Remove mandated bulk-billing from COVID-19 telehealth item numbers.

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Hon. Greg Hunt (MP), 

Re: Remove mandated bulk-billing from COVID-19 telehealth item numbers.

I applaud the introduction of the Medicare item numbers to support services normally provided under a Mental Health Care Plan to be accessible via phone or videoconferencing in instances in which patients or providers meet criteria. I recognise this as an innovative step in containing the spread of COVID-19 without compromising access to ongoing psychological support for those in need of it. 

However, the mandate that the new telehealth item numbers be bulk billed has significant repercussions:  

  • The bulk-billing rebate is approximately half the fee recommended in the Australian Psychology Society's fee schedule and hence, half the fee that many of us ordinarily charge for our services.
  • Being asked to provide the same service, with the same overheads whilst receiving half of our usual earnings is not sustainable for many of us. 
  • For financial reasons, many of us will be reluctant to introduce these item numbers into our practice thereby deterring the self-isolation (and subsequent spread of illness) that the item numbers were intended to facilitate.
  • Those who do introduce the item numbers face increased financial stress and strain, negatively impacting the physical- and emotional- health of a workforce tasked with supported a nation in crisis.
  • Many solo practitioners and private practices alike will be forced out of business, further impacting the Australian economy! 
  • The health system in Australia is already under strain! As the demands increase upon public services, more clients will be forced into the private sector. Without measures to safeguard such private services, an increasing number of clients will be faced with no treatment options.

To ensure continuity of care for vulnerable consumers and financial viability for small businesses in healthcare, it is recommended that provider discretion be permitted in charging out-of-pocket fees to those clients not experiencing financial hardship (as has always been the case under the MBS). The benefits of this are:

  • There is no financial impact on the Government,
  • Access to bulk-billing services remain available to financially disadvantaged patients with a diagnosed mental-health concern,
  • Patients with a diagnosed mental health concern who can afford an out-of-pocket fee experience no disruption to the services they have received to date, 
  • Mental-health practitioners have capacity to earn a more comparable income to that prior to the introduction of telehealth item numbers thereby, 
    • reducing the impact on the physical health and wellbeing of our mental-health workforce,
    • preserving the sustainability of private mental-health services, 
    • reducing the impact on public services, and 
    • ensuring our nationals continues to receive the mental-health support they require during the current crisis. 

We urge the government to IMMEDIATELY remove the mandate that telehealth item numbers be bulk billed for the financial stability of the Australian economy and the private mental-health sector. 

Yours sincerely, 

Dr. Kiera Buchanan, Clinical & Health Psychologist 

BPsych (Hons), DPsych (Clin), DPsych (Health)