Practice Incentives Program (PIP)—entry and eligibility
Applying for the PIP
If a practice wants to join the PIP, they must complete an application package. This can be obtained by downloading a PIP and GPII application form or by calling the PIP Enquiry Line on 1800 222 032**.
To submit the completed application and requested supporting documentation:
Email pip@humanservices.gov.au
Fax 1300 587 696
Write Practice Incentives Program
GPO Box 2572
ADELAIDE SA 5001
Applications are accepted by email if the signed completed application and supporting documentation are attached in a PDF file. Applications are assessed by Medicare Australia and practices will be advised in writing of their eligibility. If necessary, Medicare Australia will contact the practice for additional information.
Note: the submission of an incomplete application forms can result in a delay to the practice approval process.
Medicare Australia may request evidence that a practice is continuing to meet the criteria it has initially claimed, make enquiries by phone or cross-check information provided by the practice with other data held by Medicare Australia.
Medicare Australia will audit a selection of practices annually to verify they are continuing to meet the various elements they have claimed.
Entry requirements and eligibility criteria
New applicants
New applicants must complete a PIP and GPII application form and supply the required supporting documentation.
To be eligible to participate in the PIP, a practice must be accredited, or registered for accreditation, against the Royal Australian College of General Practitioners (RACGP) Standards for general practices. Practices must achieve full accreditation within 12 months of joining the PIP and maintain full accreditation thereafter.
Basic entry to the Program
The PIP guidelines require that all participating practices, including their associated or branch practice, be formally accredited as general practices.
The PIP is available to general practices that are accredited, or registered for accreditation against the RACGP Standards for General Practices (3rd Edition). General practices are broadly defined by the RACGP guidelines as displaying the key features of providing:
initial, continuing, comprehensive and coordinated medical care for individuals, families, and communities and which integrates biomedical, psychological, social and environmental understandings of health.
Other associated practices
For the purposes of PIP, practices with multiple locations will only be regarded as a single practice where one or more of the doctors practising at one location also practices at one or more of the other locations.
Additional practice locations of PIP practices (known as practice branches) with 3000 or more services per annum must be accredited or registered for accreditation to be included in the calculation of the PIP practice payment. If registered for accreditation, the practice branch will need to be accredited within 12 months of registration.
Practice branches with less then 3000 services per annum identified on the application form are included in the calculation of PIP payments for the main practice location, whether or not they are accredited in their own right.
It is not mandatory for a practice branch to be accredited. However, if the practice branch provides 3000 or more services per annum and is not accredited, then those services will be excluded from the practice payment.
Specific eligibility criteria—new practice applications
To be eligible for participation in the PIP and to receive the correct payment, a practice must provide documented evidence that:
- it is accredited or it is registered for accreditation (see below), and
- all medical practitioners at the practice have completed the Individual General Practitioner Details and Declaration section of the application form.
Accreditation timetable
Practices must be accredited within one year of the date they join the PIP, and maintain accreditation to remain eligible for the PIP.
PIP and practice accreditation
Accreditation is available through two approved organisations:
Australian General Practice Accreditation Ltd (AGPAL)
Call 1300 362 111*
Australia General Practice Accreditation website
Quality Practice Accreditation Pty Ltd
through the General Practice Australia (GPA) Accreditation plus program
Call 1800 188 088**
General Practice Australia website
Under the accreditation process, practices initially register for accreditation and then undertake a cycle of accreditation that involves:
- self-assessment against agreed standards
- peer review surveys (practice visits) of the practice's organisation and facilities, and
- the start of a continuous quality improvement cycle.
A practice is accredited on successful completion of the peer review survey.
Note: practices who use the services of Medical Deputising Services (MDS) to meet their accreditation requirements and related obligations under the PIP can only do so if the MDS are themselves registered for accreditation or are fully accredited as an MDS (as defined by the RACGP guidelines).
It is the responsibility of the practice to notify Medicare Australia when they have been fully accredited.
* Call charges apply.
**Call charges apply from mobile and pay phones only.
Last updated: 23 November, 2011