A wave of compliance letters from DoHDA will showcase its new ‘educative approach’ to regulation.
The Department of Health, Disability and Ageing will be sending out more than 500 “early intervention letters” this month, aimed at taking a proactive approach to billing errors.
Around 100 of those letters will go out to GPs who have potentially charged a gap fee for a bulk billed consult.
These early intervention letters have been described as a prompt to take “proactive steps” to address incorrect Medicare claims in a move that has been welcomed by the RACGP.
“The educational approach taken by the department is welcome, as is the involvement of the RACGP,” RACGP committee member for Funding and Health System Reform Dr Tony Bayliss told The Medical Republic.
“The approach shows this is about making the health system work as intended, not just catching GPs who make honest mistakes.
“The fact that it’s an educational approach rather than an enforcement one shows the department is aware it’s a complicated area of Medicare billing, that the vast majority of GPs try very hard to be compliant, and the bulk of non-compliance is unintended.”
The college praised the educational tone for taking GP administrative burden into consideration.
The college said it was reflective of, “the education-focused approach the RACGP has called for, that the Department is communicating with the RACGP, and that they’re open to feedback”.
“Did you know when bulk billing a patient, no additional charges can be applied for the same service?” the letter states.
“Under the Health Insurance Act 1973, bulk billing for a service means accepting the relevant Medicare benefit as full payment for that service.
“This means that you cannot charge the patient an additional amount for that service such as booking fees or consumables like dressings or bandages.”
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The letter also requests that respective providers review policies and procedures to maintain that bulk-billing requirements are met.
“If you have charged an additional fee for a bulk-billed service, or identify any incorrect claims, you can take proactive steps to correct them – including refunding out-of-pocket fees to patients or submitting a voluntary acknowledgement form,” the letter advises.
These advisory letters come after another wave of compliance letters was released earlier in the year focusing in on GPs who may have claimed MBS items whilst abroad.
“The purpose of this letter is really to raise awareness of the rules that state that providers and patients need to be in Australia,” RACGP president Dr Michael Wright said in June, in relation to the overseas billing compliance letters.
“This has been one of the priorities for Medicare compliance this year, but it can still be a surprise for people when they see these compliance letters.
“The important message for everyone who has received any of these compliance letters is that, if you are concerned, seek advice from your medical indemnity provider.”
