GP co-pay now 'optional' but rebates to be cut and frozen

Prime Minister Tony Abbott has announced the government will modify its original $7 co-payment scheme to rule out charging bulk-billed concession card holders and children under 16, but has also announced that the rebate will still be cut by $5 for non-concessional patients and indexation will be frozen until July 2018.

Describing it as an 'optional' co-payment, Mr Abbott said GPs will be able to make up the cut in the rebate by charging non-concessional bulk-billed patients a $5 co-payment, as well as all non-bulk billed patients.

The government will also not apply the original scheme to pathology and diagnostic imaging providers or GP attendances at residential aged care facilities.

In a move that is certain to raise the ire of the medical profession, the Medicare rebate will also be frozen until July 2018. Doctors groups have repeatedly called on governments to ensure indexation of Medicare rebates keeps pace with inflation.

The changes will also see a cut to the rebate for consultations that last less than 10 minutes. A standard B consultation will now need to be between 10 minutes and 20 minutes, with the government saying “it is expected that doctors will reflect any reduced rebates for short consultations through their charges to patients”.

“This change will ensure that Medicare expenditure more accurately reflects the time a GP spends with a patient. It encourages a shift away from ‘six minute medicine’ so that appropriate, comprehensive care is better rewarded over patient throughput.”

The government will still channel the $5 cut in the rebate to the planned Medical Research Future Fund.

It now appears likely that changes to general practice and diagnostic services software will not be required, as the co-payment is “optional”. Medical software vendors were forewarned last month by the Department of Human Services that new client adaptors would be needed to process the $7 co-pay and to do a verification check for concession card holders and children to ensure they were within the mooted 10-visit cap.

However, collecting a $5 fee will still require fully bulk-billing practices to install EFTPOS and credit card machines or collect and reconcile cash. Independent modelling released by the Australian Medical Association showed that the $2 “windfall” from the original $7 co-pay would almost entirely be lost through productivity decreases and red tape.

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