Council of Australian Governments (COAG) Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative

Page last updated: 04 February 2022

Section 19(2) Health Insurance Act 1973 (the Act) this section prohibits the payment of Medicare benefits where other government funding is provided for that service.

What it does

The Council of Australian Governments (COAG) introduced the Section 19(2) Exemptions Initiative (the Initiative) - Improving Access to Primary Care in Rural and Remote Areas Initiative in conjunction of the Better Health for All Australians Action Plan under the 2006-2007 Federal Budget process.

The Initiative provides for exemptions under s19(2) of the Act to allow exempted eligible sites to claim against the Medicare Benefits Schedule (MBS) for non-admitted, non-referred professional services (including nursing, midwifery, allied and dental services) provided in emergency departments and outpatient clinic settings.

Queensland, Western Australia, New South Wales, South Australia, Northern Territory and Victoria all participate in the Initiative through a bilateral Memoranda of Understanding (MoU) with the Commonwealth which have been extended from 31 December 2021 to 30 June 2022 while a new MoU with jurisdictions is being negotiated.

Tasmania originally elected not to be part of the Initiative under the original COAG agreement but remain eligible to participate.

What it Achieves?

The Initiative recognises that many patients in small rural and remote towns have limited access to primary health care services and that in response to a lack of private practices, many rural and remote public hospitals have employed medical officers to make traditional GP services available.

Eligibility Criteria

The 2016-2020 MoUs have been updated to a single criterion that requires an eligible public health site to be located within categories five to seven of the Modified Monash Model (MMM) classification system. The MoU also allows for sites to be phased out over a twelve month period where they are deemed no longer to be eligible.

The following hospitals and health services have been approved under the Initiative (128 sites):


Eligible hospitals and health services

New South Wales (47 sites)
  • Balranald Multi Purpose Service
  • Barham Multi-Purpose Service
  • Batlow Multi-Purpose Service
  • Berrigan Health Service
  • Bingara Multipurpose Service
  • Blayney Health Service
  • Boorowa Multipurpose Service
  • Coolamon Multipurpose Service
  • Culcairn Multipurpose Service
  • Dareton Primary and Community Health Centre
  • Dungog Community Hospital
  • Finley Health Service
  • Gloucester Soldiers Memorial Hospital & Gloucester Community Health Centre
  • Gundagai Health (Multipurpose) Service
  • Guyra Multipurpose Service
  • Hay Hospital
  • Henty Multipurpose Service
  • Hillston Hospital and Health Service
  • Holbrook Hospital
  • Jerilderie Hospital and Health Service
  • Junee Multi-Purpose Service
  • Kyogle Multipurpose Service
  • Lake Cargelligo Hospital and Health Service
  • Lockhart Hospital and Health Service
  • Manilla Multipurpose Service
  • Merriwa Multipurpose Service
  • Murrumburrah-Harden Hospital and Health Service
  • Narrandera Health Service
  • Nimbin Multipurpose Service
  • Nyngan Hospital and Community Health Service
  • Oberon Health Service
  • Quirindi Health Service
  • Rylstone Multi-Purpose Service
  • Temora Health Service
  • Tocumwal Health Service
  • Tottenham Multi-Purpose Service
  • Trangie Multi-Purpose Service
  • Trundle Multi-Purpose Service
  • Tullamore Multi-Purpose Service
  • Tumbarumba Multipurpose Service
  • Urana Health Multipurpose Service
  • Urbenville Multipurpose Service
  • Warialda Multi-Purpose Service
  • Wee Waa Community Hospital & Wee Waa Community Health Centre
  • Wentworth Health Services
  • West Wyalong Hospital
  • Wilson Memorial Community Hospital Murrurundi & Murrurundi Community Health Centre
Queensland (49 sites)
  • Babinda Hospital
  • Barcaldine Multipurpose Health Service
  • Biggenden Multi-Purpose Health Service
  • Blackall Hospital
  • Blackwater Multipurpose Health Service
  • Boulia Primary Health Centre
  • Capella Outpatients Clinic
  • Cardwell Community Health Centre
  • Childers Multipurpose Health Service
  • Chillagoe Primary Health Centre
  • Collinsville Hospital
  • Dimbulah Primary Health Centre
  • Dirranbandi Multipurpose Health Service
  • Eidsvold Health Service
  • Gayndah Hospital
  • Gemfields Outpatient Clinic
  • Gin Gin Hospital
  • Hughenden Health Centre
  • Inglewood Multipurpose Health Service
  • Injune Health Service
  • Isisford Primary Health Centre
  • Jandowae Health Services
  • Jundah Primary Healthcare Service
  • Longreach Hospital
  • Miles Health Service
  • Millmerran Multipurpose Health Service
  • Millmerran Multipurpose Health Service Outreach Primary Clinic (Cecil Plains)
  • Mitchell Hospital
  • Monto Health Service
  • Mossman Multipurpose Health Service
  • Moura Multi-Purpose Health Service
  • Mundubbera Health Service
  • Mungindi Multipurpose Health Service
  • Murgon Health Service
  • Nanango Health Service
  • Oakey Health Services – Oakey Hospital
  • Proserpine Hospital and Community Health Centre
  • Quilpie Multipurpose Health Service
  • Richmond Health Centre
  • Springsure Multipurpose Health Service
  • Surat Hospital
  • Tambo Primary Health Care Centre
  • Tara Hospital
  • Taroom Hospital
  • Texas Multi Purpose Health Service
  • Tully Hospital
  • Wallumbilla Health Service
  • Windorah Primary Healthcare Centre
  • Winton Multipurpose Health Service
Western Australia (22 sites)
  • Bridgetown Hospital
  • Carnarvon Hospital
  • Derby Hospital
  • Exmouth Health Service
  • Fitzroy Crossing Health Service
  • Gnowangerup Hospital
  • Halls Creek Hospital
  • Jerramungup Health Centre
  • Katanning Health Service
  • Kojonup Hospital
  • Kununurra District Hospital
  • Laverton District Hospital
  • Leonora District Hospital
  • Meekatharra Hospital
  • Norseman District Hospital
  • Onslow Hospital
  • Plantagenet – Cranbrook Health Service
  • Ravensthorpe Health Centre
  • Shark Bay Nursing Post
  • Warmun Health Clinic
  • Warren Health Service
  • Wyndham District Hospital
South Australia (3 sites)
  • Ceduna District Health Service
  • Mallee Medical Practice (Lameroo)
  • Northern Yorke Peninsula Health Service (Wallaroo)
Northern Territory (7 sites)
  • Adelaide River Health Centre
  • Batchelor Health Centre
  • Gove District Hospital
  • Jabiru Community Health Centre
  • Katherine Hospital
  • Tennant Creek Hospital
  • Yulara Community Health Centre


In 2021 the Australian Government Department of Health conducted an independent evaluation of the Initiative.

The evaluation of the Initiative assessed the extent to which the Initiative has been appropriate, effective, efficient and of quality and value to the Commonwealth and participating jurisdictions. Consultations were undertaken with a range of stakeholders including States and the Northern Territory (noting the Australian Capital Territory is not an eligible jurisdiction) as part of the evaluation. Jurisdictions were invited to respond to the draft findings of the evaluation which were considered in the finalisation of the report. The evaluation findings has provided valuable information on the operation and implementation of the Initiative.

Read the Evaluation Report.

Further Information

Please contact your health department in your State or Territory.