BILLS DIGEST NO. 124, 2017–18
PDF version [610KB]
Kaushik Ramesh
Law and Bills Digest Section
20
June 2018
Contents
The Bills Digest at a glance
Purpose of
the Bill
Commencement
details
Structure of
the Bill
Background
Committee
consideration
Position of
major interest groups
Financial
implications
Statement of
Compatibility with Human Rights
Key issues
and provisions
Concluding
comments
Date introduced: 23
May 2018
House: House of
Representatives
Portfolio: Health
Commencement: Schedule
1 commences on 1 July 2019. Schedules 2 to 5 commence on 1 July 2018.
Links: The links to the Bill,
its Explanatory Memorandum and second reading speech can be found on the
Bill’s home page, or through the Australian
Parliament website.
When Bills have been passed and have received Royal Assent, they
become Acts, which can be found at the Federal
Register of Legislation website.
All hyperlinks in this Bills Digest are correct as at
June 2018.
The Bills Digest at a glance
The Health
Legislation Amendment (Improved Medicare Compliance and Other Measures) Bill 2018
(the Bill) arises out of the Government’s policy objective of increasing
compliance under and protecting the integrity of the Medicare Benefits Schedule
(MBS), the Child Dental Benefits Schedule (CDBS) and the Pharmaceutical
Benefits Scheme (PBS). The Bill implements the 2017–18 Budget Measure Guaranteeing
Medicare—Medicare Benefits Schedule—improved compliance.
Most significantly, the Bill introduces new debt recovery
powers that allow the Commonwealth to offset Medicare payments to those practitioners
who are in debt and, for those who do not bulk-bill, allows the Commonwealth to
tap into funds that are owed to practitioners who are in debt. The Bill also
recognises that compliance debts may sometimes need to be shared between a
practitioner and their employer, and introduces new measures to this effect
that account for organisational billing practices. In addition, the Bill
standardises administrative arrangements across the three frameworks, including
those requirements relating to record keeping and administrative penalties.
The proposed amendments are likely to have broad
stakeholder support as they are backed by compacts made between the Minister
for Health and the Australian Medical Association and the Royal Australian
College of General Practitioners. The bulk of the proposed amendments commence
on 1 July 2018, however the proposed amendments relating to organisational
billing commence on 1 July 2019 to allow for additional consultation.
Specifically the Bill achieves its policy objectives by
amending the Health
Insurance Act 1973 (which provides for the MBS) the Dental Benefits Act
2008 (which provides for the CDBS) and the National Health Act
1953 (which provides for the PBS).
Purpose of
the Bill
The purpose of the Health
Legislation Amendment (Improved Medicare Compliance and Other Measures) Bill
2018 (the Bill) is to amend the Health Insurance
Act 1973 (HIA), the Dental Benefits Act
2008 (DBA) and the National Health Act
1953 (NHA) to:
- introduce
new and standardise existing debt recovery powers across the three Acts
- standardise
administrative arrangements across the three Acts
- make
other minor clarifications and corrections to the legislation.
Commencement
details
Clauses 1-3 of the Bill commence on the day of
Royal Assent. The bulk of the proposed amendments (Schedules 2-5)
commence on 1 July 2018. Schedule 1, which amends the HIA to
create shared debt determination provisions, commences on 1 July 2019. The Explanatory
Memorandum explains that this delayed commencement date is to allow for
additional consultation on the administrative aspects of the new scheme.[1]
Structure
of the Bill
The Bill contains five schedules as follows:
- Schedule
1 amends the HIA to give the Chief Executive Medicare (CEO) the
power to make a shared debt determination
- Schedule
2 amends the HIA in order to expand the scope of the Professional
Services Review’s oversight
- Schedule
3 amends the HIA to introduce new debt recovery arrangements and to
amend record-keeping requirements and administrative penalties
- Schedule
4 amends the DBA to introduce new debt recovery arrangements and to
amend record-keeping requirements and administrative penalties
- Schedule
5 harmonises the NHA with the HIA and the DBA,
introduces new debt recovery arrangements and creates a new compliance regime.
