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Monday, 23 November 2009
Page: 8589

Senator SCULLION (5:48 PM) —by leave—I move amendments (1) and (2) on sheet 5987 standing in my name:

(1)    Schedule 1, item 2, page 3 (line 23), at the end of paragraph 129AAD(1)(b), add:

    ; and (c)    has taken reasonable steps to consult with a relevant professional body about the types of documents that contain information relevant to ascertaining whether amounts paid in respect of professional services of the same kind or kinds as the service or services referred to in paragraph (a) should have been paid.

(2)    Schedule 1, item 2, page 3 (after line 30), after subsection 129AAD(1), insert:

      (1A)    In this section:

relevant professional body means a body declared by the Minister to be a relevant body for the purpose of this section.

The first of these two amendments deals with supporting documentation. The purpose of the amendment is to require Medicare Australia to work with the professional peak bodies, to design and develop a process that would capture relevant factual information specifically tailored to a medical specialty or medical practice, which could then be submitted, in the event of a Medicare compliance audit, to substantiate Medicare claims. I am probably addressing many of my remarks to Senator Siewert. As I spoke to many of the organisations—the AMA, the college of psychiatrists, the College of General Practitioners—there seemed to be a constant theme: ‘If only Medicare would come and talk to us about the sort of documentation we could keep to ensure that we met our auditing requirements, that would be something we would do. But we don’t keep medical records to meet any auditing requirements from Medicare; that’s not why they are kept, so they are probably going to be meaningless to them.’ So all of them indicated that, if Medicare came and sat down with them, it would be quite easy and they would be quite happy to talk sector by sector about what sort of information they could keep to assist Medicare in dealing with that. The reason I speak directly to you, Senator Siewert, is that it goes to the heart of the amendment about requiring the electronic medical records. What I am saying is that this is perhaps less specific but it gives the opportunity, sector by sector, to sit down and provide a suite of information, which they may keep as an addendum but specifically for auditing arrangements of Medicare.

The second aspect of the amendment dealing with supporting documentation is that at present the proposed legislation only requires that Medicare discuss internally the types of documents or evidence that is required, and specifically states that Medicare would not reveal what evidence is required. Clearly, I think that is a situation that has compounded the circumstance where Medicare is saying, ‘We want to audit you’, but you do not even know what sort of arrangements you need to keep in place.