Report on the 2010 review of the Medicare provider number legislation

2010 Recommendations

Page last updated: 15 November 2012

2010 Recommendations for section 19AA

Recommendation 1

DoHA to review all relevant Medicare Provider Number Legislation to address issues in access to provider numbers and the ability of doctors to practice.

Recommendation 2

The Government to review eligibility criteria for access to vocational training programs so that OTDs’ access to these is assessed on the basis of clinical skills and not on the basis of their residential status.

Recommendation 3

Eligibility for grandfathering of non vocationally recognised(VR) GPs who were qualified before 1996 to be determined in consultation with the profession and the Medical Board of Australia:

Provide one last opportunity to be grandfathered onto the vocational register because this recommendation was not actioned in 2005. If grandfathering is not possible because of the establishment of the national registration system; allow this group to access A1 rebates for a defined period whilst working towards Fellowship with ACRRM or the Royal Australian College of General Practitioners (RACGP).

Recommendation 4

For other non VR doctors working in general practice:

DoHA and industry stakeholders to investigate the barriers for non VR doctors in obtaining vocational recognition and how to provide better support to them, and act on the findings of the investigation.

Recommendation 5

DoHA to amend the relevant regulations and/or legislation to allow supervisors to bill for T8 items for specialist trainee doctors performing procedures in private settings.

2010 recommendations for administration of section 3GA programs

Recommendation 6

6.1: DoHA to update Schedule 5 Pt 2 of the Regulations to remove references to s3GA workforce programs that have been discontinued; namely, the Rural and Remote Area Placements Program, the Metropolitan Workforce Support Program, and the Assistance at Operations program.

6.2: DoHA to routinely update Schedule 5 of the Regulations when the status of s3GA programs change.

Recommendation 7

DoHA to remove reference to the RACGP and ACRRM as specified bodies for the Prevocational General Practice Placements Program (PGPPP) as the program is now managed by GPET.

Recommendation 8

DoHA (or relevant authority) to revise all s3GA workforce and training program guidelines to acknowledge the role of AHPRA in setting conditions for clinical practice and supervision requirements, and monitoring these conditions and requirements.

Recommendation 9

DoHA (or relevant authority) to revise relevant s3GA workforce and training program guidelines to ensure that both the RACGP and the ACRRM are both referred to as providers of general practice training, and to ensure that where the guidelines refer to Fellowship of the RACGP, they also reference the Fellowship of ACRRM.

Recommendation 10

DoHA and Medicare Australia to reduce red-tape involved in applying for provider numbers not only for doctors on s3GA workforce and training programs but across the whole sector; and to improve information services about application processes for the sector.

10.1: By 2012, DoHA to allow one application for each doctor on a s3GA workforce or training program to cover all practice locations and for the entire time they are on the program.

10.2: By 2014, Medicare Australia to issue one provider number to each medical practitioner and an identifying code number to each practice location, with the two numbers working in tandem to identify the practitioner and the location at which the service was provided.

10.3: By 2012, Medicare Australia to automatically renew provider numbers for doctors working for AMDSs when the Deeds of Agreement are renewed.

10.4: Relevant parts of the Government to improve information services so that specialist colleges, doctors, practice managers and others can get queries about the allocation of provider numbers answered in-person and in a timely way.

2010 general recommendations for section 3GA programs

Recommendation 11

DoHA to invest in support for doctors on workforce programs.

Recommendation 12

DoHA to fund a research project that assesses the extent that doctors on s3GA programs access the required level of supervision, and act on the findings of this research project. The research project could include an anonymous survey of doctors’ experiences of the quality of supervision.

Recommendation 13

Relevant program areas in DoHA (or relevant authority) to establish a mechanism that allows regular industry input into operational issues in order to identify and address any problems in delivering services under the programs, rather than wait for the five year review of the Medicare Provider Number Legislation.

Recommendation 14

DoHA to add the ACRRM Independent Pathway (a fully accredited independent general practice training pathway) to Schedule 5 of the Regulations to facilitate access to Medicare provider numbers for registrars on this pathway.

Recommendation 15

15.1:DoHA to add Fellowships of the RACGP, ACRRM, the Australasian College of Sports Physicians and the College of Intensive Care Medicine of Australia and New Zealand to Schedule 5 of the Regulations, which lists organisations and courses for s3GA of the Act.

15.2: DoHA to routinely update Schedule 5 of the Regulations as Fellowship courses are certified by the AMC.

2010 Program specific recommendations for section 3GA workforce programs

Approved Medical Deputising Service Program
Recommendation 16

DoHA to actively monitor the impact of health reforms on the provision of after-hours care by AMDSs and revise the AMDS Program Guidelines as needed.

Queensland Country Relieving Doctors Program
Recommendation 17

17.1: Queensland Health to ensure that all junior doctors on a relief placement have access to direct supervision and endeavour to place more senior doctors in remote relief placements.

17.2: Queensland Health to monitor the achievement of this recommendation and report on its success at the next review of the Medicare Provider Number Legislation in 2015.

Rural Locum Relief Program
Recommendation 18

DoHA to fund rural health workforce agencies to provide support for doctors working under the RLRP.

Program specific recommendations for section 3GA training programs

Prevocational General Practice Placement Program
Recommendation 19

GPET to ensure that all junior doctors have access to direct supervision and endeavour to place more senior trainees in remote placements.

Specialist College Trainee Program
Recommendation 20

Medicare Australia, in consultation with the specialist colleges, to prepare new guidelines about the parameters of the Specialist College Trainee Program (SCTP) including who is eligible and under what circumstances rebates under the program can be claimed. The guidelines should also describe how the program relates to the Specialist Training Program managed by DoHA.

Recommendation 21

DoHA to clarify the items that can be claimed by registrars under the program and expand eligibility to item numbers to more accurately reflect the differing practices of each specialty.

Recommendation 22

DoHA to review the level of rebates (A2) that can be claimed under the program with a view to making these in line with VR (A1) items.

2010 Recommendations for section 3GC

Recommendation 23

The Government consider amending the legislation to allow the MTRP to undertake additional activities to monitor health services capacity in providing training places for prevocational and vocational doctors and provide advice to DoHA and/or HWA on these issues.

Recommendation 24

The Government consider amending the legislation to allow the MTRP to monitor the effectiveness of training programs in meeting workforce needs and demands.

Recommendation 25

The Government consider amending the legislation to allow the MTRP to provide advice about medical training and to develop formal links with HWA.