Background
Health Benefit Compliance
As part of the 2017–18 Federal Budget, the Department of
Health’s portfolio budget statement outlined a ‘Health Benefit Compliance’
program aimed at supporting the integrity of health benefit claims under
Medicare services.[2]
Specifically, the portfolio budget statement outlined the following with
regards to this program:
In a further move to improve Medicare’s fiscal
sustainability, in 2017-18, legislation will be introduced to strengthen
compliance, including by increasing the Government’s debt recovery powers.
Currently, only 20 per cent of Medicare debts through inappropriate claiming
are recovered. This measure will generate estimated net savings of $103.8
million to be reinvested in Medicare services.[3]
The name of the specific 2017–18 Budget measure is
‘Guaranteeing Medicare – Medicare Benefits Schedule – improved compliance’ and
includes the aims of improving consistency around record keeping requirements,
administrative penalties and requirements to produce documents along with
introducing debt recovery measures.[4]
On its ‘Health Professional Compliance’ website, the Department
of Health notes the main health payment and services programs as being the
Medicare Benefits Schedule (MBS), the Pharmaceutical Benefits Scheme (PBS) and
the Child Dental Benefits Schedule (CDBS).[5]
Proposed amendments
The Department of Health sought input on proposed
amendments to the HIA, the DBA and the NHA, aimed at achieving
this budget measure, in a consultation paper.[6]
The consultation paper noted the reasoning for the proposed changes as follows:
The nature of health practice is changing from small
owner-operated medical practices to larger business enterprises. However, the
current legislative framework is focused on individual providers, rather than
the corporate entities and organisations that are increasingly billing Medicare
on their behalf.
Providers under the MBS continue to receive full payment of
benefits while they have outstanding debts arising from incorrect claiming,
inappropriate practice and in a very small number of cases, fraud. Compulsory
offsetting powers under the National Health Act 1953 and the Dental
Benefits Act 2008 allow such debts to be compulsorily recovered for PBS and
CDBS debts. It is proposed that compulsory offsetting of up to 20 per cent of
future payments be applied to the MBS.
Other inconsistencies among the three Acts mean that doctors
and other MBS providers, pharmacists and dentists face different
accountabilities and penalties for similar actions. These inconsistencies
include record keeping requirements, administrative penalties and requirements
to produce documentation to support claiming.
The proposed legislative changes are to harmonise compliance
and administrative arrangements across MBS, PBS and CDBS to ensure consistency
in approach for pharmacists, dentists, doctors and other health providers.[7]
The consultation paper put forward the following proposals
that would be achieved by way of amending the HIA, the DBA and
the NHA:
- reflect
the reality of practices, hospitals and corporations engaging in billing on
behalf of individual providers
- allow
the Department of Health to offset up to 20 per cent of future MBS payments to
help recover debt owing to Medicare
- streamline
administrative processes associated with billing and compliance.[8]
Stakeholder submissions in response to the consultation
paper are outlined in the ‘Position of major interest groups’ section below.
The proposed changes outlined in the consultation paper
and the above Budget measure form the basis of the proposed amendments put
forward in the Bill.
Committee
consideration
Senate Community Affairs
Legislation Committee
The Bill was referred to the Senate Community Affairs
Legislation Committee. The Committee determined by unanimous decision that
there were no substantive matters in the Bill that required examination.[9]
Position of
major interest groups
Responses to the consultation paper
While there is a lack of stakeholder comments on the Bill itself,
some of the submissions in response to the consultation paper discussed above are
publically available. As already noted, the proposals in the consultation paper
largely form the basis of the proposed amendments in the Bill. The ‘Key issues
and provisions’ section below looks at some of the key amendments in the Bill
in more detail.
