EOI for Medicare-PBS Payment Services

The Australian Government allocated funding in the 2014-15 Budget to go to the commercial market calling for Expressions of Interest from the private sector to provide claims and payment services for Medicare (MBS) and the Pharmaceutical Benefits Scheme (PBS).

Page last updated: 08 August 2014

PDF printable version of EOI for Medicare-PBS Payment Services (PDF 235 KB)

8 August 2014

The Australian Government allocated funding in the 2014-15 Budget to go to the commercial market calling for Expressions of Interest from the private sector to provide claims and payment services for Medicare (MBS) and the Pharmaceutical Benefits Scheme (PBS).

The Government is committed to cutting red tape in the health system and is seeking to streamline and simplify systems for patients, doctors and other health providers.

The Department of Health currently contracts the Department of Human Services to deliver the collection and payment system which remunerates doctors and other health professionals.

The current IT systems that manage the claims and payments processes are dated and in need of a substantial upgrade. In these circumstances it is good process to review and test existing and alternative systems.

The market test will determine the level of private sector interest and capability in providing those IT services for both the Department of Health and the Department of Veteran’s Affairs.

The EOI does not include the face-to-face services provided by Medicare.

The EOI process will inform the Government whether the commercial sector can deliver greater efficiency, flexibility and agility to the MBS and PBS processes.

The commercial sector may be able to provide a better service to Australians at a lower cost to the taxpayer, if so patients, doctors and the Government will reap the benefits and savings.

Commercial organisations already provide services to government involving large amounts of data and transactions.

The Department of Health is now seeking Expressions of Interest through advertisements in the media which provide information and details of the EOI process.

The EOI will close on August 22.

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