GP Network News, Issue 11, Number 38 - 30 September 2011

30 Sep 2011

GP Mental Health Funding Cuts – AMA Campaign Continues

The AMA President, Dr Steve Hambleton this week wrote to Health Minister Nicola Roxon calling for a moratorium on the Government’s Budget cuts to GP mental health services under the Better Access program, which are due to commence from 1 November 2011.

Dr Hambleton said that the Senate Community Affairs References Committee, which is currently looking into the Government’s handling of mental health services is not due to report until 20 October, leaving very little time for serious consideration of the Senate Committee report. The Inquiry has received over 1000 submissions.

“The Minister must defer the implementation of the changes to the Better Access program until at least 1 November 2012 to allow proper consideration of the compelling evidence against the cuts,” Dr Hambleton said. For the AMA press release click here.

There is still time to support the campaign and add your signature, and to encourage your colleagues, patients, friends and relatives to do the same, to the more than 3850 already collected. The petition will be sent to the Prime Minister late next week. Click here to sign the petition.

Assessments of Financial Disadvantage under the Practice Nurse Incentive Program (PNIP)

In response to concerns raised by AMA members, the AMA has confirmed with the Department of Health and Ageing that bulk billing incentives will be considered in Medicare Australia's assessments of financial disadvantage under the PNIP.

The PNIP takes effect 1 January 2012 at which time six practice nurse items (10993, 10994, 10995, 10996, 10998 and 10999) will be removed from the MBS. Practices which are not eligible for incentive payments under the PNIP may be eligible for a grandparenting payment and registered PNIP practices may be eligible for a top-up payment, if they are financially disadvantaged by the removal of six of the MBS practice nurse items and any associated Bulk Billing Incentive (BBI) items. For information click here.

Draft Rulings to Impact on GST Status of Some Medical Services

The Australian Taxation Office (ATO) recently released draft addenda to GST Rulings 2006-9 and 2006-10 for comment. The draft addenda have been prepared to take into account the outcome of the 2010 case of Commissioner of Taxation v Secretary to the Department of Transport (Victoria) (2010). These addenda will affect the GST status of some medical services.

The draft addenda appear to have the potential to create additional compliance costs for medical practitioners, who have relied on existing ATO rulings to determine the GST status of medical services.

Advice received by the AMA indicates that the proposed ATO views in the draft addenda may impact on the provision of medical services where payment comes from a party other than the patient and also where payment may come from government agencies that subsidise health services such as the Department of Health and Ageing and the Department of Veteran Affairs.

In some circumstances, medical services that are currently characterised as a GST-free supply to the patient will instead be characterised as a separate taxable supply to the paying entity.

This will not impact on MBS subsidised services, however, beyond that the extent of the impact of these addenda is still unclear. The AMA understands that the Department of Health and Ageing and the Department of Veterans Affairs are seeking a legislative change to ensure that any programs they fund are not impacted by the rulings.

A copy of AMA correspondence to the Assistant Treasurer, along with the AMA’s comments to the ATO can be viewed here.

The AMA will keep members updated as to the progress of these rulings, which at this stage are only in draft status.

Bulk Billing Clarification - Additional Charges

The AMA recently followed up on some member queries regarding whether an additional charge (e.g. for consumables) can be raised against a patient for a service that has been bulk-billed. Medicare Australia has confirmed that Clause 20A of the Health Insurance Act states that where a Medicare benefit is payable for a service and the practitioner agrees to accept the patient's Medicare rebate, the rebate is accepted in full payment of the medical expenses incurred in respect of the service. If a medical practitioner direct-bills, he/she undertakes to accept the relevant Medicare benefit as full payment for the service. Additional charges for that service (irrespective of the purpose or title of the charge) cannot be raised against the patient, with the exception of certain vaccines. Click here for more on this exemption.

The AMA encourages doctors to set their fees for medical services based on their practice costs. Where a patient needs to pay a gap, this will count towards the Medicare Safety Net. When patient billing, electronic billing options can assist in lessening the up-front cost impact on patients as the patient is quickly reimbursed the rebate.

Concerns over Guild deal with Blackmores

The AMA President, Dr Steve Hambleton spoke out earlier this week opposing a deal struck between the Pharmacy Guild and complementary medicines giant Blackmores. The deal will see the Guild promoting and recommending dietary supplements with prescription medicines. A prompt in the pharmacists computer will remind them to discuss with the customer a particular Blackmores product it claims has been designed to offset possible side-effects of their prescription medicine. Dr Hambleton said the deal is outrageous and smacks of commercial interest rather than clinical need. The prescription medicines included in the deal are anti-biotics, cholesterol and high blood pressure medication and proton pump inhibitors.

GP Survey – e-health and information technology

The AMA supports the survey being conducted by the Department of Health and Ageing to understand the use of e-health and information technology in the provision of healthcare. Survey results will inform decisions to improve the quality and sustainability of healthcare in Australia. Information will be collected through a 20 minute national survey conducted online or via telephone for which participating general practitioners will be offered $80 in appreciation of their time.

The AMA encourages you to use this opportunity to have your voice heard. Please follow this link,, to register your interest to participate.


We welcome your comments and suggestions as well. Please tell us what you think.


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In this Issue

GP Mental Health Funding Cuts – AMA Campaign Continues

Assessments of Financial Disadvantage under the Practice Nurse Incentive Program

Draft Rulings to Impact on GST Status of Some Medical Services

Bulk Billing Clarification - Additional Charges

Concerns over Guild deal with Blackmores

GP Survey – e-health and information technology

Pick up a free day on Hertz*

Email the AMA

Post new comment to the website



AMA is the peak medical organisation in Australia representing the profession’s interests to Government and the wider community. Your Federal AMA General Practice Policy team can be contacted via email or by phone (02) 6270 5400. You can unsubscribe from GPNN by emailing