Rebecca White (Lyons, Australian Labor Party, Assistant Minister for Women) Share this | Hansard source

I present the explanatory memorandum for this bill and move:

That this bill be now read a second time.

Today, I introduce the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025.

Australia has a world-class health system that offers affordable, high-quality, accessible health care to all Australians. This is due in large part to the various health benefit schemes—including Medicare and its programs—that help Australians pay for the health care they need.

The government is committed to protecting and strengthening Medicare—and part of this is improving the compliance framework that ensures the integrity of these rebates.

The Independent Review of Medicare Integrity and Compliance undertaken by Dr Pradeep Philip, known as the Philip review, was commissioned by the government to respond to concerns about the operation of the Medicare system.

In 2023, the Health Insurance Amendment (Professional Services Review Scheme) Act 2023 and the Health Insurance Amendment (Professional Services Review Scheme No. 2) Act 2023 made priority amendments in response to this review.

This bill implements further improvements responding to Philip review recommendations.

The bill implements a measure announced in the 2024-25 budget: reducing the timeframe during which Medicare claims for bulk-billed services can be made from two years to one year. Claims relating to bulk-billed services can currently be made up to two years after a health service has been provided.

This change will improve payment integrity and reduce the number of incorrect and fraudulently submitted claims. This will have minimal impact on patients and practitioners, as most claims are already made within 12 months.

There will be discretion to accept claims after that time, to ensure patients are not disadvantaged.

Currently, a range of legislative provisions across health portfolio legislation are creating barriers to effective compliance activities, particularly when it comes to deterring and responding to serious noncompliance and fraud.

The bill responds to these barriers by allowing investigative powers to be used consistently and effectively across Medicare and the Pharmaceutical Benefits Scheme. Changes will also enable powers to be used in the investigation of Criminal Code offences and remove the need for AFP assistance with executing warrants for suspected Criminal Code offences.

These amendments will improve investigative powers in health portfolio legislation and ensure they can be put into practice consistently, effectively and proportionately to respond to behaviour that jeopardises the integrity of health benefits schemes.

Under the National Health Act 1953, a pharmacist can request that the Minister for Health and Aged Care exercise a discretion to approve the supply of pharmaceutical benefits at particular premises. This is currently a two-stage process, which can take up to six months. This is frustrating and time-consuming for the applicant and may also delay the community's access to pharmaceutical benefits.

In this bill, the two-stage process is proposed to be streamlined and condensed into a single-stage process of up to four months. This will help to reduce a significant administrative burden. And it will provide the community with more timely access to pharmaceutical benefits.

The amendments improve existing powers to obtain information about potential fraud and noncompliance and enable the recovery of amounts if they should not have been paid.

The Philip review recommended the 'expansion of powers to ensure all types of serious non-compliance can be effectively dealt with' and 'a reduction in regulation and legislation that hinders compliance activities'.

The Philip review concluded there are limitations and restrictions around current compliance processes. For example, if incorrect payments are identified, current provisions don't always enable amounts to be appropriately recovered. This is because some recovery mechanisms rely on outdated claiming processes and requests for hard copy documents. These matters are restricting the ability of the Department of Health, Disability and Ageing to protect the integrity of Medicare programs and payments.

These changes will enable appropriate inquiries to be made about Medicare payments if available information suggests potential noncompliance or fraud. If payments are found to be incorrect, amounts could be recovered.

Changes will also improve the ability of regulators to protect patient safety by removing some restrictions on the admission of information obtained under the Professional Services Review's 'notice to produce' powers as evidence in relevant proceedings, including proceedings for the purposes of the national law for the health practitioner registration and accreditation scheme.

This will remove some restrictions on the admission of information obtained under the Professional Services Review Agency's 'notice to produce' powers as evidence in proceedings, including proceedings under the Health Practitioner Regulation National Law.

The existing restrictions will no longer apply in respect of prosecutions related to a failure to produce documents, proceedings to recover debts relating to the Professional Services Review Scheme and some other proceedings related to non-compliance.

The restrictions will also not apply in respect of documents produced to PSR under notice and passed onto Australian Health Practitioner Regulation Agency (Ahpra) or a national board under certain provisions in the Health Insurance Act, or information obtained or generated by Ahpra or a national board from its own investigation, triggered by documents produced to PSR under notice.

This will enable Ahpra and associated health practitioner boards to use PSR related material to trigger their own investigations into allegations involving risks to patient safety. This will also allow Ahpra and health practitioner boards to admit evidence in national law proceedings if it was referred to them under the legislation for the reasons of a significant threat to life or health or noncompliance with professional standards. These changes are required to ensure all appropriate steps are taken to protect patient safety and that the existing requirement to refer the information to Ahpra and health practitioner boards is not frustrated.

These changes will enhance the Department of Health, Disability and Ageing's capacity to address identified risks to patient safety and manage and address the consequences of noncompliance and potential fraud.

The bill makes several sensible amendments to the Therapeutic Goods Act 1989(the Therapeutic Goods Act).

The bill enhances the capacity of the government to manage and alleviate the consequences of therapeutic goods shortages in Australia. It allows the secretary of the department to approve the importation or supply of substitutable unapproved products from overseas if the secretary is satisfied that the approved medicine, biological or medical device, in the reasonably foreseeable future, may become unavailable or be in short supply.

The bill supports compliance and enforcement activities in relation to both unlawful therapeutic goods and unlawful vaping goods.

Specifically, the bill broadens the circumstances in which section 52AAA applies to ensure that forfeiture arrangements can extend to the range of circumstances in which goods may be seized under the Therapeutic Goods Act, rather than, as currently, only the circumstance where goods are seized under a warrant issued under section 50. This amendment will help deter the trafficking of such goods by sending a strong message to bad actors operating in this space that the Therapeutic Goods Association (the TGA) will take unlawful goods permanently.

This bill lowers the threshold that must be satisfied before the secretary may give an enforceable direction to a person under section 42YT of the Therapeutic Goods Act. The current requirement is that a direction is necessary to protect the health and safety of humans. The amendment will result in a more balanced approach that a direction must be considered and issued in the interests of public health and safety. This approach ensures the more appropriate availability of such directions to protect Australians from new and emerging public health threats.

The bill enhances the ability of state and territory officers to monitor, investigate and enforce compliance with the Therapeutic Goods Act and regulations by allowing for the provision, inspection, copying and retention of documents or information.

The bill also clarifies that section 61, which authorises the release of information in relation to therapeutic goods and vaping goods in certain circumstances, is not a secrecy provision.

The bill includes other minor amendments to the Therapeutic Goods Act, to keep the act up to date and to assist with the TGA's important functions.

The bill also amends the Therapeutic Goods Act to make minor consequential amendments to support the government's ground-breaking vaping reforms.

Finally, the bill amends the Public Health (Tobacco and Other Products) Act 2023 (the tobacco act) which commenced on 1 April 2024. These amendments clarify the intended operation of the provisions and are amendments that have been identified as necessary in the implementation phase of the legislation.

The measures in this bill will further the government's efforts to strengthen Medicare and will assist in the implementation of our world-leading tobacco and vaping reforms.

I commend the bill.

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