Department of Health | Temporary changes to requirements under s19AA and 19AB of the Health Insurance Act 1973

To support doctors responding to the COVID-19 pandemic the Department of Health is implementing a number of short term measures to waive or streamline Medicare program requirements. These measures will ensure eligible doctors can continue to satisfy their obligations under section 19AA and 19AB of the Health Insurance Act 1973 and provide Medicare services to patients in their current practice.

When designing the measures the key considerations were promoting a safe, quality health workforce force; removing barriers and administrative obligations; and maintaining continuity of services to the community.

What will be done?
The measures include an automatic 6 month extension of s3GA placements and 19AB exemptions expiring from 1 May 2020, including extension of locum placements. These extensions will be processed on a month-by-month basis (approximately 6 weeks in advance of expiry) and all extensions will be confirmed with each doctor via letter or email. No application form will be required for these extensions.

Note that there are some conditions attached to these changes, which are detailed in the attached table.  In addition, doctors who are within 6 months of reaching the maximum participation period will be reviewed by the Department before an extension is granted. The review will include consideration of a doctor’s prior 3GA program participation and progress to fellowship (including exam history). Doctors who are not granted an extension will be notified by email/letter by the Department.

The Department is also waiving program requirements that can no longer be met due to the current circumstances, including:
– All program milestones will be suspended for 6 months ie doctors will not need to complete fellowship exams or apply to college led fellowship programs.
– Extensions will not count towards program participation maximum
– For current AMDS doctors, evidence of Advanced Life Support re-certification will be waived for 6 months.

The attached Summary of Changes document explains the changes and any conditions. I have also attached a Q and A document which provides information on some possible questions individuals may have.

How long for?
While we anticipate these extensions will continue for up to 6 months, the Department will review the need for such changes regularly and will cease these measures when no longer required. Any placement already extended will remain in place until the amended expiry date.
We appreciate that the doctors and medical practices across Australia are currently facing significant pressures due to increased workloads and reduced workforce availability. Many of these practices are in Distribution Priority Areas (DPAs) and Districts of Workforce Shortage (DWS), and were already facing significant challenges. As the COVID-19 situation continues to evolve, one of the main priorities of the Australian Government is to ensure workforce distribution measures are not impacted in order to maintain workforce in communities most in need, particularly in rural and remote areas. This includes maintaining legislative requirements around 19AA and 19AB for all new applications. It is important that doctors who are required to work in a DPA or a DWS are not drawn away from these communities in need.

Any questions on these changes should be sent to 19AB@health.gov.au

 

VIEW SUMMARY OF CHANGES

VIEW FAQS

COVID-19 | Accreditation Update & Enhanced Support for Practices

Dear Colleagues,

As previously notified, the Australian Commission for Safety and Quality in Health Care is maintaining accreditation. You can view the announcement here. We are advised that all benefits (PIP, WIP etc) will continue for practices where their accreditation certificate has expired during this period.

This advice is in line with current government recommendations and mandates regarding the need for social distancing, isolation and infection control measures.

While it is not possible for any of us to know when the recovery phase of the pandemic will begin, the ACSQHC has advised that sufficient notice will be given for any resumption of accreditation activities.

In order to manage the uncertainty for practices and surveyors, QPA is adopting the following operational procedures:

  • Pending advice from the Commission, QPA will provide at least one month’s notice for any postponement of practice visits
  • Consistent with this policy, all practice visits for April and May 2020 will be postponed. We will make a decision after consultation with the Commission on a postponement of June visits on 30 April and continue to provide advice at the end of each month on a rolling basis
  • Any emergency response plan needs to have a policy, procedure and process to ensure orderly and timely return to normal operations
  • QPA will continue to plan and prepare for booked visits through to the end of the year, to allow for this orderly return to normal operations. Practices that have their accreditation visits postponed will be offered tentative visits in due course.

In the meantime, now is not the time to put quality and accreditation at the bottom of your to do list. Those who promote accreditation as a tired old template, tick a box system are doing practices and patients a disservice.

We would encourage and urge all practices to consider their quality systems regularly with reference to the standards and the evolving COVID-19 situation.

In particular, review your current systems now in regard to:

  • Emergency response planning
  • Infection control and cleaning
  • Triage and appointments, particularly in light of the new telehealth items
  • Risk management – consider what risks might apply with telehealth consultations and discuss practice guidelines for when patients require face to face consultations
  • Vaccine storage and cold chain management
  • Clinical stock control and waste management
  • Workplace health and safety

Clearly allocate responsibilities to individuals for each of these areas and ensure that position statements or job descriptions reflect the current circumstances. Questions are just as important as answers.

