AMA Wins Key Changes to Medicare Audit Arrangements

by VR Sreeraman on  September 17, 2009 at 12:50 PM General Health News   - G J E 4
 AMA Wins Key Changes to Medicare Audit Arrangements
AMA President, Dr Andrew Pesce, said today that persistent AMA lobbying and working with Government had resulted in important changes to the Health Insurance Amendment (Compliance) Bill 2009, which was introduced in Parliament today.

The Bill gives Medicare Australia the power to obtain documents from doctors to substantiate Medicare rebates, which includes handing over private and personal patient details if necessary as evidence for auditing of Medicare claims.


Dr Pesce said the AMA has succeeded in ensuring that only medical practitioners employed by Medicare Australia can view those records.

"Under the earlier draft Bill proposed by the Government, these personal clinical records would have been seen by administrative staff", Dr Pesce said.

"The AMA has been relentless in protecting patient privacy and preserving the confidentiality of the doctor-patient relationship.

"We pushed for a Senate Inquiry and the Senate agreed that there needed to be specific measures to ensure that patient clinical records would only be accessed when absolutely necessary.

"The Bill before Parliament now contains a number of safeguards sought by the AMA to protect the privacy of patient records during audits by Medicare Australia."

Dr Pesce commended Human Services Minister, Chris Bowen, for also addressing other concerns raised by the AMA in regards to the original Bill.

"Audits of Medicare billing will only be in cases where Medicare Australia has a reasonable concern. Audits will not be random.

"Doctors will have the right to seek an internal review of audit decisions instead of using Federal Court processes as originally proposed.

"We must now ensure that the changes do not impose any extra red tape on medical practitioners as part of the audit process, Dr Pesce said.

Source: AMA

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