MONDAY, 20 APRIL 2020
Please note, moving forward these communiques will be in the "Members Only" section of the website.
Changes to Medicare Bulk Billing as of Monday, 20 April 2020
The Minister for Health, the Hon Greg Hunt MP has amended telehealth legislation to provide allied health practitioners and other health professionals the option to bulk-bill or patient-bill a wider range of MBS telehealth consultations.
Allied health providers are no longer required to bulk-bill COVID-19 telehealth (video conference) and telephone consultations where the service is provided to a concessional or vulnerable patient or a child under 16. Allied health providers may continue their usual billing practices.
The requirement to bulk-bill certain patients only applies to a service provided under an item in Schedule 1 (general practice services). Subsection 8(4) will no longer apply to allied health services (Schedule 3).
Accredited ed Exercise Physiologists may now charge a co-payment for services provided to children under 16, concession card holders and those vulnerable to COVID-19.
These changes come into effect from today (20 April 2020).
The Minister noted that the amended legislation helps ensure the continued viability of allied health services under Medicare and recognised the advocacy of many groups, including allied health. (Note, ESSA recognises the efforts of Allied Health Professionals Australia [AHPA] for its efforts in bringing about this change.) The amendment can be found in the Federal Register of Legislation here.
In case you listened the Department of Health’s allied health webinar last Thursday (16 April, 2020), the answer to the question about bulk billing is now out of date as is the information ESSA previously provided on bulk billing in the Communique on Tuesday, 14 April.
New - Telehealth for nib health funds
ESSA has had confirmation from private health insurer, nib health funds, that it will now fund individual telehealth exercise physiology services, backdated to 14 April until 30 June 2020, in response to COVID-19. nib will review its decision in June and extend as relevant. The following services are eligible for funding:
Exercise Physiology
Item Code 710 Individual Initial/Referred Assessment by teleconsultation - INDIVID INIT ASSESS T/C
Item Code 712 Individual Subsequent Treatment by teleconsultation - INDIVID SUB TRMT T/C
Please note, nib expects AEP services to still comply with AHPRA's new guidelines. In addition, AEPs also need to meet the requirements set out in our Tele-practice Policy Statement.
Exercise Physiologists are expected to adhere to the standards/code of conduct of ESSA and any specific telehealth guidance and training including, but not limited to, these requirements:
Ø Ensure that telehealth services are delivered with the adequate security, privacy and consent in place.
Ø Adequate assessment is undertaken to ensure that services are only delivered via telehealth where it is safe and effective.
Ø AHPRA’s published guidelines in relation to telehealth that are also observed. These can be accessed here.
• Service providers need to work with nib members: their patients, to ensure their presenting symptoms can be safely and effectively managed via a telehealth mode of delivery.
• Service providers must ensure that they are working within their competency to deliver safe and effective care via telehealth.
• nib members are eligible to receive benefits for telehealth where they are covered for the face to face service on their policy.
• Normal fund rules and provider terms and conditions apply.
• Individual consultations only are covered.
ESAA will continue to lobby nib and all other health funds that AEP telehealth item codes should continue beyond COVID-19 to ensure greater access to AEP services.
Updated Information on Medibank’s Telehealth Items
Eligibility
This guideline outlines the following recommendations for telehealth consultations applying to eligible Medibank and ahm members, who have an extras product that includes cover for the allied health profession where*:
• The patient is undergoing an existing course of treatment or has been a patient of the clinic/health professional in the past six months, as preference for efficacy supported by telehealth outcomes (to be defined by clinician not Medibank).
• For new patients, consultations will remain available but preference for GP or treating specialist to provide recommendation for treatment options where possible**.
• The clinician should use their clinical reasoning to determine if the patient is clinically appropriate to receive the service via telehealth and must work within their scope of practice.
• The service is delivered between Tuesday 14th of April 2020 and the 30th of September 2020 for Medibank members (and between 30th March to 30th September 2020 for ahm members).
• The service is undertaken in accordance with each profession’s telehealth policy and guidelines.
**Please note, Medibank and ahm members will not be required to provide proof of their general practitioner’s recommendation. The telehealth consultation should not be part of a consultation where a Medicare benefit applies.
Item Codes and Claiming
Telehealth claims will not be able to be submitted via electronic claiming channels (HICAPS and Healthpoint).
The following new telehealth item numbers and descriptions have been established and provided to all Private Health funds, HICAPS and Healthpoint. It is at each fund’s discretion as to whether it will use the allocated telehealth item numbers.
