It is proposed that, on initial application or upon renewal of their approvals, all APPs would need to:
- nominate the class/classes of laboratory in which they propose to initiate MBS billing;
- indicate their proposed scope of testing (for categories M and S laboratories); and
- have their qualifications checked by Medicare Australia according to either existing mechanisms for checking registration as a medical practitioner or recognised specialist or according to the standards and guidelines for assessment of other formal qualifications and experience that are still to be developed.
For APPs wishing to be responsible for billing pathology services in category GX, GY or B laboratories, Medicare Australia will rely upon its existing process of ensuring that an applicant has a recognised specialist pathologist qualification.
For APPs in category S or category M laboratories, in addition to the above and where there has not yet been an appropriate qualification defined, Medicare Australia would seek:
- a statement of claims against the criteria set out above; and
- evidence of any current assessment by NATA of their relevant skills and experience for supervision of testing in the requested scope of testing.
For applicants who have not already been subject to NATA assessment as part of a laboratory assessment process and who do not hold a pathology specialist qualification, Medicare Australia would seek NATA’s and the relevant professional body’s or bodies’ assistance in determining the suitability of the applicant’s experience for the proposed scope of testing in the nominated laboratory/laboratories. The detail of this proposed process requires further consultation and would need to be subject to the development of transparent guidelines for implementation.
Once approved by Medicare Australia, APP status will remain valid for one year as per the current approval arrangements. In line with current arrangements, APPs will be able to move between pathology laboratories (as long as this is within the classes and/or groups of tests for which they have been approved) and will still need to notify Medicare Australia of these movements.
The revised arrangements outlined above would apply to all new APP applicants from the time that the Ministerial Determination is made.