Medicare - COAG Scheme (Council of

Australian Governments)

Learning objectives Understand the reasons for the

development of the COAG Scheme

What needs to occur to progress implementation

Background of COAG Meeting in February 2006 of Council of

Australian Governments between the Commonwealth & State leaders

Discussion on practical initiatives to improve health services

Purpose

The initiative will provide exemptions under section 19(2) of the Health Insurance Act 1973 to enable Medicare rebates to be claimed for state remunerated primary health care services (non-admitted and non-referred patients) in some Rural and Remote communities

Criteria for access to COAG

Population Workforce issues Agreed by government as in scope Consent to agree with local plans Funds to be used in the community No threat to private practices

Negotiations Extensive negotiations with

stakeholders has occurred

Local flexibility with arrangements are necessary. Consideration should be given to equity between communities and parties involved.

Implementation Process Identify site Information package Negotiate with all stakeholders Support in writing Intended enhancement to services Timeframe Local communication plan

Application of Funds Funds generated must be used in

communities eg Support for locum cover Employing additional

doctors/nurses/allied health and other supporting staff

Chronic Disease initiatives Professional development

Revenue Raised Not to be considered the most

significant benefit Some financial recognition should

be given to the person/organisation doing the Medicare billing

Mechanisms need to be in place to oversee the use of the funds

What items can be billed GP type service items as per the

Medicare Benefits Schedule Nurse Practitioner items provided on

behalf of the GP Allied Health Professional items

provided under Enhanced Primary Care Chronic Disease and Care Planning

items

Reporting Annually to the Commonwealth

to indicate how much revenue was claimed and how the revenue was used to enhance primary health care in the community

Learning Activity

Please complete the following

learning activity