details of the service and ask for their emailed consent to bulk bill or obtain a physical patient signature via snail mail.
GPs promptly pointed out the unworkability of these solutions, and Health Minister Mark Butler intervened within the week, announcing plans to modernise the system.
The Department of Health, Disability and Ageing agreed not to pursue any broad punitive actions on the issue, unless it related to fraud, until the new rules were in place.
This has been the state of play since October 2023.
The new laws originally passed parliament in May 2024; by the new start date of July 2026, it will have taken more than two years to implement.
