FEARS the $7 GP fee could be implemented without parliamentary approval have been heightened with the government telling medical software companies to incorporate the fee in their products.
Health Minister Peter Dutton has previously refused to rule out bringing in the charge via regulation, bypassing parliament in the same way the government reintroduced indexation of petrol excise.
In an email to software providers on November 7, the Department of Human Services signals it is preparing apace for the introduction of the GP co-payment fee even though it hasn’t been considered by parliament.
“The Australian Government Department of Human Services (Human Services) anticipates implementing the Patient Contribution Budget Measure from 1 July 2015,” the email says.
‘With the proposed introduction of Patient Contributions for general practitioner, pathology and diagnostic imaging services, sites will need to check whether the patient has a concessional status and may choose to charge a patient contribution at the point of service as appropriate.
“Vendors who provide software to these sites will be required to develop and implement changes to their Medicare Online software and/or Medicare Easyclaim integrated software to provide the new functionality.”
The AMA says the new email is concerning.
“I don’t accept they would work around parliament, I question if they can but I don’t think they are above trying,” says AMA president Professor Brian Owler.
The controversial budget savings measure is opposed by every major medical group and Labor, the Greens and the Palmer United Party have vowed to block it in the Senate.
Chief executive of the Medical Software Industry Association Bridget Kirkham confirmed providers had received the email but says providers still have no detail from the government on how the system will work.
“There are still details to be worked out before we could consider going forward,” she said.
A spokesperson for the Department of Human Services said “even where legislation has not been passed, forward development work of this nature is standard procedure for the department”.
“The implementation of all government measures, especially those involving ICT, require considerable forward planning. Even where legislation has not been passed, forward development work of this nature is standard procedure for the department,” the spokesman said.
“DHS was allocated additional funding to implement this measure, including revisions to its claiming and payment systems, in the 2014 — 15 budget.”
The fee is problematic because it is optional for doctors to charge it, it applies only to some item numbers and doesn’t apply to some patients once they have claimed 10 Medicare services of certain types.
Professor Owler says there is currently no way Medicare can track whether a patient has received 10 services from different providers in real time, a feature that is needed to ensure pensioners are not charged for more than 10 services.
IT blogger David More notes that “ the e-mail has no sense of just how this will be implemented — most especially the 11th patient visit cancellation of the co-payment. Just how is this to happen in real time, how are refunds to be made and so the questions go on and on.”
Opposition health spokeswoman Catherine King accused the government of trying to introduce the GP fee by stealth.
“They lied about the GP Tax before the election, and now faced with the overwhelming rejection of the Australian people and the parliament, are trying to introduce the GP Tax by stealth, just as they did with the Fuel Tax,” she said.
The concerns came as the Royal Australian and New Zealand College of Psychiatrists expressed concerns the $7 GP fee could make it harder for people with a mental illness to see a doctor.
“We already know that many people with mental illness struggle to get the care they need,” RANZCP President Dr Murray Patton said.
“However it is clear from our analysis, that the proposed co-payments will make an already bad situation, much worse. We are concerned about the effects of these Budget measures on people with serious mental illness, particularly those who also have physical illness. In particular we are concerned that the impact of the pathology co-payment has not been thoroughly considered,” he said.
“We call on the Senate to continue to block the implementation of these measures,” Dr Patton said.
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