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Health Insurance Amendment (Rural and Remote Area Medical Practitioners) Bill 2000

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1998-1999-2000

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

HOUSE OF REPRESENTATIVES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HEALTH INSURANCE AMENDMENT

(RURAL AND REMOTE AREA MEDICAL PRACTITIONERS) BILL 2000

 

 

 

 

EXPLANATORY MEMORANDUM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Circulated by authority of the Minister for Health and Aged Care,

the Hon. Dr Michael Wooldridge, MP)



HEALTH INSURANCE AMENDMENT (RURAL AND REMOTE AREA MEDICAL PRACTITIONERS) BILL 2000

 

OUTLINE

 

This Bill amends the Health Insurance Act 1973 to enable the Commonwealth to restrict access to medicare benefits for services rendered by medical practitioners who breach a contract with the Commonwealth to work in rural and remote areas.

 

Initially the Bill will be used to enforce the contract of persons who participate in the Medical Rural Bonded (MRB) Scholarship Scheme.

 

This Scheme is a new long-term strategy under the budget’s cohesive package of rural health measures to deliver more doctors to rural communities.  Under the Scheme 100 new medical students will receive $20,000 per year to study medicine, on the condition that they agree to work in a rural community for six years once they have completed their basic medical training and GP or specialist Fellowship. 



Section 19ABA of this Bill provides the legislative framework for the Commonwealth to enforce the bond. It may also have a wider application to other programs where the Commonwealth has contracts with individuals who undertake to work in a rural and remote area.  If a medical practitioner breaches the commitment to work in a rural or remote area, the Commonwealth will be able to restrict payment of medicare benefits in respect of that practitioner’s services.

 

The period for which the Commonwealth are able to restrict payment of Medicare benefits if a medical practitioner breaches such a contract is stipulated as twice that the medical practitioner agreed to work in a rural and remote area.  This will apply unless a shorter period is determined in the relevant contract.

 

This legislation applies whether the medical practitioner referred to was a medical practitioner when he or she signed the contract or at the time he or she breached it.

 

Under current legislation, it is a criminal offence for a doctor who does not have access to medicare benefits to provide services to a patient without explaining to the patient that there will be no reimbursement for the service through Medicare. Following the amendment to Section 19CC as outlined in this Bill, medical practitioners who are in breach of their agreement will also be committing a criminal offence if they do this.

 

 

FINANCIAL IMPACT STATEMENT

 

Under the MRB Scholarship Scheme there will be up to 100 extra doctors every year once the first cohort completes Fellowship training.  This will be an additional cost to the Medicare Benefits Schedule.  However this cost is in a clear area of need - rural and remote Australia.

 

 

Furthermore doctors who are in breach of their contract will be prevented from accessing Medicare benefits for a given period of time.  Thus the potential cost of these doctors providing services and therefore adding to medicare benefits costs in urban areas of oversupply over this time is prevented.

 

 

NOTES ON CLAUSES



PART 1 - PRELIMINARY

 

Clause 1 - Short title

 

This clause provides that the amending Act may be cited as the Health Insurance Amendment (Rural and Remote Area Medical Practitioners) Act 2000 .

 

Clause 2 - Commencement

 

This clause provides that the Act will commence on Royal Assent.

 

Clause 3 - Schedule(s)

 

This clause provides that each Act that is specified in the Schedule is to be amended as set out in the applicable items in the Schedule concerned.

 

Schedule 1 - Amendment of the Health Insurance Act 1973

 

Item 1

 

Item 1 of Schedule 1 inserts a new section 19ABA of the Act after section 19AB.  Subsection 19ABA (1) will provide that medicare benefits are not payable in respect of  professional services rendered by, or on behalf of, a medical practitioner who is in breach of a contract with the Commonwealth under which the practitioner agrees to work in a rural or remote area.

 

Subsection 19ABA (2) will provide that, where the medical practitioner has breached his or her contract with the Commonwealth, medicare benefits are not payable for the duration of the period equal to twice the length of that agreed to by the medical practitioner under the relevant contract, to work in a rural or remote area unless a shorter period is determined in, or in accordance with, the relevant contract.

 

Subsection 19ABA (3) of Schedule 1 will provide that both subsections 19ABA (1) and (2) apply whether or not a medical practitioner was a medical practitioner when he or she entered the contract or at the time of the breach.

 

Subsection 19ABA (4) will provide that  section 19ABA applies to contracts entered into after the commencement of the section.

 

Item 2

 

Item 2 of the Schedule will amend section 19CC to make it an offence for a medical practitioner for whom a medicare benefit is not payable as a result of section 19ABA to render a professional service without first having taken steps to inform the patient that a medicare benefit is not payable for the practitioner’s professional services.

 

A note provides that the heading to section 19CC will also be amended as a consequence of the amendments to section 19CC.

 

Schedule 3

 

Item 3

 

Item 3 of the Schedule inserts a ‘note’ at the end of section 19CC to draw attention to the different meanings of ‘professional services’ in sections 19AA, 19AB and the new 19ABA.