The Royal Australian College of General Practitioners
(RACGP) was largely supportive of the proposals. The RACGP supported the
organisational billing proposal, noting that ‘members have long raised concerns
regarding the focus on the billing practices of individual providers, as
opposed to practices who often bill on their behalf.’[10]
The RACGP was also broadly supportive of the compulsory offsetting proposal,
but questioned the rationale behind the ‘20 percent’ rate.[11]
The Australian Association of Practice Management (AAPM)
is a peak body that supports ‘effective Practice Management in the healthcare
profession’.[12]
AAPM supported the compulsory offsetting proposal in principle, noting that
practical issues may arise with reconciliations in practice management software
when MBS payments are withheld.[13]
However AAPM seemed broadly unsupportive of the shared debt determination
proposal, noting in its submission:
It is still important that the individual provider is
required to take responsibility for their billings as the patient assigns their
rights to the individual practitioner, not to the Organisation. The liability
should remain with the doctor as they determine the charge. No other staff
should determine the doctors charge. We are concerned that the liability will
automatically shift to the Organisation if the debt cannot be claimed from the
individual.[14]
Compacts
The Minister for Health, Greg Hunt, noted the following in
his second reading speech when introducing the Bill:
The amendments are supported by the government's compacts
with the Australian Medical Association and the Royal Australian College of
General Practitioners. I thank them for their help and support in the
development of these amendments. These compacts reflect shared principles that
support a stronger, sustainable health system, including improved compliance
processes to ensure Medicare overpayments are detected and recovered.[15]
The compact between the Minister for Health and the
Australian Medical Association (AMA) notes that the AMA supports measures aimed
at greater compliance in the area of health benefit payments:
In terms of accountability, changes to compliance
arrangements which provide the ability to investigate billing by organisations,
and to compulsorily offset a portion of future MBS payments against MBS debt,
are also supported.[16]
The compact with the RACGP contains similar wording:
The RACGP acknowledges that Medicare billing is often
directed by the organisation/practice, as opposed to the individual
practitioner. Therefore, changes to compliance arrangements, which encourage
quality practice and provide the ability to investigate billing by both
practitioners and organisations, are supported by the RACGP.
The RACGP also supports changes to compliance mechanisms that
compulsorily offset a portion of future MBS payments against MBS debt for
practitioners.[17]
The Minister for Health reiterated this industry support
for the proposed amendments in the Bill:
Ultimately, this follows from the government's agreements
with the sector. This change has been strongly supported by the medical sector
because it ensures that the vast bulk, the overwhelming majority, of
extraordinarily capable Australian doctors and the medical workforce will be
supported and that the very, very small number who have done the wrong thing,
either inadvertently or intentionally, will have the responsibility to make
redress. At the end of the day, though, what we are doing is ensuring that
there is a long-term absolute guarantee about the future of Medicare and the PBS.[18]
Financial
implications
The Financial Impact Statement in the Explanatory
Memorandum states that the Bill will achieve savings of $103.8 million over
four years.[19]
Statement of Compatibility with Human Rights
As required under Part 3 of the Human Rights (Parliamentary
Scrutiny) Act 2011 (Cth), the Government has assessed the Bill’s
compatibility with the human rights and freedoms recognised or declared in the
international instruments listed in section 3 of that Act. The Government
considers that the Bill is compatible, as any limitations on human rights are
reasonable, necessary and proportionate to achieving Medicare compliance and
improving healthcare for Australians.[20]
Parliamentary Joint Committee on
Human Rights
At the time of writing this Digest, the Parliamentary
Joint Committee on Human Rights had not considered the Bill.
Key issues
and provisions
Debt Recovery
The Bill introduces measures to better recover debts owed
to the Commonwealth as a result of excess payments made under the MBS, PBS and
CDBS as a result of making a false or misleading statement. This is one of the
key features of the Bill, and as highlighted in the ‘Background’ section, arose
from measures originally announced in the 2017–18 Budget.
Current section 129AC of the HIA outlines that
where payments or benefits paid under that Act exceed the amount that should
have been paid as a result of a false or misleading statement, then this excess
is recoverable as a debt due to the Commonwealth. The same section prescribes
that if a person does not produce a document in respect of a professional
service as required by a notice issued under section 129AAD, then the benefit
paid in respect of the service becomes a debt owed to the Commonwealth.
Similar provisions exist in the DBA with regards to
debts owed to the Commonwealth in relation to CDBS payments (section 56 and
56A). The NHA provides for unauthorised payments and incorrectly paid
advances under the PBS to become debts to the Commonwealth (sections 99AA and
99AB). Schedule 5 of the Bill creates provisions similar to the HIA
and the DBA in the NHA, i.e. debts to the Commonwealth resulting
from specifically making a false or misleading statement.
Debt recovery is one of the key policy purposes of the
Bill. The Bill creates debt recovery mechanisms in the form of compulsory
offsetting and garnisheeing arrangements.
