The Health Department has 'nudged' 201 GP anaesthetists for claiming items without a procedure – but its tone has improved.
The Department of Health has sent out another batch of ‘nudge’ letters, this time to 201 GP anaesthetists, requesting justification for claiming anaesthetic Medicare items without an eligible connected procedure.
The compliance letter sent last week related to providers claiming Medicare Benefits Schedule (MBS) items 20100–21990 (other than item 21965), 22060–24136, 25200 and 25205.
With most GP anaesthetists working in remote areas, Rural Doctors Association of Australia (RDAA) CEO Peta Rutherford said some of the billing practices flagged by the government were simply due to the nature of rural practice.
“For GP anaesthetists who work in rural hospitals, most patients do a pre-anaesthetic assessment with a GP anaesthetist, but it won’t necessarily be the same GP anaesthetist [who does the procedure],” Ms Rutherford said.
“You might be going in as a public patient, but your pre-anaesthetic check-up will be done as an outpatient and will be billed through Medicare.”
In this situation, according to Ms Rutherford, the Health Department would flag the pre-anaesthetic check-up as needing review.
She also confirmed that, for many, no further action will need to be taken once an explanation is provided.
These letters come almost exactly one year after the Health Department sent out letters targeting GPs co-claiming mental health with other attendance items, a move which sparked significant criticism at the time. This time, however, there has been extensive consultation with groups such as the RDAA to ensure the language used is not as accusatory.
“We have worked with [the Department of Health] to try and get them to ask for an explanation, as opposed to making an accusation,” Ms Rutherford said.
“It’s a slight change in the tone of the letter that went out as previous correspondence, which we thank the Department for, but it’s still a bit confrontational when someone gets one of those letters.”
Ms Rutherford urged any GPs needing assistance to contact the AMA or RDAA.
