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1998-1999-2000
THE PARLIAMENT OF THE
COMMONWEALTH OF AUSTRALIA
HOUSE OF REPRESENTATIVES
HEALTH INSURANCE AMENDMENT
(RURAL AND REMOTE
AREA MEDICAL PRACTITIONERS) BILL 2000
EXPLANATORY
MEMORANDUM
(Circulated by authority of the Minister for Health and
Aged Care,
the Hon. Dr Michael Wooldridge, MP)
ISBN: 0642 452644
This Bill amends the Health Insurance Act 1973 to enable the
Commonwealth to restrict access to medicare benefits for services rendered by
medical practitioners who breach a contract with the Commonwealth to work in
rural and remote areas.
Initially the Bill will be used to enforce the
contract of persons who participate in the Medical Rural Bonded (MRB)
Scholarship Scheme.
This Scheme is a new long-term strategy under the
budget’s cohesive package of rural health measures to deliver more doctors
to rural communities. Under the Scheme 100 new medical students will receive
$20,000 per year to study medicine, on the condition that they agree to work in
a rural community for six years once they have completed their basic medical
training and GP or specialist Fellowship.
Section 19ABA of this Bill
provides the legislative framework for the Commonwealth to enforce the bond. It
may also have a wider application to other programs where the Commonwealth has
contracts with individuals who undertake to work in a rural and remote area. If
a medical practitioner breaches the commitment to work in a rural or remote
area, the Commonwealth will be able to restrict payment of medicare benefits in
respect of that practitioner’s services.
The period for which the
Commonwealth are able to restrict payment of Medicare benefits if a medical
practitioner breaches such a contract is stipulated as twice that the medical
practitioner agreed to work in a rural and remote area. This will apply unless
a shorter period is determined in the relevant contract.
This legislation
applies whether the medical practitioner referred to was a medical practitioner
when he or she signed the contract or at the time he or she breached it.
Under current legislation, it is a criminal offence for a doctor who
does not have access to medicare benefits to provide services to a patient
without explaining to the patient that there will be no reimbursement for the
service through Medicare. Following the amendment to Section 19CC as outlined in
this Bill, medical practitioners who are in breach of their agreement will also
be committing a criminal offence if they do this.
Under the MRB Scholarship Scheme there will be up to 100 extra doctors
every year once the first cohort completes Fellowship training. This will be an
additional cost to the Medicare Benefits Schedule. However this cost is in a
clear area of need – rural and remote Australia.
Furthermore
doctors who are in breach of their contract will be prevented from accessing
Medicare benefits for a given period of time. Thus the potential cost of these
doctors providing services and therefore adding to medicare benefits costs in
urban areas of oversupply over this time is prevented.
NOTES ON CLAUSES
PART 1 - PRELIMINARY
Clause 1 - Short title
This clause provides that the amending Act may be cited as the Health
Insurance Amendment (Rural and Remote Area Medical Practitioners) Act
2000.
Clause 2 - Commencement
This clause provides
that the Act will commence on Royal Assent.
Clause 3 –
Schedule(s)
This clause provides that each Act that is specified in
the Schedule is to be amended as set out in the applicable items in the Schedule
concerned.
Item 1 of Schedule 1 inserts a new section 19ABA of the Act after section
19AB. Subsection 19ABA (1) will provide that medicare benefits are not payable
in respect of professional services rendered by, or on behalf of, a medical
practitioner who is in breach of a contract with the Commonwealth under which
the practitioner agrees to work in a rural or remote area.
Subsection
19ABA (2) will provide that, where the medical practitioner has breached his or
her contract with the Commonwealth, medicare benefits are not payable for the
duration of the period equal to twice the length of that agreed to by the
medical practitioner under the relevant contract, to work in a rural or remote
area unless a shorter period is determined in, or in accordance with, the
relevant contract.
Subsection 19ABA (4) will provide that section 19ABA applies to
contracts entered into after the commencement of the section.
Item
2
Item 2 of the Schedule will amend section 19CC to make it an
offence for a medical practitioner for whom a medicare benefit is not payable as
a result of section 19ABA to render a professional service without first having
taken steps to inform the patient that a medicare benefit is not payable for the
practitioner’s professional services.
A note provides that the
heading to section 19CC will also be amended as a consequence of the amendments
to section 19CC.
Item 3 of the Schedule inserts a ‘note’ at the end of section
19CC to draw attention to the different meanings of ‘professional
services’ in sections 19AA, 19AB and the new 19ABA.