Telehealth compliance delay welcomed but industry urges further action

The Royal Australian College of General Practitioners (RACGP) has welcomed the deferral of planned telehealth compliance rules but warned that Medicare rebates for longer telehealth phone consultations must be a permanent fixture of the nation’s telehealth scheme.

This comes following the announcement that the federal government will be postponing until at least September this year (a) the reintroduction of the existing 80/20 rule (amended to include video, telephone as well as face-to-face GP consultations) and (b) the implementation of a new 30/20 rule for phone services.

The RACGP Vice President Dr Bruce Willett said, “I welcome this further postponement because now is certainly not the time to impose new compliance rules on general practice.

“GPs and general practice teams are busier than ever. In addition to delivering COVID-19 vaccines and boosters, we are administering flu vaccines, helping patients who delayed or avoided consultations and screenings during the pandemic, and treating patients with serious mental health concerns. It is important to keep in mind that high rates of community transmission of COVID-19 and influenza as well as other viruses mean that many patients are still accessing care via telehealth. For most patients, particularly those not confident using video technology, consultations via phone are the preferred option.

“So, deferring these rules until September is a relief; however, the RACGP still maintains that the government should initiate a comprehensive review of the 80/20 rule and 30/20 rule to ensure that they are fit for purpose. The last thing we need are compliance rules that potentially compromise GP and general practice team wellbeing and high-quality patient care.”

The RACGP VP said it was disappointing that the government has ruled out further extending the current temporary telehealth arrangements, which includes Medicare rebates for longer phone consultations.

Medicare rebates for telephone consultations longer than 20 minutes have been removed. Dr Willett said that while he is pleased the RACGP has been able to ensure telehealth has been added as a permanent fixture to Medicare for the benefit of all patients, the RACGP strongly believes that this change to telehealth is a backward step for patient care.

“In 2020–21, phone consultations comprised 98% of all telehealth services provided by GPs and many of these were longer phone consultations lasting more than 20 minutes. Removing these Medicare rebates is particularly detrimental for older patients, Aboriginal and Torres Strait Islander people, those with disability, and for some people living outside of major cities including rural areas. These groups already have poorer health outcomes than the general population nationwide so making these Medicare items for longer phone consultations permanent is the logical step.

“The RACGP will continue fighting for longer telephone consultations to be a permanent fixture of telehealth because no patient should be left behind and phone consults make a huge difference for many patients. We also want to see Medicare phone items for chronic disease management and mental health services reinstated as part of the permanent telehealth model.”

To support safe, high-quality care for all Australians, the RACGP firmly believes that telehealth consultations must be: available for all GP consultation lengths and types; valued at the same level as face-to-face and video items; linked to a patient’s usual GP, with some exceptions for services provided by GPs with special interests upon usual GP referral.

AMA President Dr Omar Khorshid said the refusal of to extend Medicare-funded COVID-19 telehealth services from 1 July “means telephone access to doctors will be significantly limited and this will hit vulnerable patients hardest, including those who do not have access to high bandwidth internet and those who can’t operate the necessary IT systems”.

“This means that older patients, those with chronic health conditions including cancers and those who are immune suppressed will have less access to care from tomorrow [1 July] and may be put at increased risk of contracting COVID if they now have to attend their doctors appointment face to face.

“We understand the government has had to make a lot of decisions in a very short timeframe since it won the election. It appears to the AMA that this decision has been rushed and the AMA will work to encourage the government to rethink its approach and put our most vulnerable patients first,” Khorshid said.

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