RACS appreciates the Australian Government’s amendments to the Health Insurance Act 1973 to enhance Medicare by strengthening their compliance processes. Maintaining public confidence in the system and ensuring Medicare sustainability are key aims. But while the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2024 is imposing radical changes to deal with non-compliance and fraud, it may also create issues relating to regulatory oversight, fiscal prudence, patient consent and administrative burden on surgeons.
To limit and mitigate these issues, RACS suggests:
• Reinforcing regulatory monitoring so insurers and billing agents are brought into line to be responsible for compliance requirements and payment recoveries, and patient financial consent prior to Medicare benefit assignments.
• Improving patient consent conditions before Medicare benefit awards to allow fiscal accountability and make well-informed decisions.
• Including a conflict resolution process in order to preclude unnecessary litigations and administrative burden upon practitioners.
• Determining information disclosure obligations in statutory cases to eradicate juridical uncertainty for multi-disciplinary surgical teams.
• Ensuring procedural fairness in regulatory action, particularly among surgical specialists in managing complicated matters.
• Simplify a complex process: Especially in light of a patient’s understanding and not place the burden solely on the back of the medical practitioner, in our case the surgeon.
RACS would welcome ongoing consideration of these critical issues and is happy to work with the Department of Health and Aged Care to ensure that Medicare reforms achieve a balance of compliance, accountability and quality surgical care in Australia.
Read submission (PDF 304.86KB).