Compulsory Offsetting
The Bill introduces the ability for the Commonwealth to offset
payments under the MBS in order to recover a debt owing to it. As stated in the
Bill’s Explanatory Memorandum:
Only some practitioners who incur a Medicare debt agree to
enter into arrangements to repay it. Those that refuse to agree to a repayment
arrangement can continue to make further Medicare claims and may continue to
receive payments directly from the Commonwealth for bulk-billed services.[21]
Item 31 of Schedule 3 of the Bill inserts proposed
section 129AEF into the HIA, this proposed section allows for
amounts owing to the Commonwealth to be ‘set off’ against amounts payable under
the HIA. Proposed subsection 129AEF(3) caps the amount to be set
off at 20 per cent of the payable amount unless the CEO and the person agree to
a higher percentage.
In effect this amendment means that Medicare can withhold
up to 20 per cent of payments under the MBS in order to pay off debts owed by
practitioners to the Commonwealth. Provisions already exist in the NHA
and DBA to allow for such compulsory offsetting,[22]
however Schedule 5 creates offsetting provisions in the NHA with
respect to debts arising from false and misleading statements specifically.
Garnisheeing of Funds
The Bill will also allow for the garnisheeing of certain
funds to allow for debts owed to the Commonwealth under the MBS, PBS and CDBS
to be repaid. Item 31 of Schedule 3 of the Bill inserts proposed
section 129AEG into the HIA to allow the CEO to issue a garnishee
notice to a person who owes or may later owe money to a person who has a debt
to the Commonwealth. Item 12 of Schedule 4 of the Bill inserts a
similar provision (proposed section 58AA) into the DBA and item
5 of Schedule 5 inserts a similar provision (proposed section
99ABJ) into the NHA.
The Bill thereby strengthens the Commonwealth’s ability to
recover debts under the MBS, the PBS and the CDDS. The Explanatory Memorandum
explains the rationale of this mechanism in relation to the HIA
amendments:
For those practitioners that owe a debt who do not bulk-bill,
the amendments will allow garnisheeing of other funds owed to them including
funds held in bank accounts and income from employers. In addition to the
capacity to recover debts, the garnishee provisions are intended to be a
disincentive to practitioners who seek to avoid set off arrangements by
reducing or stopping bulk-billed services.[23]
The second reading speech accompanying the Bill makes
clear that the garnisheeing mechanism is considered a last resort and an
incentive to repay debts owing to the Commonwealth:
An offset or garnishee arrangement will only apply if all
rights for review have expired and the practitioner does not agree to a
repayment plan within 90 days. These new arrangements will start on 1 July
2018. Indeed, it is my hope that the very fact of these new arrangements will
mean that they do not have to be brought into action.[24]
All three Acts will be amended so as to allow the
possibility of reviewing a decision to give a garnishee notice in the Administrative
Appeals Tribunal (AAT) (see item 31 of Schedule 3, item
12 of Schedule 4 and item 5 of Schedule 5).
Shared Debt Determinations
(Organisational Billing)
Schedule 1 of the Bill introduces the power for the
CEO to make shared debt determinations under the HIA. These amendments
effectively allow for debt owed to the Commonwealth under the HIA to be
shared. The Government’s rationale for such amendments is explained in the
Minister’s second reading speech:
The current legislation places all of the liability for
Medicare claiming against an individual practitioner, except in clear cases of
fraud. This reflects the old business model of single-doctor practices.
However, in contemporary practice there has been an increase in the role of
practices, corporate entities and hospitals in the billing of MBS services on
behalf of individual practitioners.
The amendments will introduce a scheme where, if there is an
employment or other contractual relationship, the practitioner and their
employer (or other related party) will each be responsible for the repayment of
part of the compliance debt.[25]
The Explanatory Memorandum states:
from 1 July 2019, [the Bill will] introduce fairer approaches
to address corporate billing reflecting the reality that large practices,
corporations and hospitals increasingly undertake billing on behalf of
individual practitioners and should share responsibility if that billing is
incorrect.[26]
Item 14 of Schedule 1 inserts proposed
section 129ACA (making of a shared debt determination) and proposed
section 129ACB (review of decisions relating to shared debt determinations)
into the HIA. Proposed section 129ACA allows for a debt to the
Commonwealth under the HIA to be claimed or claimed in part from a secondary
debtor. Proposed paragraph 129ACA(2)(b) provides that the secondary
debtor must have employed or otherwise engaged the primary debtor
to render professional services in respect of which the original Commonwealth
payment was made, or had an arrangement or agreement with the primary
debtor relating to those professional services, or is in a class of
person prescribed under a legislative instrument made by the Minister (see proposed
paragraph 129ACA(9)(a)).
