What the 2023 Federal Budget means for specialists

By Geir O'Rourke

10 May 2023

Labor’s first Federal Budget in a decade is unlikely to have any immediate impact on specialist medicine, although there will be flow on effects from the major funding and reform package coming for general practice.

But specialists may notice the first stages of a crackdown on fraudulent and inappropriate Medicare claims, funded following allegations of widespread abuse of the system aired.

Core to the Federal Government’s health platform is major overhaul of general practice, backed by some $5.7 billion in funding – $3.5 billion of which will cover the tripling of bulk-billing incentives. In metropolitan areas, this brings the rebate from $6.85 to $20.65, rising beyond that in rural and remote locations.

It hasn’t captured the headlines, but perhaps the more significant reform is the government’s plan to reshape chronic disease care, with a voluntary patient enrolment system to be called MyMedicare.

Based on the recommendations of the Strengthening Medicare Taskforce, the new system will be “voluntary and open to anyone, with patients able to register with their preferred practice, GP and care team,” according to the budget papers.

Designed to support continuity of care, it will also be linked with “easier access to telehealth consultations”, the papers say.

“MyMedicare will provide practices with more comprehensive information about their regular patients, while giving patients and their care team access to additional funding packages, tailored to their health needs.”

Funding is also being provided for longer GP telehealth consultations for linked patients, along with money to reduce administration costs for practices and provide new funding packages for general practices to provide comprehensive care to patients who are frequent hospital users; and for Australians in residential aged care.

“This will help the more than 13,000 patients with complex, chronic conditions who go to hospital 10 or more times each year because they are not getting the comprehensive, team-based care they need,” the papers said.

Taskforce to “identify and pre-emptively disrupt” Medicare fraud

Almost $30 million is being spent over four years on measures to stamp out inappropriate Medicare billing by doctors, in response to the claims of widespread wrongdoing aired in the media last year.

Most of this money is going towards the establishment of a taskforce within the health department to “identify and disrupt instances of fraud and serious non-compliance before they occur,” according to the government.

The budget papers flag legislative and policy changes including to limit the duration of backdated patient-billed claims through practices, something which is meant to prevent fraudulent claims being submitted.

Additionally, Services Australia will be given powers to block bank accounts of known fraudsters from receiving claims payments, and health officials will no longer need to consult with peak bodies before issuing demanding documents from providers under audit.

The government may consider additional Medicare integrity measures “pending consideration of broader policy aspects”, the budget papers conclude.

Funding for Australian Centre for Disease Control

Meanwhile, $91.1 million is being set aside over two years to commence the establishment of an Australian Centre for Disease Control (CDC).

“The centre will provide a national focal point for disease management to improve our ability to respond to health emergencies and other public health challenges,” the government says.

Creating an agency like the US CDC has long been on the wish-list the AMA and groups like the Public Health Association of Australia (PHAA), both of whom welcomed the announcement.

PHAA CEO Adjunct Professor Terry Slevin said he was encouraged by the inclusion of preventative health in the organisation’s mission, alongside the focus on preparing for and managing future pandemics.

“The $90 million dollar announcement is an encouraging start, but it is just that – a start,” he said.

“The government will need to look beyond the horizon and put sustainable funding in place to ensure the ACDC is doing leading public health work for decades to come.”

“It needs to be a well-established, long-term leading agency if it is to create enduring health improvements for current and future generations.”

Other spending

There is $100 million over four years to address the rise of occupational silicosis and silica-related diseases. Included in the funding is money to develop a prevention strategy.

Some $951 million is being allocated to the Australian Digital Health Agency to “upgrade and modernise” My Health Record.

According to the budget papers, this will make is easier for patients and providers to use and support the secure, safe and efficient sharing of information, and reduce duplication in the system.

More than $500 million on preventative health, including a national lung cancer screening program and cash for the Aboriginal Community Controlled Health Services to better support Indigenous patients with cancer.

Nearly $50 million for wound care to support patients with diabetes and chronic wounds to access dressings and bandages.

And $40 million for clinical quality registries, including for dementia, cystic fibrosis and pelvic floor disorders.

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