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  Considered Health

Issue 17 - Health Newsletter
         

Shared Debt Recovery Scheme (SDRS)

Background Information

The Health Legislation Amendment (Improved Medicare Compliance & Other Measures) Bill 2018 amends the Health Insurance Act 1973. The amendment is known as the Shared Debt Recovery Scheme (SDRS).

What does this mean?

The purpose of the SDRS is to introduce a reasonable method of addressing organisational billing practices and will enable the Department to hold an employing or contracting organisation responsible for a portion of any debts incurred because of incorrect Medicare claiming.

The change identifies that there has been an increase in the role of practices, corporate entities and hospitals in the billing of MBS services on behalf of individual practitioners. All of which highlights that both parties (Medical Practitioner and Medical Practice) have a responsibility to ensure MBS claims are made correctly, in that:

  • Medical Practitioners are responsible for all claims made under their provider number and meet the MBS requirements; and
  • Medical Practices are responsible for all their Medical Practitioners within the practice and ensuring that they are claiming MBS items correctly.

Actions

Practices should take this opportunity to review their contractor/associate agreements to ensure there is the capacity to recover any lost revenue directly from the doctors, and the impact this will have on service fee calculations and adjustments.

When will it take effect?

The Shared Debt Recovery Scheme will commence from 1 July 2019.

Important note: Practices should take an interest in the MBS billing practices of the doctors working in their practices. If a Medical Practitioner is audited and found that he/she must pay back any money that has been previously claimed, the Medical Practice will share the liability.

 

What is the Primary Health Network (PHNs)?

The Australian Government established 31 PHNs across Australia with some very specific objectives in mind:

  • To improve the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes.
  • To improve the coordination of care to ensure patients receive the right care, in the right place, at the right time.?

How can PHN help General Practitioners?

PHNs work to re-position and improve the primary health care system by taking a patient-centred approach to medical services in their regions.

They have three main roles:

  • They commission health services to meet the identified and prioritised needs of people in their regions and address potential gaps in primary health care.
  • Through practice support, they work closely with general practitioners (GPs) and other health professionals to build a workforce capacity so that GPs can deliver a high-quality of care.
  • Working collaboratively within their regions to integrate health services at the local level to create an improved experience for patients, encourage better use of health resources, and eliminate service duplication.

The Australian Government has identified seven priority areas to guide the work of PHNs. These include:

  • Mental Health
  • Aboriginal and Torres Strait Islander Health
  • Population Health
  • Digital Health
  • Health Workforce
  • Aged Care
  • Alcohol and other drugs

Connecting you to health


Earlier this year, Rick Albertini (Managing Partner) at Brentnalls SA was re-appointed on the Board of Adelaide PHN.

Rick said, "I'm looking forward to the ongoing commitment to the health sector, through increasing efficiencies and effectiveness of health services and improving coordination of care to ensure patients in Adelaide receive the care they need."

PHNs are here to ensure that Commonwealth funding goes to those that need it the most, as well as ensuring the health sector can work in a truly integrated and collaborative way, combining all sectors, public and private to work together better.







 

 

My Health Record

As the deadline to Opt-out of having an online My Health Record fast approaches, we consider the key issues prior to the 15 November deadline.

Why have a My Health Record?

The health system in Australia is really a collection of siloed organisations working in the health sector rather than being a well-integrated system.  It's not until you have the experience of trying to navigate the health system that you discover how disconnected the parts are and how limited the flow of communication is between each health service provider.

My Health Record provides Australians with a single place to store their important medical information so that it is available whenever they access health services.  This includes a record of allergies so that critically ill patients admitted to hospital in an emergency are potentially not given the wrong medication.  It also includes a list of prescribed medications so that patients aren't given the wrong medication or wrong dose.

A My Health Record is particularly useful for people who travel frequently.  It means they have access to all their important health information when they require it.   It also enables parents to track their child's development which can be linked to My Child's Health Record app. 

This is an opportunity for Health to catch up with technology and use it to break down the silos that obstruct effective communication between providers and patients.

What is in a My Health Record?

  • The My Health Record can contain the following information:
  • A patient's shared health summary (e.g. diagnoses, current medications, allergies and adverse reactions)
  • Medication prescribing and dispensing history
  • Discharge summaries
  • Specialist referrals and letters
  • Pathology reports
  • Diagnostic imaging reports
  • Information about a patient's past health events
  • Child development information
  • Advanced Care Planning information
  • Medicare overview

The My Health Record does not include all the details and progress notes that are contained in a medical record held by the patient's usual GP.

What security protects this information?

There has been a lot of commentary about the privacy risks involved with having a My Health Record.   The My Health Record is secured within the MyGov website and has a high level of security measures to protect the privacy of the information.  The Australian Digital Health Agency has established the Digital Health Cyber Security Centre with its primary purpose to protect National digital health systems and personal health information of Australians from cyber threats.  

The following additional security measures help to protect the privacy of the information contained these records: 

  • Only registered health providers can access a patient's My Health Record.
  • Access can be restricted to specified providers.
  • A 4-digit security code can be activated to provide additional security.
  • SMS or email notifications can be set to notify a person any time their record has been accessed.
  • There are huge fines applying for any health provider inappropriately accessing a record.

What are the benefits for health practitioners?

In time when a critical mass of people has a My Health Record and it is being used regularly by providers, there will also be significant benefits for practitioners accessing this information on behalf of their patients:

  • Reduced time waiting for other providers to fax through the patient's latest health information.
  • Greater certainty when prescribing medications.
  • More efficient means of clinical handover.
  • Improved access to discharge plans.
  • Improved access to clinical information from other practitioners involved in the patient's care.

The current system is a platform for improved communication and sharing of vital patient information across the health system.  It is a foundational platform for enabling the health sector to venture into the digital age, providing the seamless digital communication that patients expect.  It is the start of a journey rather than a destination.

Further information is available on the My Health Record website.

 

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The information provided in this newsletter does not constitute advice. The information is of a general nature only and does not take into account your individual objectives, financial situation or needs. It should not be used, relied upon, or treated as a substitute for specific professional advice. We recommend that you contact Brentnalls SA before making any decision to discuss your particular requirements or circumstances. Brentnalls is not a partnership or a joint venture. Instead, the business of Brentnalls SA is independently owned and operated and it is an independent member of the Brentnalls Affiliation of Accounting Firms. Individual member firms do not accept responsibility or liability for the actions or inactions of any other individual member firm.
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