The college has taken specific issue with the government’s proposed 90-day delay on reimbursing doctors for eligible gap-only services.
While the RACGP is in favour of ending the cheque-based Pay Doctor via Claimant scheme, it is not necessarily on board with the Department of Health, Disability and Ageing’s replacement plan.
Responding to a DoHDA consultation paper from December, the college criticised what it labelled the “central structural flaw” of the PDVC scheme – a significant, sometimes months-long delay between the service and the reimbursement – which has been carried over into the proposal for the new scheme.
More specifically, the new scheme would allow doctors to just bill patients for the gap between their private fee and the Medicare schedule fee – but Medicare’s chunk of the payment will be delayed by 90 days.
It will also only work for services where the MBS fee is more than $697.
The consultation document noted that this was specifically done to “preserve the attractiveness of bulk billing (immediate payment) relative to gap-only billing”.
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According to the RACGP, the regulatory burden – i.e., the administrative cost of reconciling each affected transaction – of implementing the new scheme in its proposed form would amount to $3.9 million per year.
“If the government’s policy objective is to preserve incentives for bulk billing through differential payment timing, the RACGP notes that a 90-day delay is commercially unworkable for most general practices,” the submission read.
The college even went so far as to note that a 90-day delay would force GP clinics to “absorb financing costs that would not be acceptable in other small business sectors”.
Instead of the 90-day delay, the college proposed amendments to the Health Insurance Act 1973 to allow doctors to be the legal payees of Medicare rebates for privately-billed services with real-time payment services.
The effect of this would be to allow Medicare to directly pay its share of a privately billed appointment to the doctor in two to three days, rather than in three months.
To a lesser extent, the college also called for the government to reconsider its $697 threshold, which it said “may inadvertently exclude common services in general practice that still impose significant costs on patients”.
