Practice Stream obligations

Practices that successfully apply for the Practice Stream have ongoing obligations to keep receiving payments.

Maintaining eligibility

Practices are required to maintain their eligibility to receive payments. They must maintain:

• practice accreditation (renewing before it expires)
• employment of at least one full-time or part-time general practitioner
• engagement of at least one eligible health professional
• eligibility for Practice Incentives Program (PIP) – if a PIP consenting practice
• a specified amount of public liability insurance as per the guidelines.

Practices must also ensure all of the health professionals within the practice maintain their correct level of professional liability insurance, as specified in the WIP Practice Stream Guidelines.

Completing Quarterly Confirmation Statements

Practices must confirm the type of health professionals they engaged, and the hours they have worked per week on average, within each quarter. This is done through a Quarterly Confirmation Statement (QCS).

Services Australia sends a QCS to the practice each quarter (except the first quarter the practice is approved for the payment). Services Australia cannot release that quarter’s Practice Stream payment to the practice until it has received the completed QCS from the practice.

Practices receive their QCSs by the 15^th day of the point-in-time month via either:

• their Health Professional Online Services (HPOS) account (if registered with HPOS – this is the fastest and easiest way)
• the regular post (if not registered with HPOS, or if they opt to receive a printed copy by mail).

The QCS includes the current practice details. The authorised contact person or practice owner must complete the QCS by:

• confirming the practice details are correct
• providing details of any changes in practice arrangements, if applicable. This includes changes to the eligible health professionals engaged and/or the hours they worked per week on average.

Submitting the QCS on time

Practices must submit the QCS through either:

• HPOS (by the relevant point-in-time date)
• fax to Incentive Programs (at least 7 calendar days before the relevant point-in-time date).

If a practice does not return a fully completed QCS by the point-in-time date, Services Australia will withhold the practice’s payment until it is received. Services Australia will then assess the statement and release the payment if the practice is eligible.

Point-in-time dates

Record keeping

Practices must keep a copy of all documents relating to the Practice Stream for at least 6 years. This includes the application, supporting documents, and records of hours worked by relevant health professionals.

Audits

Audits are conducted to check practices are complying with Practice Stream eligibility requirements and claims for payments. If a practice cannot substantiate their claims, Services Australia may recover Practice Stream payments for up to 6 years.

The WIP Practice Stream Guidelines provide details of what evidence a practice must keep to support its claims for payment.

Advising Services Australia of changes

Practices must advise Services Australia of any changes to practice arrangements within 7 calendar days, or at least 7 calendar days before the relevant point-in-time date, whichever is first.

Relevant changes include:

• changes to the authorised contact person(s) for the practice
• practitioners leaving or joining the practice
• changes to the practice’s bank account details
• changes in accreditation status
• changes to the practice location, ownership or amalgamations
• lapses in the practice’s public liability insurance or an individual practitioner’s professional indemnity cover
• changes in hours worked by each eligible health professional
• changes in provider details
• any other information that may affect program eligibility or claims for payment.

The easiest way to do this is online through HPOS. Most changes are effective immediately and can be made up to, and on, the relevant point-in-time date.

Alternatively, practices can complete the relevant form and send it to Services Australia at least 7 calendar days before the relevant point-in-time date. This allows time for manual processing.

If the practice does not notify Services Australia of changes, incentive payments may be reduced, recovered, suspended or ceased.

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