A new bulk billing incentives calculator and expressions of interest for the BBPIP will be available from next month, according to the Department of Health, Disability and Ageing.
With major Medicare reforms due in less than three months, the Department of Health, Disability and Ageing have now provided answers to commonly asked questions about the scheme.
The Monday webinar, which was the first session in a series of three, was hosted by DoHDA director of bulk billing clinical design and implementation Bianca McCulloch, assistant secretary of MBS policy Louise Riley, MBS affordability director Jacob Grooby and Services Australia acting national manager Rachel Macaulay.
Here’s the quick and dirty rundown of some of the more pressing queries from among the audience.
Question: if the practice is signed up to the bulk billing practice incentive program – in which the whole clinic must commit to bulk billing all GP non-referred attendance items – but one doctor accidentally privately bills a patient, does the clinic forfeit the whole PIP for that quarter?
Short answer: not necessarily
According to Ms McCulloch, there will be a process by which a provider can make retrospective changes to a lodged claim in the event of an accidental private billing.
“Retrospective changes can result in an underpayment or an overpayment of a previously paid incentive payment, which would be adjusted in the next quarter,” she said.
“We will have the ability to make adjustments per quarter to correct any errors in claiming, and we also are currently considering system arrangements that allow for a small error margin.”
There will also be instructions on how to claim MBS items for newborn babies or patients who have lost their Medicare card without impacting the practice’s eligibility for the BB PIP.
“The intention is that all eligible services for all eligible patients are bulk billed,” Ms McCulloch said.
“But of course, we recognise that there are some instances where that is difficult or can’t happen or where there are then errors, so we will have some instructions on what to do in those circumstances.”
Question: if the practice doesn’t sign up for the BB PIP, will its patients still benefit from the expanded bulk billing incentive?
Short answer: yes
The November 1 Medicare changes are technically two separate programs, although both hinge on bulk billing.
All practices, regardless of whether they run on a mixed billing or universal bulk billing model, will be able to access the bulk billing incentive every time a patient is bulk billed for an eligible item.
But only practices that commit to 100% bulk billing of GP non-referred assessment items will benefit from the new practice incentive payment, which amounts to 12.5% of the practice’s bulk billing income.
According to department modelling, if mixed-billing practices were to continue bulk billing patients at the current rate come November, there will still be an extra $1 billion washing through the system.
“I’ve had a few questions over the last little while that suggests some people might have misunderstood that there are no other changes to the bulk billing incentive items,” Ms Riley said.
“We’re not changing which incentive applies to which item, or anything like that.
“It’s literally expanding the eligibility.
“Over 15 million more Australians, from 1 November, are going to be eligible for incentives and 45.5 million bulk billed services will now attract a bulk billing incentive.
“That’s around an extra $1 billion per annum if providers don’t do anything differently to what they’re doing now.”
Related
Question: can practices only start the BB PIP at the beginning of a financial year quarter?
Short answer: no
The payments for the bulk billing practice incentive program, which are only for those practices which have committed to universal bulk billing, will be made quarterly in arrears.
Practices can join at any time throughout a quarter, and practices will have the opportunity to backdate their registration.
“We’ll also have a forecasting tool available in the Services Australia system that will allow you to check throughout the quarter how you’re tracking against the requirement and to get … a sense of whether you’ll meet the eligibility claiming requirement for that quarter,” Ms McCulloch said.
Question: will all practices that sign up to the BB PIP have to be accredited or on a pathway to accreditation?
Short answer: no
Right now, the rules are that unaccredited practices that want to bulk bill all patients will be allowed to sign up for the BB PIP.
If that changes in the future and the waiver for unaccredited practices is revoked, there will be ample forewarning.
“We always encourage practices to work towards accreditation and maintain those standards of quality,” Ms McCulloch said.
“But at this stage, there’s no requirement or expectation for practices who aren’t accredited but do participate in the program to become accredited.
“We know that … for some practice types, accreditation is not easily obtained and we know it’s a long pathway to accreditation.”
Question: has the department considered payroll tax implications for practices?
Short answer: no
The department spokespeople could give no advice on whether the BB PIP would affect payroll tax liability.
“Payroll tax is a state and territory tax,” Ms McCulloch said.
“We would encourage practices to do your due diligence about the implications of state and territory taxation arrangements for your practice, and to consider those the implications for your practice when determining whether you would participate in the BB PIP.”
There are additional DoHDA webinars on Wednesday 6 August at 4pm AEST and Friday 8 August at 1pm AEST.
