DoHDA is moving in on GPs who it believes may have billed the MBS while out of the country.
Over 1100 GPs across Australia have received “early intervention letters” from the Department of Health, Disability and Ageing (DoHDA) as it begins to tighten compliance on overseas billing.
A further 4600 “education letters” were sent last month to GPs who may have claimed an MBS item whilst overseas.
Under section 10 of the Health Insurance Act 1973, Medicare benefits are only payable when the service is performed in Australia, including telehealth services.
The RACGP has reiterated that GPs who have received only an “education letter” would not need to take any further action with any incorrect billing being at “low level or low value”.
“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.
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“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.”
In a recent poll of 1496 doctors conducted by NewsGP, 84% stated that they were not fully aware of current laws regarding overseas billing.
Earlier this year DoHDA had announced their top compliance priorities for the year, with international billing being one of them.
Other prioritised areas for compliance were bulk-billing and raising additional charges, suspected fraud, duplicate payments and inappropriate claims for high-cost PBS medicines.
The RACGP has reiterated that it cannot intervene in the aforementioned compliance cases but has made calls for feedback from those who believe they have received “intervention letters” in error.
