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Monday, 26 October 2009
Page: 10991


Ms HALL (4:54 PM) —I rise to support the Health Insurance Amendment (Compliance) Bill 2009. I am not really clear whether the opposition will support this legislation or whether it will oppose it in the House. I note that the shadow minister talked of some amendments to be moved in another place, but I am still not sure whether or not that means that the opposition is seeking to oppose this legislation. This bill will enable Medicare to give a notice requiring the production of documents to a practitioner or another person who has control of documents to substitute an amount of Medicare benefit paid in respect of professional services. This initiative aims to protect the integrity of Medicare and to enhance Medicare Australia through an audit process and sees the government deliver on its commitment of responsible economic management. The 2008-09 budget measures also included an increase in the number of audits conducted under the compliance program.

This legislation ensures that Medicare remains viable. Expenditure on Medicare has now increased to $14 billion per year, and it has more than doubled over the last 10 years. It is in that light that the government has introduced this legislation. It establishes a compliance measure to be undertaken by Medicare Australia administrative staff to maintain the integrity of Medicare. It is a vital part of the government’s overall economic management and a vital part of the government’s strategy to ensure that Medicare remains viable into the future.

Medicare is an institution that protects all Australians. The shadow minister indicated that, when he was the minister for health, his government was the best friend that Medicare ever had. I would strongly argue against that proposition put by the shadow minister. It was under his reign as minister that bulk-billing plummeted. It was under his reign as minister that many problems developed within Medicare. It was only because of Labor constantly keeping him on his toes that Medicare actually survived the Howard years. So it is with great pleasure that I am able to stand up in this place and support the bill we have before us.

I note very strongly that most medical practitioners do the right thing and charge appropriately. Other medical practitioners may make mistakes. I think that most errors that occur would just be an oversight, and this legislation takes into account those kinds of problems. The Senate Community Affairs Legislation Committee inquiry into compliance audits on Medicare benefits recommended:

… as part of the Medicare compliance audit process specific measures are detailed in the regulations to ensure that patient clinical records are only required to be accessed where necessary.

The government has taken into account what this legislation’s purpose is and listened to what the Senate Community Affairs Legislation Committee put forward.

The government has also consulted widely, and that is a really important point for me to make at this point in my contribution to this debate. We have also consulted very widely with all sectors of the community that are involved in this. Key stakeholders have all been consulted, and they were given the opportunity in 2008 and in the first half of this year to comment. This included the AMA, as it did the Senate committee. As I have already stated, the Senate committee’s recommendations have been considered and are reflected in the legislation that we are debating here in the chamber today.

I should walk through a few aspects of this legislation. In doing so I should mention that the government decided that it was very much appropriate to address the issues covered by this legislation in primary legislation rather than regulation. Therefore, the bill was amended to include significant involvement by medical advisers in the compliance audit process. A ‘medical adviser’, for the record, is a medical practitioner employed by Medicare Australia. That is of vital importance, because the audit is not an audit of clinical process, clinical decisions or clinical practice but rather an administrative audit. The documents that will be required to be produced by a medical practitioner will not in any way impinge on patient privacy or in any way look at patient decisions in relation to patient care and appropriate medical decisions. If it is found that there has been some breach, there are a number of conditions that need to be satisfied before the CEO can act: firstly, the CEO must have reasonable concern that Medicare benefits paid in respect of a service may exceed the amount that has been paid; secondly, the CEO must take advice from a medical adviser before a notice can be issued; and, thirdly, the CEO must give a person a reasonable opportunity to voluntarily respond to the audit request prior to formal notice.

It is important to note that this legislation was needed because currently 20 per cent of medical practitioners do not comply voluntarily with the audit and it was felt by the government that this needed to be right across the board to ensure the integrity, ongoing success and viability of Medicare. Medicare Australia will continue to work with all the stakeholders, will continue to see that it involves everybody and will continue to consult. That is something that is very different from the previous government. It is something that is very different to what happened when the previous minister for health, in the Howard government—the member for Warringah, who just spoke—held the portfolio and had an opportunity to have an impact in these areas. The bill also looks at the penalty rate. Where a person voluntarily admits they have made a mistake there will be a 100 per cent reduction in the penalty. Where it has been paid, there will be a 50 per cent reduction. Before the completion of the audit, there will be a 25 per cent reduction. But if a person does not respond to the audit then they will have a 25 per cent increase.

Overall, this is a very fair piece of legislation. It is legislation that has been designed to ensure the ongoing viability of Medicare, and it is very reasonable that both sides of this House support it. It did worry me that, when the shadow minister spoke a few moments ago, he indicated that he may not support this legislation. I was hoping that he would clarify that fact for me. I will be very disappointed if the shadow minister does not get behind this very sensible piece of legislation, which is designed to ensure the long-term viability of Medicare.