Medicare initiatives and programs

Signed by all Australian governments, the 2020–25 Addendum to National Health Reform Agreement (NHRA) aims to improve health outcomes for all Australians and ensure our health system is sustainable.

This project aims to remove the legislative need for collaborative arrangements between participating midwives, nurse practitioners and medical practitioners to provide Medicare Benefits Schedule (MBS) services and prescribe Pharmaceutical Benefits Scheme (PBS) medications.

Electronic prescribing is now widely available. It provides an option for prescribers and their patients to use an electronic prescription as an alternative to paper prescriptions. Paper prescriptions are still available.

From 1 November 2023, we are increasing Medicare Benefits Schedule (MBS) bulk billing incentive payments for Commonwealth concession card holders and children under 16 years of age for a range of MBS consultation items.

The Medical Treatment Overseas Program (MTOP) helps approved Australians who have a life-threatening medical condition access life-saving medical treatment overseas where treatment is not available in Australia.

The MBS Continuous Review ensures the MBS continues to support high-quality care, remains flexible, and stays up to date. We do this through a process of ongoing expert reviews.

The MBS Review considered how MBS items could be better aligned with contemporary clinical evidence and practice, to improve health outcomes. The review ran from 2015 to 2020. The Australian Government is progressively considering and implementing the recommendations.

The expanded eligibility for aged care residents under the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access) initiative, through GP referral, ceases on 31 December 2022.

Medicare Urgent Care Clinics (UCCs) give you and your family more options to see a doctor or nurse when you need care for urgent, but not life-threatening illnesses or injuries.

MyMedicare is a new voluntary patient registration model. It aims to formalise the relationship between patients, their general practice, general practitioner and primary care teams. Find out who is eligible and how you can register.

The Practitioner Review Program (PRP) identifies and intervenes where practitioners’ and corporate entities’ activities under Medicare, the Pharmaceutical Benefits Scheme (PBS), and the Child Dental Benefits Scheme (CDBS) may indicate potential inappropriate practice.

The Quality Use of Pathology Program (QUPP) provides grants for projects that improve the management, delivery or use of Medicare pathology services.

The Radiation Oncology Health Program Grants Scheme helps public and private radiation oncology providers in areas of greatest need to purchase eligible radiation therapy equipment.

If we detect incorrect Medicare payments during a compliance audit, the Shared Debt Recovery Scheme allows us to split a debt between the practitioner and the person who manages their billing and claiming.

This initiative gives general practitioners (GPs) an opportunity to self-assess their pathology referral process using data relevant to them. It supports quality use of pathology requests, or other alternatives if they are a better choice.

This review examines how effective our current health workforce ‘distribution levers’ are. These levers consist of policies and geographic classifications that are intended to distribute health workforce across areas that need them most.