Fact Sheet – Class exemptions under section 19AB of the Health Insurance Act 1973
What is a class exemption?As part of the Australian Government’s focus on reducing red tape, the Department of Health (Health) and the Department of Human Services (DHS) have been working to simplify the Medicare provider number (MPN) application process for Overseas Trained Doctors (OTDs) and foreign graduates of an accredited medical school (FGAMS). The MPN application process has been significantly simplified for most OTDs and FGAMS by the introduction of several class exemptions under s 19AB of the Health Insurance Act 1973 (the HIA).
Class exemptions cover groups or ‘classes’ of doctors, allowing them to satisfy the s19AB HIA requirements. If a doctor belongs to one of the classes, DHS will grant them an MPN without having to seek an assessment from Health. This means:
- a single agency (DHS) takes responsibility for assessing the application and granting the Medicare provider number; and
- the applicant doctor will receive their provider number more quickly.
What class exemptions have been made?The attached table identifies each of the current s19AB class exemptions and explains the respective groups of doctors who are covered. The class exemptions primarily cover doctors who require a provider number to address a known medical workforce shortage, including working in:
- recognised District of Workforce Shortage (DWS) or for an after-hours service provider;
- the Northern Territory;
- a medical specialty that has very few qualified practitioners across Australia; or
- an approved placement under one of the various general practice workforce and training programs.
When can a doctor start claiming Medicare Benefits Schedule (MBS) rebates under a class exemption?DHS must apply the class exemption before an OTD or FGAMS is eligible to claim MBS rebates. A restricted doctor must confirm that they have been granted an exemption and MPN before they can consult patients. MPNs cannot be backdated and it is each medical practitioner’s responsibility to ensure that their provider number is in place before commencing practice.
Further work on class exemptionsHealth is continuing to work with DHS to make further class exemptions. This fact sheet will be updated to cover the new class exemptions as they are signed into effect.
If you have questions regarding any of the class exemptions, please contact Health by emailing: 19AB@health.gov.au.
|Class exemption name||Date of Effect||Coverage and description|
|Rural Locum Relief Program||27 Sept 2016||Covers OTDs and FGAMS for the purpose of completing approved placements on the Rural Locum Relief Program.|
|Queensland Country Relieving Doctors Program||27 Sept 2016||Covers OTDs and FGAMS for the purpose of completing approved placements on the Queensland Country Relieving Doctors Program.|
|Special Approved Placements Program||27 Sept 2016||Covers OTDs and FGAMS for the purpose of completing approved placements on the Special Approved Placements Program.|
|Aboriginal and Torres Strait Islander Specific Primary Health Services||27 Sept 2016||Cover OTDs and FGAMS who are employed by government-funded Aboriginal and Torres Strait Islander Specific Primary Health Services as defined in the Health Insurance (Section 19AB Exemptions) 2016.|
|Australian General Practice Training Program||16 Nov 2015||Covers GP Registrars who undertake placements on the rural and the general pathway of the AGPT Program, with the exception of extended skills placements and extensions awaiting fellowship.|
|District of Workforce Shortage||2 Nov 2015||Covers GPs, radiologists, anaesthetists, general surgeons, psychiatrists and cardiologists who are seeking to practise at a street address that is identified as DWS for their specialty on the DoctorConnect locator map.|
|Specialties in acute shortage||1 July 2014||Some specialties are considered to be DWS across Australia. Covers OTDs and FGAMS who are specialists in cardiothoracic surgery, dermatology, emergency medicine, endocrinology, geriatric medicine, gastroenterology, general medicine, haematology, intensive care medicine, nephrology, neurology, neurosurgery, orthopaedic surgery, paediatric medicine, paediatric surgery, plastic and reconstructive surgery, urology, and vascular surgery.|
|Northern Territory||1 July 2014||Covers OTDs and FGAMS seeking to work in the Northern Territory (which is DWS for all specialties) as long as they do not need a 3GA program placement to qualify for a Medicare provider number.|
|Temporary residents working in after-hours||1 July 2014||Covers non-specialist OTDs and FGAMS for after-hours employment engagements while they are Australian temporary residents.|
|Specialists working in after-hours||1 July 2014||Covers OTDs and FGAMS who have satisfied the specialist recognition requirements of s19AA of the HIA for after-hours employment engagements.|
|Class exemption Name||Date of Effect||Coverage and description|
|Remote Vocational Training Scheme||1 July 2014||Covers OTDs and FGAMS for the purpose of completing approved placements on the Remote Vocational Training Scheme.|
|Approved Medical Deputising Service Program||19 Sept 2011||Covers OTDs and FGAMS for the purpose of completing approved placements on the Approved Medical Deputising Service Program.|
|Approved Private Emergency Department Program||19 Sept 2011||Covers OTDs and FGAMS for the purpose of completing approved placements on the Approved Private Emergency Department Program.|
|Moratorium Scaling||1 July 2010||Covers OTDs and FGAMS once they are scaled off their ten year moratorium.|
|Assistance at operations||1 April 2006||Allows permanent resident OTDs and FGAMS to be granted a provider number for the Assistance-at-Operations provisions of the Medicare Benefits Schedule.|
|World Health Organization||18 Oct 2001||Removes DWS requirements from doctors who on 1 January 1997 were:
|Academic Class Exemption||27 Feb 1997||Applies to OTDs and FGAMS who are employed in an academic appointment with an Australian medical school. Allows these doctors to claim Medicare rebates for the clinical services they must perform as part of their academic appointment.|