Every time a patient is bulk billed, they are legally required to assign their Medicare benefit to their doctor. Agreeing the rebate is full payment for the medical service.
Next month, this established process is set to change. Starting 1 July, practices must obtain a written or electronic patient signature for every bulk billed service before lodging a claim. The longstanding paper form is abolished, and verbal consent, including for telehealth, is no longer permitted.
If a valid assignment cannot be obtained, the doctor cannot bulk bill. The alternative is a private charge; meaning, the patient is billed the full fee directly, receives only the Medicare rebate (typically $42.85 for a standard GP consultation), and pays the gap out of pocket. For aged care residents on fixed incomes, that gap can run to tens or hundreds of dollars per visit. Responding to this change to bulk billing practice, Dr Monique Ryan, Independent Member for Kooyong, said:
“The Government deserves credit for expanding bulk billing, but it can’t invest $11.4 billion in GP access then introduce paperwork that makes it harder for doctors to bulk bill their most vulnerable patients. Aged care residents will find it challenging to sign electronic forms received via SMS link.
“This reform was delayed once already because the original timeline was unworkable. If the government fails to announce a transitional arrangement for residential aged care before 1 July, it risks leaving some of Australia’s most frail people without timely bulk billed GP care.
“The Albanese Government has set a target of 90 per cent bulk billing by 2030. I strongly support that goal, but targets mean nothing if the administrative architecture undermines them.
“The enduring consent mechanism that will solve this problem; a single MyMedicare-linked consent covering all future visits to a regular GP; won’t be available until 2027. The Government has left a one-year gap with no adequate bridge. It will be small GP practices and vulnerable patients who will fall into that gap.”
Dr Ryan has written to Minister Butler seeking a briefing on implementation readiness and calling for either a targeted exemption for residential aged care or a formal compliance safe harbour for practices acting in good faith during the transition period. Background: A detailed media briefing document on the AoB changes is available on request.
