Commonwealth of Australia Explanatory Memoranda

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HEALTH LEGISLATION AMENDMENT (IMPROVED MEDICARE COMPLIANCE AND OTHER MEASURES) BILL 2018

                            2016-2017-2018




 THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA




                  HOUSE OF REPRESENTATIVES




HEALTH LEGISLATION AMENDMENT (IMPROVED MEDICARE
    COMPLIANCE AND OTHER MEASURES) BILL 2018




       SUPPLEMENTARY EXPLANATORY MEMORANDUM




         Amendments to be Moved on Behalf of the Government




(Circulated by authority of the Minister for Health, the Hon Greg Hunt MP)
 AMENDMENTS TO THE HEALTH LEGISLATION AMENDMENT (IMPROVED
     MEDICARE COMPLIANCE AND OTHER MEASURES) BILL 2018

OUTLINE
The Health Legislation Amendment (Improved Medicare Compliance and Other Measures)
Bill 2018 (the Bill) would amend the Health Insurance Act 1973 (Health Insurance Act), the
Dental Benefits Act 2008, and the National Health Act 1953.

The amendments moved by the Government would amend Schedules 2 and 3 to the Bill.
Schedule 2 to the Bill proposed amendments to the Professional Services Review Scheme
which is provided for by Part VAA of the Health Insurance Act. Schedule 3 to the Bill
proposes a number of other amendments to the Health Insurance Act which would commence
on 1 July 2018.

The first amendment would omit an amendment that was proposed to Part VAA of the Health
Insurance Act. Section 106B deals with the power of a Professional Services Review
Committee to summons a person to attend a hearing and give evidence. The AMA identified
that the change may have the unintended consequence of subjecting a practitioner to both
disqualification to billing Medicare and a possible criminal prosecution for failing to attend in
accordance with a summons. This was not the intention of the proposal, but to avoid doubt
the Government proposes removing the relevant provision.

The second amendment corrects an unintended error in the current Bill in relation to the
application provision at item 34(7) so that the set off provisions (new section 129AEF of the
Health Insurance Act) apply to existing Medicare debts. Section 129AEF allows Medicare
compliance debts to be recovered by a compulsory offset of up to 20 per cent of bulk billed
payments to a provider. This compulsory power is subject to a number of safeguards, which
are outlined in item 31 in the Explanatory Memorandum. This does not mean that the Bill
applies retrospectively. Rather, the amendment ensures that this new option for recovery will
apply to existing debts, as well as new debts.

Financial Impact Statement
There is no financial impact of the first amendment. The second amendment is necessary to
achieve the anticipated financial impact of the measure as outlined in the original explanatory
memorandum.




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                      Statement of Compatibility with Human Rights


Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

 Health Legislation Amendment (Improved Medicare Compliance and Other Measures) Bill
                                        2018

The amendments to the Bill are compatible with human rights and freedoms recognised or
declared in the international instruments listed in section 3 of the Human Rights (Parliamentary
Scrutiny) Act 2011.

Overview of the amendments
Amendment 1 would omit item 6 from Schedule 2 to the Bill. This item proposed to amend
section 106B of the Health Insurance Act. By omitting this item, the status quo, that a
Committee member may summon a person, other than the person under review, to appear at
a hearing to give evidence and to produce such documents (if any) as are referred to in the
summons, will be maintained.

Amendment 2 concerns the application of new section 129AEF of the Health Insurance Act.
New section 129AEF would give the Chief Executive Medicare a discretion to compulsorily
set off an amount that is a debt due to the Commonwealth against an amount that is payable
under the Health Insurance Act.

The Bill imposes a limit of 20 per cent of MBS payments which can be set off against
compliance debts, unless the practitioner asks to repay their debt more quickly. Practitioners
experiencing hardship may seek a repayment plan which, if agreed, would mean a
compulsory set off against future payments would not be used.

Set off arrangements will only apply if an alternative payment arrangement cannot be agreed
with the practitioner and all rights of review have expired.

Human rights implications
These amendments do not engage any of the applicable rights or freedoms.

Conclusion
The amendments to be moved by the Government are compatible with human rights as they
do not raise any human rights issues.


                     The Hon Greg Hunt MP, the Minister for Health




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 AMENDMENTS TO THE HEALTH LEGISLATION AMENDMENT (IMPROVED
     MEDICARE COMPLIANCE AND OTHER MEASURES) BILL 2018


NOTES ON CLAUSES

Amendment 1: Summons to give evidence
Amendment 1 would omit item 6 from Schedule 2 to the Bill.

Item 6 of Schedule 2 to the Bill proposed to amend section 106B of the Health Insurance Act.
Section 106B is located in Subdivision B of Division 4 of Part VAA of the Health Insurance
Act, and which generally regulates the proceedings of a Committee which has been set up to
investigate whether a person under review has engaged in 'inappropriate practice' within the
meanings given by section 82 of the Health Insurance Act.

By omitting item 6 from Schedule 2 to the Bill, the status quo, that a Committee member
may, by instrument, summon a person, other than the person under review, to appear at a
hearing to give evidence and to produce such documents (if any) as are referred to in the
summons, will be maintained.

Amendment 2: Application of new section 129AEF
Amendment 2 would amend item 34(7) of Schedule 3 to the Bill.

Item 34 of Schedule 3 to the Bill is drafted so that new section 129AEF of the Health
Insurance Act would apply in relation to recoverable amounts as mentioned in
subsection 129AEF(1) of the Health Insurance Act that became debts due to the
Commonwealth on or after the commencement of that item. The effect of new
section 129AEF of the Health Insurance Act is that the Chief Executive Medicare may, on
behalf of the Commonwealth, set off the whole or a part of an amount mentioned in
subsection 129AEF(1) against an amount payable to the person or estate under the Health
Insurance Act.

The effect of amendment 2 is that the Chief Executive Medicare may set off the whole or a
part of the recoverable amount against an amount payable to the person regardless of whether
the amount became due to the Commonwealth before, on, or after the commencement of
item 34 of Schedule 3 to the Bill. This means that the Bill will meet its intended purpose,
which is to recover debts owed to the Commonwealth by practitioners who fail to pay their
compliance debts.




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