Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

In continuation on my contribution on the Health Insurance Amendment (Professional Services Review Scheme) Bill 2023: the fact that the Albanese government is overseeing plummeting bulk-billing rates at a time when Australians are struggling to pay bills just proves how unbelievably important it is to ensure that the viability of Medicare is safeguarded into the future. The coalition will always be committed to supporting the integrity and financial viability of Medicare to ensure that all Australians have access to the critical support provided by Australia's healthcare system into the future. In fact, this bill continues the reforms started by the former coalition government to strengthen the PSR's review mechanisms, particularly for claims relating to the MBS.

We were glad to see the government pass the Health Legislation Amendment (Medicare Compliance and Other Measures) Act 2022 in December. This was a coalition bill that we proudly introduced in the 46th Parliament to strengthen the compliance powers of the PSR and add a degree of flexibility to the PSR's ability to address any inappropriate practice. We understood that it is vital that there continues to be rigorous and effective health practitioner compliance to protect the financial integrity of Medicare. We also have a strong track record of supporting our hardworking healthcare practitioners and peak bodies to correctly claim health payments with a clear focus on education, engagement and consultation. Australians rightly expect that their tax dollars are being used appropriately and effectively, particularly when they're being spent on our healthcare system, which is facing increasing pressure. We need to support practitioners who are doing the right thing by the taxpayer and by their patients but we also need to identify the healthcare practitioners who are not acting in good faith.

We acknowledge that this bill builds on the coalition's work to strengthen the PSR and protect the viability of Medicare through additional reforms; however, we do have concerns about the lack of consultation that was undertaken prior to the introduction of this bill, particularly in regard to the review on which these reforms are based. Time and time again we are concerned by the government's refusal to allow for appropriate levels of consultation on their policies, to follow proper process. Dr Philip stated in his report:

Given the timeframes set for this Review, my formal consultation with stakeholders has been necessarily limited, supplemented by informal discussions with participants, and I have based most of my work on desktop analysis.

It is really disappointing that the limited time frames for this review have acted as a significant barrier to Dr Philip's ability to undertake thorough consultation. That is why the opposition saw it as critical to gather more information from stakeholders on the impact of these reforms through a committee process. As we noted in our comments, we support this legislation but we do have concerns over the failure of the Albanese Labor government to properly consult with relevant stakeholders. This is a well-entrenched theme of Labor. They don't properly consult with people who'll be most impacted by their policies, they don't do adequate modelling, and they continue to ram policy through this place without properly considering the implications. Any consultation that is performed by this government seems to be merely a political exercise. Their focus continues to be on the headline, never on the detail.

We also note the concerns, raised by industry bodies through the submission process, relating to the removal of the requirement for the Chief Executive Medicare to consult with stakeholder groups prior to issuing a notice to produce documents. Not only has the government failed to ensure there is thorough consultation on this bill; the changes contained in this bill also reduce consultation. As expressed by the Australian College of Rural and Remote medicine:

Whilst removing input from the relevant professional body may well streamline the process, this is potentially detrimental to the practitioner who is required to produce documents under this section and is not in keeping with the recommendations from the Review.

The coalition will not stand in the way of good policy, but upholding adequate consultation in this area is critical to protecting the integrity and viability of Medicare and our world-class healthcare system.

Once again, the coalition will support this bill and the proposed changes, in the interests of increasing transparency of the Professional Services Review scheme; however, we put on record our concerns about the removal of consultation and engagement with stakeholders.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

nator STEELE-JOHN () (): I am speaking on behalf of the Greens in support of this bill, the Health Insurance Amendment (Professional Services Review Scheme) Bill 2023. The bill removes the requirement for the AMA to agree to the appointment of the Director of the Professional Services Review, PSR, on the basis that the current arrangement is inconsistent with public expectations regarding the independence of the PSR. It also amends consultation requirements for appointing other statutory office holders of the PSR to enable consultation with relevant peak bodies directly, rather than via the AMA. They are both very sensible changes.

This bill is the result of recommendations from the Independent Review of Medicare Integrity and Compliance, better known as the Philip review. The report rightly points out that the legislation governing systems processes and tools is currently not fit for purpose and, without significant attention, will result in significant levels of inefficiency and fraud. The PSR is responsible for reviewing the Medicare billing practices of over 150,000 health professionals; however, it examines only about a hundred cases of fraud and inappropriate billing every 12 months, which is less than 0.07 per cent of those it monitors.

The recommendation to remove the AMA's veto power is consistent with public expectations. The PSR should be, in our view, independent and trusted by the public. This measure is an important step, in the view of the Greens, towards the modernisation of Medicare.

Carol Brown (Tasmania, Australian Labor Party, Assistant Minister for Infrastructure and Transport) Share this | Link to this | Hansard source

I thank both the opposition and the Greens for their support of this bill. The Medicare program provides universal access for all Australians to most healthcare services. The Health Insurance Amendment (Professional Services Review Scheme) Bill 2023 is a timely and appropriate response to issues raised in the independent review of Medicare integrity and compliance.

The bill removes the veto power of the Australian Medical Association over the appointment of the director of the Professional Services Review, known as the PSR. The bill also amends consultation requirements for appointing other statutory officeholders of the PSR, enabling direct consultation with relevant peak bodies. This will ensure the regulator can operate with impartiality and independence and improve public perception of the fairness and integrity of Medicare. The bill also allows the appointment of associate directors of the PSR, which will provide for alternative decision-makers to manage conflicts of interest, unexpected absences and workload pressures for the director. This will allow PSR members to be finalised more quickly in some cases.

One of the key issues identified in the review of Medicare integrity and compliance was the length of time the compliance processes currently take. Both practitioners under review and the community will benefit from faster resolution of compliance issues.

Finally, the bill will remove the need for engagement with stakeholder groups before requesting documents, which will improve processes used to audit payments relating to Medicare services. This will also strengthen and speed up Medicare compliance functions without limiting the types of documents a person may provide during an audit. The person being audited will continue to have an opportunity to make submissions about the compliance matter and provide any relevant information or documents. The measures in this bill will strengthen the regulatory framework supporting the integrity of Medicare to ensure all Australians can continue to receive necessary health services. I commend the bill to the Senate.

Question agreed to.

Bill read a second time.