Medibank and ahm will accept the following new telehealth item numbers and descriptions. These telehealth item numbers are available for all Medibank and ahm recognised providers, not just for Medibank Members’ Choice providers.
COVID-19 Small Business Videos
The Australian Small Business and Family Enterprise Ombudsman (ASBFEO), an independent advocate for small business owners, has published a number of videos to help small business owners respond to the COVID-19 crisis:
· Ombudsman calls for 30-day payment times to be legislated
· COVID-19 – Now is the time to take care of yourself
· Access to credit critical to small business survival: Ombudsman
· My Business Health boosted to support small businesses through Coronavirus crisis
· COVID-19 - What the JobKeeper payment means for small businesses
· JobKeeper to help small businesses survive Coronavirus crisis
· COVID-19 - Mandatory commercial tenancy code
· Mandatory commercial tenancy code opens door to rent negotiation
· COVID-19 - Your JobKeeper questions answered
· COVID-19 not an excuse to delay paying small businesses: Ombudsman
To access these videos, click here.
NBN Co Update
Speed Boost for Health Clinics
NBN Co is supporting the delivery of enhanced telehealth services by upgrading eligible GP and health clinics with a fixed line service to 50Mbps download and 20Mbps upload connections at no extra cost for a period of six months.
Telehealth Premises means a premises identified by the Retail Service Provider(RSP), in accordance with processes specified by nbn from time to time, as being a registered business premises used by an appropriately qualified service provider to provide telehealth services—being any of the following medical consulting services delivered using voice or internet services over the nbn™ Network:
i. general practitioner services;
ii. medical specialist services;
iii. nurse practitioner services;
iv. mental health treatment;
v. chronic disease management;
vi. Aboriginal and Torres Strait Islander health assessments;
vii. treatment of eating disorders;
viii. pregnancy support counselling;
ix. treatment of patients in aged care facilities;
x. disability services; and
xi. any other services notified by nbn to RSPs as being telehealth services;
It is important to note that upgrades are not automatic – so to take advantage of this offer simply call your current RSP to activate and refer to the services above which you provide. Read the media release from the Minister for Communications, Cyber Safety and the Arts, the Hon Paul Fletcher MP here.
In relation to getting the best from your nbn service – here are some easy tips below. Keep an eye on the nbn COVID-19 blog, where there will be updates.
Get the right speed
Depending on the nature of your work, you may be surprised at the download and upload requirements needed to effectively get the job done.
Sending and receiving large files, taking video conference calls, and simultaneously running multiple online programs are just some of the typical work tasks that can affect internet speed.
And if you work at night, remember that internet speeds tend to slow down in the after-dinner ‘busy period’.
Work from Home Tip: Talk to your phone and internet provider about the speed tiers available in your area*. If needed, consider speaking with your provider about changing your plan – even temporarily – to accommodate your working from home needs.
Get the right plan
Working from home doesn’t have to be an isolating experience. Apps like Slack are useful for real-time team collaboration, while the likes of Trello can help with project management.
For some virtual face-to-face time, try apps like Skype and Zoom, and share files over the cloud – including real-time document co-authoring and version control – with those including Google Docs and OneDrive.
While undoubtedly handy, keep in mind that the more reliant your remote work is on internet-based software, the more bandwidth you may need. So, while sharing basic documents will have a relatively minor impact on your bandwidth, downloading and uploading massive files could have a noticeable effect.
Work from Home Tip: Ask your provider about the plans available to you. Tell them about the ways you’ll be using your connection for work and downtime so they can help you pick the right plan*.
Get the optimum performance
Even with the right speed and plan, factors around the home can affect your online experience*. To help make the most of your workday, start by ensuring you have the best possible internet set-up in your home.
Using Wi-Fi? Make sure your modem isn’t hiding behind the likes of brick walls, large electrical appliances or mirrors. These – and more – can cause poor signal.
Living in a device-happy home? Basic modems can generally support eight devices connected at one time, so chat to your provider to make sure you have the right modem for your needs.
Older cabling or devices at your place? These can lead to slower speeds. Get an assessment from a registered cabler and consider upgrading older devices, like printers or computers.
Consistently uploading large files? Consider doing so during off-peak hours (between 12am and 7am).
Work from Home Tip: Make sure your nbn™ connection has the chance to perform its best by following this list of tips to optimise your experience.
Internet down?
Many businesses use a Virtual Private Network (VPN) to allow their employees to log in remotely – and safely – to work servers and systems.
