General practices that fail to meet upload targets for the eHealth incentive program may escape financial penalties
General practices that fail to meet upload targets for the eHealth incentive program may escape financial penalties if they can show their efforts were foiled by software glitches.
The AMA says that as many as 1500 practices have fallen short of the new requirement to upload a portion of their patients’ shared health summaries to the My Health Record system and will be unfairly penalised under the new rules.
AMA vice president Tony Bartone today renewed a call for Health Minister Sussan Ley to put a moratorium on the upload target, saying it would damage GPs who were already burdened by the Medicare rebate freeze.
“The PIP Digital Health Incentive has now been in place for a full quarter, and the AMA has been advised that 1500 general practices have failed to meet their SHS upload target, and a further 69 practices have formally withdrawn from participation in the incentive,” the Melbourne GP said.
“This means that close to one-third of previously eligible general practices now face losing significant financial support in an already testing environment of the Medicare rebate freeze and other funding cuts.”
Practices that did not meet the target and did not opt out of the new incentive scheme introduced in the May-July quarter are being asked to give back payments they may have received.
The Health Department has confirmed it is reviewing Practice Incentive Program and My Health Record data to check whether practices are meeting the ePIP requirements to upload at least 0.5% of their standardised weighted patient equivalent.
But the department has also signalled a possibly more flexible approach that may avoid penalising those that come up short.
“The department is aware that some practices have experienced a combination of issues, including within their software systems, that may have prevented them from meeting their eHealth PIP (ePIP) targets,” a health spokesperson told TMR.
“The department is considering possible compliance approaches … to provide a mechanism to ensure those practices that have made genuine efforts to comply but experienced real problems, are not penalised.”
According to the Department of Human Services, 222 practices bailed out of the ePIP scheme during the May-July quarter of the 4985 that had been registered for the incentive.
While 69 withdrew from the scheme entirely, 153 opted out of the quarterly obligation, it said.
But DHS said that, as of 1 September, only 13 ePIP-registered practices reported that they had failed to meet the target.
The ePIP requirements were imposed in May-July despite strong resistance from doctors’ groups, amid predictions that large numbers of practices would be unable to meet their upload targets.
The AMA in June reported that nearly 40% of the 658 practices that responded to its survey said they could not meet the target and 36% were unsure.
The practices that claimed they would be unable to comply estimated they would suffer, on average, $23,400 a year in lost ePIP incentive payments.
Towards the end of July, however, GPs rushed to comply. In the week ended 31 July, GPs uploaded more than 25,000 shared health summaries – compared with about 2,000 per week in April.
Where practices determine they cannot meet the target, they are required to opt out online through the DHS Health Professional Online Services. The opt-out deadline for the May-June quarter was July 31.
“Practices that received a payment for the May–July quarter and did not meet their target or opted-out, must contact the department to organise repayment,” a DHS spokesperson said.
While compliance is managed by Health, DHS is in charge of the eHealth incentive payments, which are made retrospectively to practices that have not opted out.
The Health Department said it would take advice shortly on possible compliance approaches that could be implemented within the PIP guidelines to protect practices struggling to meet the upload requirements.
