S19(2) COAG Exemption Initiative_HMA KB Evaluation_Final Report_14 October 2021


Evaluation of the COAG Section 19(2) exemptions initiative – improving access to primary care in rural and remote areas final report

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Publication date: 
14 October 2021
Last updated: 
17 December 2021
Publication type: 
Intended audience: 
General public

Section 19(2) of the Health Insurance Act 1973 (the Act) prohibits the payment of Medicare benefits where other government funding is provided for that service. The COAG Section 19(2) Exemptions Initiative overrides this Section of the Act and allows for Medicare benefits to be paid for approved services by approved eligible sites. The COAG Section 19(2) Exemptions Initiative - Improving Access to Primary Care in Rural and Remote Areas was introduced in 2006 to support the delivery of primary health care services in small rural and remote communities. The Initiative aims to provide greater patient access to primary health care services locally, including after hours in small public hospitals and health services. The Initiative recognises that many patients in small rural and remote towns have limited access to primary health care services and in response to the lack of private practices, many rural and remote public hospitals have employed medical officers to make primary health care services available.

The Evaluation of the Initiative assessed the extent to which the Initiative has been appropriate, effective, efficient and of quality and value to the Commonwealth and participating jurisdictions. Consultations were undertaken with a range of stakeholders including States and the Northern Territory (noting the Australian Capital Territory is not an eligible jurisdiction) as part of the evaluation. Jurisdictions were invited to respond to the draft findings of the evaluation which were considered in the finalisation of the report. The evaluation findings has provided valuable information on the operation and implementation of the Initiative.