23 August 2017
Review of National Disability Insurance Scheme Costs Productivity Commission GPO Box 1428 Barton ACT 2600
Dear Commissioners
Medicare funding for National Disability Insurance Scheme services performed in general practice
Thank you for providing the Royal Australian College of General Practitioners (RACGP) the opportunity to provide further comment on the Productivity Commission’s Review of National Disability Insurance Scheme (NDIS) Costs. The RACGP acknowledges the enormous task of developing comprehensive supports for people with disability. However, we have identified an important issue for the Productivity Commission to consider as part of its review.
GPs play an important role in assisting patients to access NDIS services, in part by providing evidence to support a request to access the NDIS. GPs have been advised that they should complete NDIS forms, such as the Access Request form, during a routine consultation with their patient and that patients are eligible to receive Medicare rebates for these consultations. However, the RACGP understands patients are not eligible to receive a Medicare rebate when a GP completes NDIS work outside of these consultations, or completing the form is the sole purpose of a consultation.
In summary, patients seeking access to the NDIS are not eligible to receive Medicare rebates when their GP:
- completes an Access Request form with the patient as the sole purpose of their consultation
- completes a patient referral at the request of a carer (when the patient is not present)
- compiles information, including copies of specialist reports, at the request of an NDIS care coordinator.
If rebates or alternative financial supports are not available to patients, they will need to meet the total cost of the service provided by their GP. GPs and general practices cannot be expected to forego payment for the work they undertake, to support patients to access the NDIS or for any other care provided. Many general practices are small businesses already under significant cost pressures with limited ability to absorb additional costs.
While Medicare excludes benefits for health screening services for NDIS purposes, there are exemptions for some health screening services or medical examinations performed by GPs when a patient is seeking access to other social security benefits. These include Disability Support Pension, Mobility Allowance, and Essential Medical Equipment Payment.
The RACGP understands that Ministerial determination may allow patients to access Medicare
rebates for working with their GP to complete NDIS forms or compile information. However, if this approach is not pursued to support patient access to their GP, the Productivity Commission should consider the need for financial support to assist patients who need to have these assessments and follow up services performed by their GP.
Many of our members are already providing NDIS services and more GPs and patients will encounter this issue as transition to the NDIS continues.
If you would like to discuss this matter further, please contact me or Mr Roald Versteeg, Manager – Advocacy and Policy,
Yours sincerely
Dr Bastian Seidel President