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30 June 2022

RACGP welcomes compliance delay but urges further action needed on telehealth

The Royal Australian College of General Practitioners (RACGP) has welcomed news that the Government will be deferring planned telehealth compliance rules but warned that Medicare rebates for longer telehealth phone consultations must be a permanent fixture of the nation’s telehealth scheme.

It comes following today’s announcement that the federal Government will be postponing until at least September this year (a) the reintroduction of the existing 80/20 rule (amended to include video, telephone as well as face-to-face GP consultations); and (b) the implementation of a new 30/20 rule for phone services. The RACGP recently pushed for the Government to delay these rules until a comprehensive review has been undertaken to ensure they are fit for purpose, accurately reflect the new telehealth environment, and don’t negatively impact patient care.

In short:

  • the 30/20 rule would result in any GP providing more than 30 daily phone consultations on 20 or more days over a 12-month period being referred to the Professional Services Review, the body responsible for reviewing and examining possible inappropriate practice by practitioners providing Medicare services

  • the 80/20 rule would deem a GP to have engaged in inappropriate practice if they render or initiate 80 or more professional attendance services on 20 or more days in a 12-month period. The 80/20 rule currently includes face-to-face services only, but would also have included telehealth consultations if the planned changes had proceeded.

It follows the decision made last year to defer these rules until 1 July 2022 in response to the growing number of COVID-19 cases and the need for GPs and general practice teams to focus on delivering care to patients.

RACGP Vice President Dr Bruce Willett said the deferment was welcome, but that a comprehensive review of the rules was still necessary.

“I welcome this further postponement because now is certainly not the time to impose new compliance rules on general practice,” he said.

“GPs and general practice teams are busier than ever. In addition to delivering COVID-19 vaccines and boosters, we are administering flu vaccines, helping patients who delayed or avoided consultations and screenings during the pandemic, and treating patients with serious mental health concerns. It is important to keep in mind that high rates of community transmission of COVID-19 and influenza as well as other viruses mean that many patients are still accessing care via telehealth. For most patients, particularly those not confident using video technology, consultations via phone are the preferred option.

“So, deferring these rules until September is a relief; however, the RACGP still maintains that the Government should initiate a comprehensive review of the 80/20 rule and 30/20 rule to ensure that they are fit for purpose. The last thing we need are compliance rules that potentially compromise GP and general practice team wellbeing and high-quality patient care.”

The RACGP Vice President said it was disappointing that the Government has ruled out further extending the current temporary telehealth arrangements, which includes Medicare rebates for longer phone consultations.

“Tomorrow, Medicare rebates for telephone consultations longer than 20 minutes will be removed. While I am pleased the RACGP has been able to ensure telehealth has been added as a permanent fixture to Medicare for the benefit of all patients, the RACGP strongly believes that this change to telehealth is a backward step for patient care.

In 2020-21, phone consultations comprised 98% of all telehealth services provided by GPs and many of these were longer phone consultations lasting more than 20 minutes. Removing these Medicare rebates is particularly detrimental for older patients, Aboriginal and Torres Strait Islander people, those with disability, and for some people living outside of major cities including rural areas. These groups already have poorer health outcomes than the general population nation-wide so making these Medicare items for longer phone consultations permanent is the logical step.

“The RACGP will continue fighting for longer telephone consultations to be a permanent fixture of telehealth because no patient should be left behind and phone consults make a huge difference for many patients. We also want to see Medicare phone items for chronic disease management and mental health services reinstated as part of the permanent telehealth model.”

To support safe, high-quality care for all Australians, the RACGP firmly believes that telehealth consultations must be:

  • available for all GP consultation lengths and types

  • valued at the same level as face-to-face and video items

  • linked to a patient’s usual GP, with some exceptions for services provided by GPs with special interests upon usual GP referral.

The RACGP’s submission to the Australian National Audit Office’s (ANAO) audit of the expansion of telehealth services outlines several challenges the new Government must face head on to improve our telehealth system. This includes learning from mistakes made in implementing telehealth services and making longer telephone consultations a permanent fixture of Medicare.

Media enquiries

Journalists and media outlets seeking comment and information from the RACGP can contact:

John Ronan

Senior Media Advisor