Title page
Contents
Purpose of the Discussion Paper 3
Significance of the assignment of benefit process 4
Scale of bulk billing under Medicare 4
Scale of practitioner agreements (PHI) 5
The importance of bulk billing (Medicare) 5
The importance of simplified billing (PHI) 5
Maintaining the integrity of Medicare 6
Modernising assignment of benefit process (Medicare) 6
Stakeholder perspectives 7
Current assignment of benefit processes 8
Patient consent required to assign their benefit 9
Pre-assignment of benefit not allowed 10
Patient must sign the approved form 12
Patient agreement must be evidenced in an approved form 13
Patient must receive a copy of the assignment of benefit form 15
Assignment of benefit arrangements - principles and mechanisms 16
Assignment of benefit principles and mechanisms 16
Reform considerations 17
Enabling digital technologies 17
Discussion Questions 19
Protecting the integrity of Medicare 19
Discussion Questions 21
Steps toward delivering change 22
Submissions 22
Recommendations 22
Implementation of solutions 22
Communication, education and awareness 23
Attachment A 24
Attachment B 25
Attachment C 26
Attachment D 28
Attachment E 35
Attachment F 36
Table 1. MBS Category and Bulk Billed Services 4
Table 2. Practitioner agreement type and gap outcome for in hospital medical services 5
Table 3. Principles and mechanisms of assignment of benefit 16
Boxes
Box 1. Health Insurance Act 1973 Section 20A (1) (a) (b) 10
Box 2. Health Insurance Act 1973 Section 20A (2A) (a) (b) 10
Box 3. Health Insurance Act 1973 Section 20A (2) 11
Box 4. Health Insurance Act 1973 Section 19 (6) 11
Box 5. Health Insurance Act 1973 Section 127 (1)(a) 12
Box 6. Health Insurance Act 1973 Section 20B(3) 12
Box 7. Electronic Transactions Act 1999 Subsection 10(1) 13
Box 8. Health Insurance Act 1973 Subsection 3(1) and Subsection 3(16) 14
Box 9. Health Insurance Act 1973 Section 20B(3) 15
Attachment Figures
Figure 1. Current Assignment of Benefit Arrangements for Bulk Billed Services 24
Figure 2. Current Assignment of Benefit Arrangements for Simplified Billing 25