GA 2020/066
Answer
No.
Context
Doctor A wanted to know whether billing to Medicare was permitted in circumstances where an Australian, Medicare eligible patient, was overseas working or holidaying, and the doctor was in Australia, and the service took place via telehealth.
Relevant Legislative Provisions
Other Relevant Materials
1. Parliamentary Bills Digest – Health Legislation Amendment (Data-matching and Other Matters) Bill 2019.
2. Industry article regarding the passage of the Medicare data matching bill through parliament in 2019. Medicare data-matching bill passes parliament https://www.innovationaus.com/medicare-data-matching-bill-passes-parliament/
Case law
NA
Departmental Interpretation
mbsonline.gov.au (accessed 25 June 2020)
AN.0.6 Patient Eligibility
Medicare covers services provided only in Australia.
GN.12.31 Services rendered on behalf of medical practitioners
Supervision from outside of Australia is not acceptable.
Detailed Reasoning
Please refer to GA 2020/065
The only way to legally bill in this scenario is to issue a private invoice and not claim through Medicare.
Examples and other relevant information
Australia has reciprocal health care arrangements in some countries. You can find out which countries at this link. Under these agreements eligible Australian’s visiting countries where we have agreements are usually covered for acute medical care.
Who this applies to
Everyone
When this applies
Always. Further, the new data-matching laws apply retrospectively in the sense that this has always been illegal, but now the Government has the ability to easily view immigration records to prove it has occurred.