Connecting Health Services With the Future: Questions and Answers for Residential Aged Care Facilities
Questions and answers which have been prepared to assist residential aged care facilities in understanding the new MBS items and incentive payments introduced under the
‘Connecting Health Services With the Future: Modernising Medicare by Providing Rebates for Online Consultations’ initiative.
Why has the Australian Government introduced this initiative?
What is a telehealth video consultation?
Is a telehealth video consultation claimable from Medicare?
Can video consultations be claimed through the Department of Veterans’ Affairs?
Where can these services be provided?
Who can provide telehealth services?
How do I find a specialist who will provide video consultations?
Who is eligible to support a telehealth service?
Can I bill telehealth services which are conducted by phone or email?
Can MBS billed telehealth services be provided to admitted hospital patients?
What is an eligible residential aged care telehealth facility?
How do I register to be an eligible residential aged care telehealth facility to host telehealth services?
What are the technical requirements for a video consultation?
What financial incentives are available to practitioners to encourage the uptake of video consultations?
What are the incentives for?
How do I register with the Dept of Human Services to host a video consultation?
Who do I call if I have problems filling in the registration form?
How will I get the funds for getting onboard with telehealth?
Do the incentive payments include GST?
Are RACF's audited on how they spend the incentive payments?
When will a Medicare or DVA rebate be payable for a video consultation?
Can a patient receive multiple video consultations on the same day?
Can I use Skype?
Why has the Australian Government introduced this initiative?
The telehealth initiative is integral to the Australian Government’s broader agenda to make it easier for patients to access medical services and in particular specialists. Patients using telehealth facilities located in eligible residential aged care facilities, eligible Aboriginal Medical Services or who are outside inner metropolitan areas, will be able to ‘see’ specialists without the time and expense involved in travelling to major cities, in many cases sooner than would otherwise be the case.
What is a telehealth video consultation?
For the purposes of this initiative, a video consultation is where a patient and eligible specialist, consultant physician or psychiatrist undertakes a consultation via video conferencing (ie. visual and audio).
Is a telehealth video consultation rebatable by Medicare?
Yes. New Medicare Benefits Schedule (MBS) items will be introduced for video consultations from 1 July 2011.
A full list of telehealth MBS items is available
here.
Can video consultations be claimed through the Department of Veterans’ Affairs?
Yes
Where can these services be provided?
Under this initiative the specialist/consultant can be located anywhere in Australia but the patient must be in a telehealth eligible geographical area at the time of the consultation. However, the geographic restrictions do not apply to an approved care recipient of a residential aged care facility or a patient at an eligible Aboriginal Medical Service.
Maps of eligible geographical areas are available
here.
Who can provide telehealth services?
Specialist-end
Video consultations can be provided by any medical practitioner who is registered or authorised to practise (as described in the Health Insurance Act 1973), as a consultant physician, psychiatrist or specialist.
Patient-end
Medicare and DVA rebated clinical services can be provided at the patient end of a video consultation by any medical practitioner, midwife or nurse practitioner who has a Medicare provider number linked to an eligible patient location. In addition, a practice nurse or Aboriginal health worker can provide a patient-end service ‘for and on behalf of a medical practitioner’ to a patient. Other people, for instance employees at an aged care facility can accompany and assist a patient in a video conference with a specialist but Medicare will not pay a rebate for this assistance.
How do I find a specialist who will provide video consultations?
Relevant professional colleges may be able to assist with this.
Who is eligible to support a telehealth service?
A registered medical practitioner, participating midwife or participating nurse practitioner who has a Medicare provider number linked to an eligible patient location can provide a MBS telehealth support service. In addition, a practice nurse or Aboriginal health worker can provide a telehealth support service ‘for and on behalf of a medical practitioner’ to a patient. Other people can support a person in a video conference with a specialist, but Medicare will not pay a rebate for the support person.
What about telehealth services which are conducted by phone or email?
No. The new MBS video consultation items are not payable for telephone or email consultations. There must be a visual link between the patient and the eligible specialist, consultant physician or psychiatrist in order to bill the video conferencing item.
Can MBS billed telehealth services be provided to admitted hospital patients?
No. Medicare rebates are not payable for video consultations with an admitted hospital patient. This applies to both public and private admitted patients.
What is an eligible residential aged care telehealth facility?
An eligible residential aged care telehealth facility is a facility where care and accommodation are provided to residents under the Aged Care Act 1997 and which meets the following telehealth eligibility requirements: possesses sufficient equipment and facilities to host a video consultation; and is registered with the Dept of Human Services.
How do I register to be an eligible residential aged care telehealth facility to host telehealth services?
A residential aged care telehealth facility will need to register with the Dept of Human Services and provide reports on telehealth consultations provided in order to receive telehealth hosting service incentives. Registration details can be found at
www.medicareaustralia.gov.au
What are the technical requirements for a video consultation?
In order to meet the requirements of the MBS item a visual and audio link with the patient must be present.
The Government is not prescribing any particular technical solution; however, there is some information about technical considerations available
here.
What financial incentives are available to encourage the uptake of video consultations?
There are five types of Incentives available for practitioners and Residential Aged Care Facilities (RACFs):
- Telehealth On-Board Incentive;
- Telehealth Service Incentive;
- Telehealth Bulk Billing Incentive;
- RACF On-Board Incentive; and
- Telehealth Hosting Service Incentive.
What are the incentives for?
Incentive payments are to encourage changes in the way doctors and aged care facilities provide services and recognise that incorporating telehealth into everyday workflow represents a significant change that will potentially require IT system changes and require additional staff training.
How do I register with the Dept of Human Services to host a video consultation?
RACFs applying for the RACF On-Board Incentive will need to have provided at least
one (1) Hosting Service and then submit the Application for Telehealth Hosting Service Incentive Payment form (available from the Health Professionals section of the the Dept of Human Services web site:
www.medicareaustralia.gov.au to the Dept of Human Services.
Who do I call if I have problems filling in the registration form?
For assistance with completing the form, call the Dept of Human Services on 1800 222 032.
How will I get the funds for getting onboard with telehealth?
The RACF On-Board Incentive payment will be deposited via electronic funds transfer (EFT) to the bank account where aged care payments are usually made for the RACF. This payment will be included in the next monthly Aged Care Services payment run.
Do the incentive payments include GST?
The Department of Health and Ageing has received advice that incentive payments are not subject to the Goods and Services Tax (GST).
Are RACF's audited on how they spend the incentive payments?
No. There will not be audits or reporting requirements on how incentive payments are spent. Incentive payments are intended to encourage a change to the facility's business to incorporate online video consultations. The way a business spends an incentive payment is up to them. You may, however, be audited on your eligibility to receive an incentive payment and if you have received an incentive payment inappropriately, you will be required to repay it.
When will a Medicare or DVA rebate be payable for a video consultation?
The MBS items will be available from 1 July 2011.
Can a patient receive multiple video consultations on the same day?
Yes. Medicare benefits may be paid for more than one video consultation for a patient on the same day by the same practitioner, provided the second (and any following) video consultations are not a continuation of the initial or earlier video consultations.
Can I use Skype?
The Government is not mandating or endorsing any particular technical solution for telehealth. In providing MBS billed telehealth services, clinicians should be confident that the technical solution they choose is:
- capable of providing sufficient video quality for the clinical service being provided; and
- sufficiently secure to ensure normal privacy requirements for health information are met. Individual clinicians will need to be confident that the technology used is able to satisfy the item descriptor and that software and hardware used to deliver a videoconference meets the applicable laws for security and privacy.