27 November 2009 Changes to MBS compliance audit legislation
In the 2008–2009 Federal Budget, the Australian Government announced a plan to increase the number of Medicare Benefits Schedule (MBS) Compliance Audits and compel Medicare providers to produce evidence to verify their claim.
The college opposed this contentious provision, which gave Medicare the power to request health information about an individual. We felt that medical records were an inappropriate tool for measuring Medicare compliance and we didn’t believe the legislation had sufficient safeguards for patients’ privacy.
After strong lobbying by the college, the Australian Medical Association and others, the Government has introduced important changes to the Health Insurance Amendment (Compliance) Bill, 2009.
The changes will protect the privacy of patients and preserve confidentiality, which is fundamental in the patient-doctor relationship. They will also clarify what specific data practitioners should keep in case of an audit by Medicare. Everyone knows that the MBS has grown in complexity. Medicare itself gives conflicting advice to doctors from time-to-time on how to bill properly, and even excellent doctors with good intentions can make mistakes.
Given the current complexity of the MBS, a strong argument could be made for the government’s focus to be on strengthening education around appropriate billing practices, while sanctions such as fines should be preserved for repeat offenders only. In reality the solution is to simplify the MBS.
M5 Project - RACGP men's health initiative helping men to help themselves
M5 encourages men and those who care about them to recognise the importance of men forming an ongoing relationship with a GP.
