Hunt agrees to restrict MBS funding for telehealth to usual GP or practice
The federal government has agreed to restrict Medicare-subsidised telehealth services to a patient's regular GP or medical practice, beginning next week.
Temporary MBS items for telehealth were introduced in March to try to help reduce community transmission of COVID-19, especially for high-risk patients, but were later expanded to become general in nature with no relation to diagnosing or treating COVID-19. They are due to expire in September.
Posted in Australian eHealth
Tags: Telehealth, COVID-19
Comments
* Anybody who has changed place or residence and cannot attend previous GP - not supported
* Doctors who have done the right thing and not had face-to-face consults with patients - not supported
This rule change, while I understand the reasoning, has not been well thought out and seems rushed.
• Very vulnerable patients who require consultation with a GP by telehealth or phone who have not had a face-to-face consultation in the previous 12 months. For example:
o patients who attend Headspace
o senior school students
o patients who attend Sexual and Reproductive Health Clinics.
• Patients whose consultation with the GP, or at the GP’s practice, in the previous 12 months, was by telehealth or phone service due to the COVID-19 pandemic.
• A GP’s or practice’s regular patients who have not attended a face-to-face consultation in the previous 12 months.
• New patients who have difficulty attending a face-to-face consultation.
• New patients who prefer a telehealth consultation to a face-to-face consultation.
• Patients living in regional, rural and remote areas who have not had a face-to-face consultation with the GP, or at the GP’s practice, in the previous 12 months, and who would have to travel a long distance to access GP care.
• Patients who attend new practices that have not yet built up a patient base or practice population.
• Patients who attend GPs who do not do face-to-face consultations during the pandemic for personal health reasons (for example, GPs who are immunocompromis ed and GPs who have respiratory disorders).
• Patients with mental disorders who have been receiving GP mental health care by video or phone may no longer be able to access this through Medicare - unless they have attended the GP, or the GP's practice, for a face-to-face service, in the previous 12 months.
• Patients who develop mental disorders needing initial treatment on or after 20 July will be unable to access Medicare benefits for GP mental health care by video or by phone without a face-to-face service with the GP, or the GP's practice, in the previous 12 months.
• GPs who provide Focused Psychological Strategies (level 2, MHST) will only be able to provide mental health care by video (items 91818 and 91819), or by phone (items 91842 and 91843), for patients whom they have seen face-to-face in the past 12 months, and for patients who have attended other doctors in the GP's clinic for a face-to-face service in the past 12 months. Medicare benefits will not apply for video or phone consultations for new patients who have been referred to the GP from outside of the GP's practice.
A possible way around this would be if the locum doctors count as belonging to the same 'practice' - eg, if they are working for the same FIFO agency (regarding an agency as a 'practice' may be a moot point).
Indigenous people who live in remote communities are also unlikely to be eligible for Medicare benefits for the pre-COVID-19 GP telehealth items for people in remote areas (Monash 6 and 7). The item numbers are: 2463,2464, and 2465. It's very unlikely that they will meet the requirement for three (yes, three!) F2F consultations in the previous 12 months with the same GP.
What's your experience of GP telehealth (video) with Indigenous people living in remote communities?
In common with other Aboriginal Medical Services that cover multiple communities with multiple doctors it's also the case that some of the patients who have seen a doctor three times in a year won't have seen the same one -- and I have no idea if we count as a "practice" as we're Community Controlled.
Do you think there could be a role for GP telehealth in your service? What about the practicalities - broadband, computers, smartphones, webcams, etc?