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Behind the news - 10 April 2012
Will GPs be remunerated for e-health set-up? The answer is still confusing.
HEALTH Minister Tanya Plibersek certainly caught the attention of Australian GPs recently when she announced MBS rebates would be available to cover the cost of creating health summaries for the coming PCEHR.
Remuneration, or the lack of it, for GPs acting as nominated providers under the new system with responsibility for creating and curating a patient’s health summary has been a burning issue for supporters and critics of the system alike.
And while the minister’s announcement was welcomed by the RACGP and the AGPN, the AMA and readers of MO online made it clear they were far from convinced.
At issue is the question of whether a GP undertaking a straightforward consultation normally billed as a Level B would be justified in billing a Level C to cover the time taken to create or update the summary.
Although the minister and a health department spokesperson maintained GPs would exercise their judgement about what they were justified to claim, the AMA has demanded answers.
Dr Steve Hambleton
“Sources in the department have confirmed if the content of the consultation was going to be a Level B and the length of the consultation was extended [to create or curate the shared health summary] that would not justify claiming a Level C.
“The Level C and D consultations are for complex conditions and you have to demonstrate that in your notes when the PSR comes knocking.
“The department will take a dim view if it is clearly a Level B consultation and the GP is claiming a Level C.
“I’m not sure there’s anything extra in the minister’s announcement. If it is new money, then how much are they committing and where will it come from? There’s no suggestion here that doing the extra work will provide extra remuneration for the GP.
“The announcement is welcome... but this is a new clinical service with new responsibilities and we urgently need some clarification.”
“[The PCEHR system will be] good news for all clinicians – perhaps for GPs more than most.
“I am pleased to confirm MBS consultation items will be available to GPs as part of providing continuity of care to a patient, and if they are creating or adding to a shared health summary on an e-health record which involves taking a patient’s medical history as part of a consultation.
“I want to confirm that the use of the longer consultation items will be seen as appropriate by the Medicare Australia Practitioner Review Process and the Professional Services Review in circumstances where there is clear evidence of patient complexity and there is documentation of a substantial patient history.
“I understand that issues surrounding the use of MBS items have caused some uncertainty in the profession, so I am happy to offer these clarifications today.”
Dr Emil Djakic
“The three MBS items provided that cover the extra time it can take to record a patient’s medical history of up to 20 minutes, more than 20 minutes or for more than 40 minutes, provides a realistic incentive framework in which GPs can operate.
“At a macro level though, AGPN is still urging the federal government to realise the need for two other elements that will be critical in changing business processes required to have general practices successfully adopt the PCEHR.
“General practices must also be provided with an eHealth Practice Incentive Payment to support the establishment of the necessary PCEHR infrastructure and adequate resourcing of Medicare Locals to support general practices to build… infrastructure needed to get the PCEHR up and running.
“Combined with the right levels of flexible funding, Medicare Locals are well placed to... build change-readiness among [health] professionals around the benefits of a PCEHR.”
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