Proposed paragraph 129ACA(2)(c) sets out criteria
that the CEO should have regard to when deciding whether to make a shared debt
determination; this criteria includes whether the secondary debtor
could have controlled or influenced the circumstances that led to the making of
the false or misleading statement to which the debt relates and whether the secondary
debtor directly or indirectly obtained a financial benefit from the
making of the false and misleading statement.
Under the new regime, this secondary debtor will
normally be the employer of the medical practitioner:
The secondary debtor will, in most circumstances, be the
person who employs or engages the person (the primary debtor) who rendered a
professional service under the Health Insurance Act (or on whose behalf
such a professional service was rendered) for which an amount was paid and
which would have been recoverable solely from the primary debtor under
subsection 129AC(1).[27]
The Explanatory Memorandum notes that the intention is
that a legislative instrument will stipulate the amount of debt apportionment
where a contractual arrangement is identified between a secondary and primary
debtor.[28]
Power to obtain information
relating to a debt
All three Acts will be amended in a similar fashion to give
the CEO or the Secretary of the Department of Health, as appropriate, power to
obtain information in relation to a debt.
For example, proposed section 56H under item 11
of Schedule 4 to the Bill gives the CEO power to obtain certain
information relating to a debt under the CDBS, such as an address and
information and documents relating to the person’s financial situation. Proposed
subsection 56H(4) also requires a person to give information or a document
that would help locate another person who owes the prescribed debt to the
Commonwealth. The proposed section creates a civil penalty of 20 penalty
units ($4,200) for an individual or 100 penalty units ($21,000) for a body
corporate for failing to comply with a notice requiring the person to provide the
requested documents or information (proposed subsection 56H(6)).
This is another mechanism that the Bill uses to strengthen the Commonwealth’s
debt recovery powers in this area.
Professional Services Review
Schedule 2 of the Bill amends provisions of the HIA
relating to the Professional Services Review (PSR). The Explanatory Memorandum
outlines the function of the PSR:
The Professional Services Review (PSR) is a separate
statutory agency within the Health Portfolio. Part VAA of the Health
Insurance Act establishes the agency, sets out its role, powers and
processes, including its key role of conducting peer review.
The PSR protects patients and the community from the risks
associated with inappropriate practice, and protects the Commonwealth from
having to meet the cost of medical services provided as a result of
inappropriate practice. Inappropriate practice is conduct by a medical
practitioner in connection with rendering or initiating services that a
practitioner’s peers could reasonably conclude was unacceptable to the general
body of their profession.
PSR is responsible for reviewing and examining possible
inappropriate practice by practitioners when they provide Medicare services or
prescribe Government subsidised medicines under the PBS. PSR examines suspected
cases of inappropriate practice which have been referred by delegates of the
Chief Executive Medicare. PSR cannot initiate its own reviews of a
practitioner.[29]
Schedule 2 clarifies the persons whom the PSR can
review. In particular, items 1,2,3,5 and 18 expand the scope of
PSR related provisions to capture persons where there is no formal employment
relationship through use of the words ‘or otherwise engaged’. The rationale for
these amendments is that ‘practitioners are increasingly employed as
contractors’.[30]
Improving consistency of
administrative arrangements
One of the proposals put forward in the Department of
Health consultation paper involved ‘changes to harmonise administrative arrangements
across the three Acts so that the same standards and administrative penalties
apply to all health providers, including pharmacists and dentists.’[31]
The Explanatory Memorandum notes specifically that record keeping requirements
to produce and retain documents relating to claims will be standardised across
all three professions (along with the associated penalties).[32]
AAPM made comments in its submission that it ‘agrees that bringing all health
care professionals under the same set of regulations is also very reasonable.’[33]
Record keeping requirements
The Bill attempts to standardise and clarify record
keeping requirements across the MBS, PBS and CDBS frameworks. The most
significant of the record keeping amendments are those that will affect the MBS.
