Commonwealth of Australia Explanatory Memoranda

[Index] [Search] [Download] [Bill] [Help]

HEALTH INSURANCE AMENDMENT (90 DAY PAY DOCTOR CHEQUE SCHEME) BILL 2008

                                     2008



    THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA




                      HOUSE OF REPRESENTATIVES




HEALTH INSURANCE AMENDMENT (90 DAY PAY DOCTOR CHEQUE
                  SCHEME) BILL 2008




                     EXPLANATORY MEMORANDUM




 (Circulated by authority of the Minister for Health and Ageing, the Hon Nicola
                                  Roxon, MP)
  HEALTH INSURANCE AMENDMENT (90 DAY PAY DOCTOR CHEQUE
                    SCHEME) BILL 2008

OUTLINE

This Bill amends section 20 of the Health Insurance Act 1973 (the HIA) to allow
specialists and consultant physicians access to the 90 Day Pay Doctor Cheque Scheme
where the original claim for the Medicare benefit is submitted electronically to
Medicare Australia.

Subsection 20(2) of the HIA provides that where a person is entitled to a Medicare
benefit in relation to a professional service but has not paid their medical bill, the
person can request that a cheque be drawn in favour of the medical practitioner who
rendered the service for the amount of the Medicare benefit. The patient is then
provided with a pay doctor via claimant cheque. A pay doctor via claimant cheque,
also known as a pay doctor cheque (cheque) is a cheque for the amount of Medicare
rebate made out to the medical practitioner that provided the service. The cheque is
provided to the patient who is then responsible for forwarding the cheque on to the
medical practitioner along with any co-payment required to satisfy the full account.
This arrangement allows patients to use their Medicare rebate towards the payment of
their medical bill, rather than paying the medical bill in full at the time of the service.

Currently subsection 20(3) of the HIA provides that where a cheque given under
subsection 20(2) or 20(2A) of the HIA has not been banked by the medical
practitioner within 90 days of it being issued to the patient, the cheque may be
cancelled and Medicare Australia may pay the applicable Medicare rebate directly to
the general practitioner. Subsection 20(5) of the HIA allows for Medicare Australia
to make this payment via electronic funds transfer. This arrangement is known as the
90 Day Pay Doctor Cheque scheme and is currently restricted to general practitioners.

This Bill will allow specialists and consultant physicians access to the 90 Day Pay
Doctor Cheque Scheme on the condition that the original claim for the Medicare
benefit was submitted to Medicare Australia electronically in the manner prescribed
by the Regulations.

Financial Impact Statement

The implementation of this Bill has a cost of $4.5 million over four years. This
funding was included in the Portfolio Additional Estimates Statements 2007-08 for
the Human Services Portfolio. The budgeted annual costs, which include the cost to
Medicare Australia to introduce the necessary system changes and manage the
program, are set out in the table below:

          2007-08             2008-09              2009-10             2010-11
         ($ million)         ($ million)          ($ million)         ($ million)
             1.2                 1.1                  1.1                 1.1




                                             1
  HEALTH INSURANCE AMENDMENT (90 DAY PAY DOCTOR CHEQUE
                    SCHEME) BILL 2008

                               NOTES ON CLAUSES


Clause 1
This clause provides that the Act may be cited as the Health Insurance Amendment
(90 Day Pay Doctor Cheque) Act 2008.

Clause 2
This clause provides that sections 1 to 3 of the Bill commence on the day that the Bill
receives Royal Assent. Schedule 1 commences on a day to be fixed by Proclamation.

Schedule 1 contains amendments to the Health Insurance Act 1973 to allow
specialists and consultant physicians access to the 90 Day Pay Doctor Cheque
Scheme. The purpose of setting the commencement date of Schedule 1 by
Proclamation is to allow Medicare Australia adequate time to complete and test
changes to the internal administrative claiming systems which are required to
implement the 90 Day Pay Doctor Cheque scheme for specialists and consultant
physicians.

Clause 3
This clause provides that each Act that is specified in a Schedule to this Bill is
amended or repealed as set out in the applicable items in the Schedule concerned, and
any other item has effect according to its terms.

Schedule 1- Amendment relating to the 90 day pay doctor cheque scheme

Schedule 1 amends the Health Insurance Act 1973 (the HIA) to allow access to the 90
Day Pay Doctor Cheque Scheme to specialists and consultant physicians, where the
original claim for the Medicare benefit has been made electronically.

Item 1:
This item inserts into subsection 20(3) and (4) the terms "specialist and consultant
physician" after general practitioner wherever it occurs. This makes services
provided by specialists and consultant physicians eligible for the 90 Day Pay Doctor
Cheque Scheme subject to the new subsection 20(6).

Item 2:
This item adds a new subsection 20(6) to the HIA to provide that the 90 Day Pay
Doctor Cheque Scheme will only apply to services provided by specialists and
consultant physicians where the original Medicare claim is submitted electronically in
the manner prescribed by the Health Insurance Regulations 1975.

Item 3:
This item provides the professional services rendered on or after the day of these
amendments take effect are eligible for the 90 day pay doctor cheque scheme.




                                           2