Health Secretary urged to delay changes to telehealth rules

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Proposed changes to MBS’s claims rules should be further delayed, the RACGP said in a letter to Professor Brendan Murphy.

There are concerns that incoming telehealth restrictions could impact patient access to general practice services.


RACGP Vice President Dr Bruce Willett has written to Federal Health Secretary Brendan Murphy strongly recommending that changes to the prescribed 80/20 and 30/20 service rules be postponed.


Currently scheduled to be implemented on July 1, the 30/20 rule would mean that any GP providing more than 30 daily telephone consultations for 20 days or more over a 12-month period would be referred to the Professional Services Review (PSR ).


Similarly, updated Medicare compliance rules would also see phone and video services follow the established 80/20 rule, which deems a GP or other doctor to have engaged in an “improper practice” s renders or initiates 80 or more professional attendance services on 20 or more days in a 12 month period.


However, there are concerns that these restrictions are “problematic” and impact patient access to general practice services, particularly in the context of the ongoing COVID-19 pandemic and the current high rates of influenza and other respiratory illnesses in the community.


In the letter, Dr Willett wrote that a “comprehensive review” should be undertaken before the rules are implemented to ensure they are fit for purpose and accurately reflect the new telehealth environment.


“The high number of COVID-19 cases in the community continues to be a challenge for GPs and the wider health sector,” he said.


“The RACGP is concerned that circumstances have not changed since the decision to postpone and that the reintroduction of these rules in July 2022 could generate unnecessary anxiety among GPs which could impact patient care.


“Telehealth consultations, particularly by telephone, have been an essential tool in the response to the pandemic [and] access to telehealth is even more critical during the winter months, as the incidence of seasonal illnesses increases.


The letter goes on to state that many patients still prefer to access care via telehealth due to the high number of COVID cases in the community, which “raises further questions” about the appropriateness of the 30/20 rule. .


“While we recognize that the prescribed model of service rules are designed to deter corporate abuse and malfeasance, GPs should not be punished and their well-being put at risk when they do their best to take care of their patients,” Dr. Willett wrote.


“The RACGP has been advised by many members that the punitive compliance program pursued by the Federal Government regarding the management of the pandemic and the use of item numbers is a reason for general practitioners to consider early retirement from profession, seek non-clinical roles and/or reduce their consulting hours.


“The extension of the postponement of these rules provides a timely opportunity to undertake a comprehensive review…to ensure that the department’s goal of having the rules can be achieved without compromising GP welfare and patient care. “


The vice-president of the RACGP also called for a simplification of the rules before any extension.


“Most GPs continue to do the right thing, despite numerous changes to telehealth rules and bureaucratic interventions in medical practice,” he wrote.


‘[But] without a clear understanding of the need for these rules and how referrals have been determined, GPs’ confidence in the system will be undermined.


“Unless the rules are simplified and more resources devoted to education and awareness activities to ensure practitioners fully understand the rules, this will inevitably impact patient care due to a reduction in medical staff and an increase in stress for practitioners.”


The extension of the 80/20 and 30/20 rules has already been delayed once due to the high number of COVID cases and it is hoped that a similar result will be achieved before the end of the month.


“The government announced an extension to the funding arrangements for the COVID-19 response following the June 17 National Cabinet meeting, which we believe includes a postponement of the prescribed model of service arrangements for the telehealth until December 31 of this year,” Dr Willett said.


“We urge the department to heed our advice and use this opportune time to urgently postpone and review the prescribed 80/20 and 30/20 service model rules.”



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