Schedule 3 of the Bill contains several proposed amendments largely
aimed at introducing a uniform two=year record keeping period into the HIA.
The Explanatory Memorandum summarises the changes to record keeping
requirements under the HIA as follows:
| Current Law |
New Law |
| Specialists and consultant physicians are required to keep
copies of referrals for 18 months |
Specialists and consultant physicians are required to keep
copies of referrals for two years |
| Pathologists and radiologists are required to keep copies
of referrals for 18 months |
Pathologists and radiologists are required to keep copies
of referrals for two years |
| There is no requirement for allied health practitioners to
keep copies of referrals |
Allied health practitioners are required to keep copies of
referrals for two years |
| The payment of a rebate for a professional service may be
conditional on the creation of a document, but there is no requirement for a
practitioner to keep a copy of the document |
If a document is specifically mentioned in an item (such
as a GP Health Assessment), and is created by the practitioner, then the
practitioner must keep a copy for two years |
Source: Explanatory
Memorandum, Health Legislation Amendment (Improved Medicare Compliance and
Other Measures) Bill 2018, p. 25.
Administrative Penalties
Schedule 4 of the Bill introduces an administrative
penalty scheme to the DBA similar to the scheme that already exists
under the HIA. Item 11 of Schedule 4 introduces this new
administrative penalty scheme by adding proposed sections 56E, 56F, 56G
and 56H into the DBA.
Proposed section 56E stipulates when a person is
liable for an administrative penalty, namely if the person is served a notice
by the CEO that they have a debt owing to the Commonwealth and if this debt is
more than $2,500. Proposed subsection 56F(2) outlines that an
administrative penalty for a dental service is 20 per cent of the recoverable
debt to the Commonwealth. However, proposed subsection 56F(3) provides that
this base penalty amount is reduced by a stipulated percentage in certain
circumstances (for example the base penalty will be reduced by 100 per cent if
the person voluntarily informs Medicare of an overpayment prior to being
contacted).
Proposed section 56G outlines the requirements of
the written notice that the CEO must provide to a person liable for an
administrative penalty. Proposed subsections 56G(3) and (4) allow a
person to apply to the AAT for a review of an administrative penalty assessment
if a garnishee notice is given under proposed subsection 58AA(2)
(similar amendments will be introduced to the administrative penalty scheme in
the HIA, see item 29 of Schedule 3).
Schedule 5 of the Bill inserts similar provisions
into the NHA to provide for an administrative penalty scheme where an
overpayment under the PBS has occurred due to a false or misleading statement. Item
5 inserts proposed section 99ABE that creates a liability for an
administrative penalty where a debt to the Commonwealth exceeds $2,500 and proposed
section 99ABF stipulates that the penalty will be 20 per cent of the
recoverable debt. Under proposed subsection 99ABF(3) a penalty will
be reduced by 50 per cent if the person voluntarily informs the Secretary of
the Department of an excessive payment after a notice to produce documents relating
to a pharmaceutical benefit is given (proposed subsection 99ABB(2)).
House of
Representatives Amendments
After the introduction of the Bill into the House of
Representatives, the Government proposed two amendments to the Bill as
introduced.[34]
These amendments proposed to amend item 6 of Schedule 2 of the
Bill and item 34 of Schedule 3 of the Bill. The Bill’s Supplementary
Explanatory Memorandum notes that the first proposed amendment, relating to
the PSR, was the result of advice from the AMA:
The first amendment would omit an amendment that was proposed
to Part VAA of the Health Insurance Act. Section 106B deals with the
power of a Professional Services Review Committee to summons a person to attend
a hearing and give evidence. The AMA identified that the change may have the
unintended consequence of subjecting a practitioner to both disqualification to
billing Medicare and a possible criminal prosecution for failing to attend in
accordance with a summons. This was not the intention of the proposal, but to
avoid doubt the Government proposes removing the relevant provision.[35]
The Government’s second amendment allows the CEO to set
off the whole or part of a recoverable amount under proposed section 129AEF,
regardless of whether the debt became due to the Commonwealth before, on, or
after the commencement of item 34. The Government notes that this will
allow the Bill to meet its purpose of recovering compliance debts.[36] The
Government’s amendments were agreed to by the House of Representatives after
debate.
