PIP eHealth Incentive – update on compliance processes

18 May 2017

Further to the GP Network News articles published on 20 April 2017 and 10 May 2017, the Department of Health has now written to practices that it believed had not met their Shared Health Summary (SHS) upload targets under the PIP eHealth Incentive for the period 1 May 2016 to 31 January 2017. The AMA advises practices to check their records to confirm that the SHS uploads and payments received concurs with the amounts stated in the Department’s letter.

Please note that the amount listed as paid to the practice is a statement of fact (assuming it is correct) and may not be the amount you may be required to repay.

Practices are also reminded that they may qualify for proportional payment if they met their target in any month or 50 per cent of their target overall. If, for example, you met 65% or more of your overall target for the period from 1 May 2016 to 31 January 2017 the repayment due would be 35% of the total you received in payment for the eHealth Incentive over that period. If, for example, you met 49 per cent or less of the overall target for the period from 1 May 2016 to 31 January 2017 but did meet your target for one of those quarters you will only be required to repay the payments received for the quarters that you did not meet the required SHS uploads.

The Department of Health (DoH) has advised the AMA that payments have been calculated using information from the Department of Human Services payment systems and upload information from the My Health Record System Operator. As detailed in the letters, practices have been asked to check their records and provide the Department with advice if they believe the information in the letter is not accurate. The DoH has advised that part of the data matching process is currently manual and it is therefore important for practices to check their records.

The DoH has advised that they have a dedicated team dealing with the significant number of enquiries received following the mail out of the eHealth compliance letters. Each enquiry will be dealt with in order. We are advised that practices who have contacted the Department via the voluntary.compliance.team@health.gov.au email will have received a short confirmation response advising that there will be a delay in responding.

The AMA has confirmed with the Department that practices who have submitted an enquiry need not worry that a formal debt recovery notice will be issued before the Department has responded to their query.

Practices that have not contacted the Department will receive a formal debt notice after 21 days, with a short grace period to address any postage delays.

DoH has prepared a frequently asked questions (FAQ) document about the ePIP compliance letters. A copy of the FAQ document has also been sent to all PHNs.

Practices who experienced issues outside their control that prevented them from meeting the requirements of the incentive may qualify for an exemption. If you have any questions or issues contact the Department of Health at voluntary.compliance.team@health.gov.au.