Look after your people. Anxiety and fear are normal emotional reactions. Do not assume that all of your doctors and staff are fully aware of written policies and procedures or know how to apply these. To view our webinar discussing this, please register for the recording here.

QPA will continue to operate at this time as long as possible, while protecting and supporting our people. QPA will offer enhanced support for practices and surveyors during this time. A series of small group zoom teleconferences will be offered to allow practices to have discussions with our team. Our Quality Accreditation Managers will continue to make contact will all practices, particularly those affected by the postponement of visits and accreditation.

While the following may not apply to your practice, in our practice, we are reviewing procedures with reface to the standards and published professional and Government announcements at least every second day through Zoom meetings with doctors and staff. All patients are now being triaged through a telehealth consultation and managed appropriately according to stringent clinical guidelines. We are actively identifying patients at risk and advising them by telephone, use of an SMS and social media of the need for infection control and social isolation. Where any uncertainty exists, patients are offered a face to face consultation and we have established a respiratory/fever clinic with appropriate entrance and isolation. We are developing a process for influenza vaccination and follow up of patients.

In this environment it is easy to become stressed, anxious and even depressed. We all should try to find some beauty in the world outside of our practice and medicine. Let me share with you, something beautiful I have discovered, a song played by my American guitar teacher here.

Regards,

Dr Paul Mara – Managing Director

Accreditation – Responding to extraordinary circumstances arising from COVID-19 pandemic

Announcement from the Commission

The COVID-19 pandemic is a public health emergency requiring an extraordinary response by the health system and society. Social distancing is a key measure being utilised to limit transmission of COVID-19. This measure is aimed at reducing transmission of the disease in the community, and importantly, the demand on healthcare services.

To assist general practices and in line with social distancing measures, the Commission is maintaining requirements for accreditation to the Royal Australian College of General Practitioners (RACGP) Standards for general practices, effective immediately. These changes are being enacted as part of the National General Practice Accreditation (NGPA) Scheme.

  1. The accreditation status of general practices will be maintained during the response phase of the COVID-19 pandemic. These arrangements will be monitored with changes anticipated in the recovery phase of the pandemic.
  2. General practices that have completed an onsite assessment and are in the remediation phase of their assessment cycle, and require an onsite assessment to complete the final assessment, will not be assessed until the recovery phase commences.
  3. Reintroduction of onsite assessments will take into consideration the lead-time for planning and preparation of assessments.

The intent of these measures is to maximise the capacity of the health system to deliver care during a period of unprecedented demand, and for assessors and the general practice workforce to comply with social distancing requirements. As the implementation of the changes is administrative, general practices are not required to take any further action at this time.

While the Commission recognises the unprecedented impacts on the day-to-day operations of general practices, it is more important than ever that general practices comply with the RACGP Standards for general practices, in particular infection prevention and control measures.

Further explanatory information is available on the Commission’s website or via the Advice Centre.  Please email your query to accreditation@safetyandquality.gov.au and include your contact number.  A member of the Advice Centre will then contact you as soon as practical.

FAQs:

What does maintaining accreditation mean for my practice?

Under usual circumstances, an accreditation cycle is three years.  The extraordinary measures enacted suspends the current accreditation status of a general practice, which will be maintained until the recovery phase of the pandemic begins and these measures are ceased.  For example, a general practice that would normally have one year before its scheduled assessment, will have one year before its next assessment from the time these measures are ceased.

When do these measures commence?

Immediately. As the implementation of the changes is administrative, general practices are not required to take any further action at this time.

Do efforts to implement the RACGP Standards for general practices (5th edition) cease?

No. General practices will be relying on their safety and quality systems to ensure patient care is safe and of good quality.  All general practices are expected to ensure safety and quality systems are being used, monitored and address any breeches in practice.

Can my practice continue to access Practice Incentives Program (PIP) and Workforce Incentive Program (WIP) – Practice Stream funding?

Yes. Introducing these measures will not change a general practice’s current eligibility for funding under the Department of Health’s Practice Incentives Program (PIP) and Workforce Incentive Program (WIP) – Practice Stream.

The Commission’s process for reviewing gaps in accreditation will still be accessible for general practices where the gap has occurred prior to the release of this announcement. General practices that are currently accredited, will have their accreditation continue until these measures are cease in the recovery phase.

General practices that are not currently accredited, and wish to become accredited, can commence the accreditation process by completing the self-assessment audit but will not undergo an onsite assessment until the recovery phase.

My practice has had its onsite assessment, can it be finalised?

General Practice that have completed an onsite assessment, are in the remediation phase of their assessment cycle and require an onsite assessment cannot be finalised.

General practices can finalise their assessment if they have completed an onsite assessment and are able to finalise their assessment as a review of documentation.