Concluding comments
The Bill strengthens debt recovery powers and harmonises
administrative requirements across three professional segments of the healthcare
industry and attempts to better reflect modern billing practices.
Members, Senators and Parliamentary staff can obtain
further information from the Parliamentary Library on (02) 6277 2500.
[1]. Explanatory
Memorandum, Health Legislation Amendment (Improved Medicare Compliance and
Other Measures) Bill 2018, p. 9.
[2]. Australian
Government, Portfolio
budget statements 2017–18: budget related paper no. 1.10: Health Portfolio,
p. 106.
[3]. Ibid.
[4]. Department
of Human Services (DHS), ‘Guaranteeing
medicare — Medicare Benefits Schedule — improved compliance – Budget 2017–18’,
DHS website, updated 27 August 2017.
[5]. Department
of Health (DoH), ‘Health
Professional Compliance’, DoH website, updated 6 February 2018.
[6]. DoH,
Consultation
paper: improving Medicare compliance , DoH, Canberra, September 2017.
[7]. Ibid.,
p. 2.
[8]. Ibid., pp. 3–4.
[9]. Senate
Community Affairs Legislation Committee, Consideration
of time critical Bills, 2018, The Senate, 5 June 2018, p. 1.
[10]. B
Seidel, Consultation
paper: improving Medicare compliance (RACGP submission), The Royal
Australian College of General Practitioners, Melbourne, 11 October 2017, p. 1.
[11]. Ibid.,
p. 2.
[12]. Australian
Association of Practice Management Ltd (AAPM), ‘About AAPM’, AAPM website, 2018.
[13]. AAPM,
Consultation
paper on improving Medicare compliance: AAPM Submission, October 2017,
AAPM, Melbourne, October 2017, p. 4.
[14]. Ibid.,
p. 2.
[15]. G
Hunt, ‘Second
reading speech: Health Legislation Amendment (Improved Medicare Compliance and
Other Measures) Bill 2018’, House of Representatives, Debates,
23 May 2018, p. 2.
[16]. Australian
Government and the Australian Medical Association, A
shared vision for Australia's health system: principles agreed to by the
Government and the Australian Medical Association (AMA), n.p., 2017–18,
p. 2.
[17]. Australian
Government and the Royal Australian College of General Practitioners (RACGP), Strengthening
Medicare: agreement with the Royal Australian College of General Practitioners
(RACGP) on behalf of general practitioners, n.p.,
2017–18, p. 3.
[18]. G
Hunt, ‘Second
reading speech’, op. cit., p. 3.
[19]. Explanatory
Memorandum, Health Legislation Amendment (Improved Medicare Compliance and
Other Measures) Bill 2018, p. 2.
[20]. The
Statement of Compatibility with Human Rights can be found at pages 3–7 of the Explanatory
Memorandum to the Bill.
[21]. Explanatory
Memorandum, Health Legislation Amendment (Improved Medicare Compliance and
Other Measures) Bill 2018, p. 26.
[22]. Section
58 of the DBA and section 99AA and 99AB of the NHA.
[23]. Explanatory
Memorandum, Health Legislation Amendment (Improved Medicare Compliance and
Other Measures) Bill 2018, p. 26.
[24]. G
Hunt, ‘Second
reading speech’, op. cit., p. 2.
[25]. Ibid.,
p. 3.
[26]. Explanatory
Memorandum, Health Legislation Amendment (Improved Medicare Compliance and
Other Measures) Bill 2018, p. 1.
[27]. Ibid.,
p. 13.
[28]. Ibid.,
p. 9.
[29]. Ibid.,
p. 19.
[30]. Ibid.
[31]. DoH,
Consultation
paper: improving Medicare compliance, op. cit., p. 4.
[32]. Explanatory
Memorandum, Health Legislation Amendment (Improved Medicare Compliance and
Other Measures) Bill 2018, p. 1.
[33]. AAPM,
Consultation
paper on improving Medicare compliance: AAPM Submission, October 2017,
op. cit., p. 5.
[34]. Government
proposed amendments, Health
Legislation Amendment (Improved Medicare Compliance and Other Measures) Bill
2018, Government (Sheet EU135).
[35]. Supplementary
Explanatory Memorandum, Health Legislation Amendment (Improved Medicare
Compliance and Other Measures) Bill 2018, p. 1.
[36]. Ibid.
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