Carina Garland (Chisholm, Australian Labor Party) Share this | Hansard source

As we've heard from the previous speaker, securing and supporting Medicare's future is absolutely so important to the Albanese Labor government. We've delivered urgent care clinics right across the country, including one in Mount Waverley, in my own electorate. I know that, in the City of Stonnington area, which is in my electorate too, there is currently a tender out for another urgent care clinic, which is very welcomed by the community.

The Health Legislation Amendment Bill 2025 makes amendments to legislation in the health portfolio to make sure we strengthen Medicare. Of course, this is one of my favourite topics of conversation in this place, as indeed it is for everyone sitting on this side of the House. Schedule 1 of the bill will streamline the allocation of Medicare provider numbers under the Health Insurance Act, allowing practitioners to treat patients sooner. We know that the sooner people are able to access medical services, generally the better the health outcomes can be.

Amendments under schedule 1 will allow the Chief Executive Medicare to approve the use of a computer program to make appropriate non-discretionary decisions to allocate Medicare provider numbers in line with the review of Australia's regulatory settings for overseas health professionals. Decisions to refuse a provider number will continue to be checked and authorised by the Chief Executive Medicare or their delegate. Some Medicare provider numbers have already been allocated through the use of a computer program without any clear legislative support, and this bill will tidy up that process and validate previous computer issued Medicare provider numbers.

Currently an overseas health professional faces a wait time of up to three months for a Medicare practitioner number, delaying them from commencing work in the Australian health system and treating patients under Medicare. We all know how important it is that everyone has access to health professionals when they need them. Reducing the time it takes for Medicare numbers to be issued will absolutely support the growth of our medical workforce, which is a clear priority for the Albanese Labor government. Internationally qualified health practitioners currently supplement the domestic workforce and aid in addressing workforce shortages, making for a more sustainable health workforce overall.

Schedule 2 of this bill will amend the Private Health Insurance Act to support the process for claiming the private health insurance rebate under the premiums reduction scheme. This will ensure that registrations for the private health insurance rebate scheme and claims under the scheme are administered consistently under the act. This will also ensure that persons are validly registered as participants and that payments of rebates to insurers are lawful. The private health insurance rebate scheme is an initiative to help Australians cover the cost of premiums, supporting access to private healthcare services for participants. We know individuals who are eligible for the private health insurance rebate can claim the rebate as a premium reduction through their private health insurer or as a tax offset. Under the scheme, the private health insurer claims a reimbursement through a system administered by Services Australia and reduces the premium payable by the policyholder by the amount of the rebate.

Some elements of the registration and claims-processing system for the premiums reduction scheme have been administered inconsistently with the requirements of the Private Health Insurance Act. Schedule 2 of the bill will amend the Private Health Insurance Act to align the registration process in division 23 with requirements of the system operated by Services Australia, provide for self-assessment by participating insurers of the amount of rebate required to be reimbursed in division 279, require an insurer to provide information or documents to support their claim, ensure overpayments can be recovered despite any unintended system or process defects in division 282 and allow for computer assisted decision-making and the approval of forms and systems by the Chief Executive Medicare in division 333. Participating insurers will continue to be subject to regular post-payment compliance activities to ensure integrity of the payment process, and the amendments will support the existing registration and claims processes in such a way that there will be minimal impact on consumers and private health insurers.

Of course, strengthening bulk-billing is a priority of the Albanese Labor government, and schedule 3 of the bill will amend the Health Insurance Act 1973 to modernise assignments of the Medicare benefits process. Assignment of benefit is a longstanding requirement of the Health Insurance Act, and it underpins payments of Medicare benefits where the patient assigns their right to benefit to a medical provider, private health insurer or approved billing agent. Last year, as one of many measures our government has taken to strengthen Medicare, the parliament passed the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024 with its changes to assignment benefits commencing 18 months from the day the act received royal assent. It streamlined the assignment process for patients, for medical providers, for private health insurers and for approved billing agents and also enabled digital assignment options. The bill before us now will build on those changes and address limitations of the assignment-of-benefits act. This bill will delay the commencement of the assignment-of-benefits act to 1 July 2026, which will support industry and consumers to comply with the new assignment-of-benefits requirements, and it will allow time for new processes to be developed and for IT systems to be updated. In the meantime, bulk-billing can continue under the current processes, including additional incentives for bulk-billed services which will start from 1 November this year in line with the government's election commitment.

Bulk-billing is vital for equitable access to health care. It helps with cost-of-living pressures and ensures every Australian receives the best health care they deserve. Our government is passionate about bulk-billing. The government has committed $15.2 million in 2025-26 to fund the implementation of reforms outlined in the assignment-of-benefits act and subordinate regulations. This includes updates to Services Australia's software systems and education and communications activities to ensure stakeholders are aware of and prepared for new digital arrangements. The passage of this bill will ensure that the Albanese Labor government's 2025 election commitment of $7.9 billion in bulk-billing incentive payments to encourage increased bulk-billing rates will not be adversely impacted by non-compliant business software.

Schedule 4 of this bill will amend the Health Insurance Act 1973 to ensure the consequences for Bonded Medical Program participants who withdraw from the program or fail to complete their return-of-service obligation are fair. It will balance the personal circumstances of the bonded participant and the broader interest of the community and allow all work completed by a bonded participant in good faith, consistent with program objectives, to be counted towards their return-of-service obligation.

This bill allows the Minister for Health and Ageing to make additional rules to ensure that past work completed by bonded participants delivering health services in regional, rural and remote locations in Australia, for instance, can count it to their return-of-service obligation where this is consistent with program objectives. Currently, former Medical Rural Bonded Scholarship Scheme bonded participants who fail to complete their return-of-service obligation within the allowed 18-year period or who have withdrawn earlier face repayment of their scholarship and a six-year Medicare ban. While the financial penalty is appropriate, subjecting these doctors to a Medicare ban will jeopardise continued service provision and access to care for Australians living in regional, rural and remote communities and in other areas of workforce shortage. Given those broader workforce shortages, a six-year Medicare ban is not in the interests of either the doctor or the Australian community. Students can currently withdraw from the program without consequence up to the HECS census date in their second year of study. If the student withdraws after that date, they incur a debt to the Commonwealth equal to the full cost of their Commonwealth supported place up to the date of the withdrawal. This will be in addition to their HECS-HELP liability.

Our government is squarely focused on strengthening Medicare and on ensuring that we have a strong health workforce. That means that Australians, no matter where they live, are able to access high-quality medical care when they need it. This is part of our ongoing commitment to strengthen Medicare, to fight for Medicare and to ensure that bulk-billing is accessible and equitable. I'm really pleased to support this bill in the House today.

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