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Monday, 23 November 2009
Page: 8599


Senator LUDWIG (Special Minister of State and Cabinet Secretary) (7:32 PM) —I do have advice in relation to the amendment. The provision within the Health Insurance Act 1973 that relates to pathology, specifically section 23DKA , allows the CEO of Medicare Australia to compel the production of entire pathology records. These provisions do not have a requirement that there be a reasonable concern about the accuracy of a Medicare payment. They operate, quite simply, to require a person to produce entire pathology records within seven days of receiving a request. Section 23DKA states that only a medical practitioner employed by Medicare Australia may make and retain copies of the documents produced by a pathologist. It does not limit who may handle or inspect the documents for administrative purposes. The bill that is currently before the Senate does not allow the Medicare Australia CEO to request the production of whole documents and contains additional privacy protections, including a limitation on the circumstances in which documents may be requested.

To begin with, the clause dealing with pathology relates to producing the whole record, whereas this instance is quite a different circumstance. Here we are seeking from the provider only those documents that they want to provide to substantiate the claim. The amendment that Senator Fielding has moved would have a significant impact in that it would limit all use and administration of a document to medical advisers. That would mean Medicare would have to have medical advisers to deal with the administration as well—in other words, the subsidiary matters of handling a particular document. In this way the amendment is an overreach and, in some parts, a misunderstanding of how the pathology section of the act works. It would create an administrative burden which would be, as I indicated, highly unworkable and would require highly qualified medical advisers to undertake simple administrative and processing tasks.

I do not think, in all reasonableness, that is what you actually are trying to achieve, Senator Fielding. I think you are trying to achieve something similar to the pathology clause, which would provide some safeguards—if I am to use your words not mine. If we look at the volume of audits currently undertaken by Medicare Australia within the Medicare program we find it is about 2,500 per annum or roughly four per cent of the active number of providers. Requiring a medical adviser to be the sole person who could handle documents for audits would be an inefficient and impractical use of medical expertise. I think everyone would agree with that. The government would much prefer them to provide their valuable knowledge in the audit process, which is why their involvement in providing advice in a decision to audit is proposed in the legislation.

We will not be supporting the amendment. I can say, however, that the principle you are trying to enunciate is something we want to look at a little more closely. I do not want to stretch to saying that we agree in principle, but I think that with a little time we might be able to meet somewhere very close to you. We will hold on to the concept you are putting forward—that is, our intention is not to support the amendment as distributed in the Senate, but the bill will have to go to the House and come back. In that process we might invite the minister, when he returns, or an adviser to provide some input into how we might meet you halfway. If that meets your expectations of how the section could work then I am sure we would lean heavily in favour of supporting it. I think we can probably get there but I do not want to make that commitment to something I am not in control of and that the minister will have to have the final call on. That is why we will not be supporting your amendment. I would prefer that it not go down, but that will depend on the opposition as well.