A breach of Medicare rules?
Thousands of Australians are being asked to pay membership fees to GP clinics to access bulk-billed medical care. This practice, according to experts, is a breach of Medicare rules and amounts to "double dipping."
Cleanbill, a medical data company, reports that almost 100 GP clinics have started charging these fees. The Australian Government's Services Australia website defines bulk-billing as a service where patients don't have to pay for medical care. Instead, the clinic bills Medicare and accepts the benefit as full payment.
One example is Kure Medical, a Mildura-based medical chain. They charge $220 for an individual or $330 for a family to access 12 months of bulk-billed care. The ABC verified that Kure Medical billed Medicare for consultations while also charging membership fees.
The Royal Australian College of General Practitioners president, Nicole Higgins, confirms that charging an annual fee for guaranteed bulk-billed services violates Medicare rules. The Medicare Benefits Schedule states that practitioners cannot charge additional fees for bulk-billed services.
Mildura pensioner Sue Watson criticizes this practice, calling it a "rip-off." She and her partner cannot afford the upfront cost due to their limited income.
Peter Breadon, Grattan Institute health program director, highlights the issue's prevalence in regional areas with fewer bulk-billed services. He emphasizes the unfairness of communities with more illness and disadvantage having less access to affordable healthcare.
Breadon suggests that clinics found "double dipping" should repay government rebates and be ineligible for further incentives.
Cleanbill data reveals that at least 98 clinics nationwide are charging membership fees for bulk-billed services. Medical billing expert Margaret Faux describes the practice as "rampant" and difficult to detect.
Faux also points out that these fees distort government data on bulk billing. The government claims 79% of GP visits were bulk-billed in May, but this figure doesn't account for membership fees.
The federal health department confirms that charging membership fees for guaranteed bulk-billed services is a breach of the Health Insurance Act. They investigate allegations of non-compliance.
However, Dr. Faux notes that previous court cases haven't addressed the issue of membership fees charged on a different day than a bulk-billed service. This leaves a legal loophole that needs clarification.