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Health Insurance Amendment (90 Day Pay Doctor Cheque Scheme) Bill 2008

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2008

 

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

 

 

 

 

 

HOUSE OF REPRESENTATIVES

 

 

 

 

 

 

 

 

HEALTH INSURANCE AMENDMENT (90 DAY PAY DOCTOR CHEQUE SCHEME) BILL 2008

 

 

 

 

EXPLANATORY MEMORANDUM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Circulated by authority of the Minister for Health and Ageing, the Hon Nicola Roxon, MP)





HEALTH INSURANCE AMENDMENT (90 DAY PAY DOCTOR CHEQUE SCHEME) BILL 2008

 

OUTLINE

 

This Bill amends section 20 of the Health Insurance Act 1973 (the HIA) to allow specialists and consultant physicians access to the 90 Day Pay Doctor Cheque Scheme where the original claim for the Medicare benefit is submitted electronically to Medicare Australia.

 

Subsection 20(2) of the HIA provides that where a person is entitled to a Medicare benefit in relation to a professional service but has not paid their medical bill, the person can request that a cheque be drawn in favour of the medical practitioner who rendered the service for the amount of the Medicare benefit.  The patient is then provided with a pay doctor via claimant cheque.  A pay doctor via claimant cheque, also known as a pay doctor cheque (cheque) is a cheque for the amount of Medicare rebate made out to the medical practitioner that provided the service.  The cheque is provided to the patient who is then responsible for forwarding the cheque on to the medical practitioner along with any co-payment required to satisfy the full account. This arrangement allows patients to use their Medicare rebate towards the payment of their medical bill, rather than paying the medical bill in full at the time of the service.

 

Currently subsection 20(3) of the HIA provides that where a cheque given under subsection 20(2) or 20(2A) of the HIA has not been banked by the medical practitioner within 90 days of it being issued to the patient, the cheque may be cancelled and Medicare Australia may pay the applicable Medicare rebate directly to the general practitioner.  Subsection 20(5) of the HIA allows for Medicare Australia to make this payment via electronic funds transfer.  This arrangement is known as the 90 Day Pay Doctor Cheque scheme and is currently restricted to general practitioners.

 

This Bill will allow specialists and consultant physicians access to the 90 Day Pay Doctor Cheque Scheme on the condition that the original claim for the Medicare benefit was submitted to Medicare Australia electronically in the manner prescribed by the Regulations.

 

Financial Impact Statement

 

The implementation of this Bill has a cost of $4.5 million over four years. This funding was included in the Portfolio Additional Estimates Statements 2007-08 for the Human Services Portfolio.  The budgeted annual costs, which include the cost to Medicare Australia to introduce the necessary system changes and manage the program, are set out in the table below:

 

2007-08

($ million)

2008-09

($ million)

2009-10

($ million)

2010-11

($ million)

1.2

1.1

1.1

1.1

 

 



HEALTH INSURANCE AMENDMENT (90 DAY PAY DOCTOR CHEQUE SCHEME) BILL 2008

 

NOTES ON CLAUSES

 

 

Clause 1

This clause provides that the Act may be cited as the Health Insurance Amendment (90 Day Pay Doctor Cheque) Act 2008.

 

Clause 2

This clause provides that sections 1 to 3 of the Bill commence on the day that the Bill receives Royal Assent.  Schedule 1 commences on a day to be fixed by Proclamation.

 

Schedule 1 contains amendments to the Health Insurance Act 1973 to allow specialists and consultant physicians access to the 90 Day Pay Doctor Cheque Scheme.  The purpose of setting the commencement date of Schedule 1 by Proclamation is to allow Medicare Australia adequate time to complete and test changes to the internal administrative claiming systems which are required to implement the 90 Day Pay Doctor Cheque scheme for specialists and consultant physicians.

 

Clause 3

This clause provides that each Act that is specified in a Schedule to this Bill is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item has effect according to its terms.  



Schedule 1- Amendment relating to the 90 day pay doctor cheque scheme

 

Schedule 1 amends the Health Insurance Act 1973 (the HIA) to allow access to the 90 Day Pay Doctor Cheque Scheme to specialists and consultant physicians, where the original claim for the Medicare benefit has been made electronically.

 

Item 1:

This item inserts into subsection 20(3) and (4) the terms “specialist and consultant physician” after general practitioner wherever it occurs.  This makes services provided by specialists and consultant physicians eligible for the 90 Day Pay Doctor Cheque Scheme subject to the new subsection 20(6).

 

Item 2:

This item adds a new subsection 20(6) to the HIA to provide that the 90 Day Pay Doctor Cheque Scheme will only apply to services provided by specialists and consultant physicians where the original Medicare claim is submitted electronically in the manner prescribed by the Health Insurance Regulations 1975 .

 

Item 3:

This item provides the professional services rendered on or after the day of these amendments take effect are eligible for the 90 day pay doctor cheque scheme.