If your internet appears to go down while working, it could be your VPN.
To check whether it’s your VPN or an issue with your nbn™ connection, try accessing a non-work website like Google. If it loads normally, contact your workplace to let them know your VPN isn’t working. You can also check if any unforeseen incident may be impacting your services over the nbn™ access network.
Assistance to Families and Businesses - Low-income families with school-aged children
$50 million in funding is be allocated to help connect low-income families with school-aged children so they can access the internet for educational purposes. NBN Co will waive the $37 monthly wholesale charge, paid for by internet providers, for many services on the 25/5 Mbps speed tier plan available from April until September. This is an opt-in scheme for internet providers. Participating providers will have their corresponding retail offering assessed by an internal panel at NBN Co to ensure that low-income families will have access to the most cost effective NBN packages.
Assistance to Families and Businesses - Sky Muster satellite customers
40 per cent additional bandwidth at no extra charge across all NBN Co access technologies and additional broadband data for Sky Muster satellite customers in rural and remote Australia during COVID-2019. Read the media release on these two initiatives from the Minister here.
COVID-19 Information for workplaces
Safe Work Australia (SWA, an Australian government statutory body established in 2008 to develop national policy relating to WHS and workers’ compensation, has developed resources on managing work health and safety in a COVID-19 environment, including working from home.
Sector specific information is also available for health, aged care and disability providers. More details available here.
Insurance
Q. Do I need to contact my insurer if my business is now offering telehealth services?
Yes. If you are not insured with Guild, a reminder to contact your insurer to check that you are now covered to use telehealth for new and existing clients.
Q. What happens if I get a fine for breaching stay at home or non-essential public health or emergency declaration orders?
Please follow your state or territory government public health or emergency declaration orders. If you disobey a government order, then this may become a criminal offence and from an insurance perspective a deliberate act, with certain fines and penalties attributable the said act. From an insurance perspective, a professional indemnity policy will generally exclude any fines or penalties including claims caused by criminal acts and as such no cover will apply.
Q. Can I claim lost revenue on Business Interruption insurance?
Business insurance policies have optional cover for Business Interruption. Pandemics, including COVID-19 are excluded from Guild Insurance’s Business Interruption cover.
Insurance Queries
If you are insured by Guild, please call your Account Manager or the main Guild Insurance contact number – 1800 810 213. Should you experience issues with contacting Guild, please contact Belinda at [email protected].
Summary Department of Health (DoH) COVID-19 response update for Allied Health Practitioners Webinar – 16 April
Q. Where is line drawn on remedial massage?
Remedial massage can be provided if these treatments allowed within the law of your state and territory. Remedial massage is not covered by Medicare.
Q. What is an essential allied health service?
What is essential will vary from patient to patient and will need to follow state directives.
There is no national determination of what is an essential allied health service. (Note, ESSA is writing to each state and territory Chief Health Officer this week to confirm that exercise physiology is an essential health service.)
Q. Can health care workers with mild symptoms going to work?
However mild your symptoms are, do not go to work. Seek medical advice or get a test.
Q. How should Personal Protective Equipment (PPE) be used?
Ensure you are well. Check your patient is well and you can maintain social distancing and good general hygiene, including hand washing.
PPE is not the first line of defense. You only need to wear PPE for things that you would normally need PPE for.
Q. How should services be delivered?
Talk to your patient first whether face-to face services can be delivered. Provide safe face-to face services where necessary or alternatively refer patients to other professionals if you are unable to provide face-to-face services for treatments that require a face-to face consultation.
Q. How to use telehealth?
Use the resources developed by your professional association.
A reminder that ESSA has a Tele-practice Policy Statement to guide our members on the provision of telehealth services.
Q. Can you work in allied health in both hospitals and aged care facilities?
Disclose if you have more than one employer to other employers so each employer can determine whether any additional requirements need to be met.
Q. Can hydrotherapy pools open? Can I use a private pool for hydrotherapy?
Look at the advice from state and territory government agencies. (Note from ESSA, the state or territory government public health or emergency declaration orders do not specifically state that hydrotherapy pools can be used.)
Q. Any update on telehealth platforms?
Ensure platforms are safe and address security and privacy requirements.
The DoH is reluctant to regulate providers. More information is available on MBS online. (Note from ESSA, an updated overview of telehealth platforms is now available here on the ESSA COVID-10 website).
Q. Can pain management be delivered within aged care facilities?
Talk to the facility. Provide treatments that can be done with social