BB 2021/0232
Answer
No.
Context
The question posed was: Can the bulk bill “Assignment of Benefit” be specific to the hospital setting? We understand that patients sign this upon admission, and while it is not specific to any one doctor, it covers all the services rendered to the patient whilst in care.
Relevant Legislative Provisions
Other Relevant Materials
Please read this answer in conjunction with BB 2020/061
Academic journal article published in the Journal of Law and Medicine, with detailed analysis of bulk billing arrangements: Medicare Billing Law and Practice: Complex, Incomprehensible and Beginning to Unravel. https://www.ncbi.nlm.nih.gov/pubmed/31682343
Case law
Health Insurance Commission v Peverill [1994] HCA 8
Wong v Commonwealth of Australia; Selim v Lele, Tan and Rivett constituting the Professional Services Review Committee No 309 [2009] HCA 3 (2 February 2009)
Departmental Interpretation
N/A
Detailed Reasoning
Before reviewing the bulk billing law let’s start with a logic check.
Medicare is funded by taxpayers and is a fee-for-service scheme. Do you think the government would be meeting its constitutional obligations to properly account for public money by giving people a blank cheque book? If the answer to this question were yes, it would effectively mean the government was condoning anyone obtaining a patient's signature once, and forever after bulk billing anything, anytime, without the patient even knowing.
Now to the law:
Both section 20A and 20B of the Health Insurance Act 1973 use the singular ‘service‘ as opposed to the plural ‘services‘. The bulk bill process is clearly described as requiring the patient to consent to each separate service. It does not facilitate any form of ongoing consent, which would be antithetical to the operation of Medicare’s fee-for-service structure.
Further, the High Court has confirmed on numerous occasions that each bulk bill transaction is discreet, and the parties to each transaction are a doctor, a patient, and the government.
In the High Court case of Wong, cited above, the court confirmed again the central requirement of consent in every bulk bill transaction.
How can a patient consent to something they have not seen and may not even know about?
Further, the HIA contains numerous sections such as Section 127 which expressly prohibits asking patients to sign blank bulk bill forms or forms with missing details.
So the answer to this question is an emphatic no!
Examples and other relevant information
N/A
Who this applies to
Everyone
When this applies
Always