Practice Incentives Program quarterly news update
It’s time to re-register your eligible Aboriginal and/or Torres Strait Islander patients for the Indigenous Health Incentive for 2014.
This can be done using PIP Online through Health Professional Online Services (HPOS). It’s quick, easy and you don’t need to send us any paperwork. It also tells you straight away whether you’ve successfully registered your patients.
If you register your patients online you don’t need to send us the patient consent form, but you must keep it on file at your practice.
Your practice will need a Medicare Public Key Infrastructure (PKI) Individual Certificate to access HPOS. To register for a PKI certificate and access HPOS, go to HPOS.
The Indigenous Health Incentive re-registration process doesn’t apply to patients who are at risk of a chronic disease and are already registered for the Pharmaceutical Benefits Scheme (PBS) Co-payment Measure. The PBS Co-payment Measure is a once-only registration. Registration for the PIP Indigenous Health Incentive and the PBS Co-payment Measure are independent of each other. If a patient develops a chronic disease then they may be registered for the Indigenous Health Incentive.
If you don’t have access to PIP Online through HPOS, complete the Indigenous Health Incentive and PBS Co-payment Measure patient registration and consent form available from Forms and guidelines.
Make sure you complete each part of the form, including the section on patient consent, and send all parts to us.
For more information on the Indigenous Health Incentive read the guidelines.
The timeframe to commission a compliant secure messaging product for Requirement 2 of the PIP eHealth Incentive was extended.
For the November 2013 eHealth Incentive payment, practices are considered to be compliant with Requirement 2 if they booked, arranged or registered for a compliant secure messaging product to be commissioned by 1 August 2013, and commissioning was completed by 31 October 2013.
Practices must keep evidence that a suitable booking was arranged by 1 August 2013 in case of an audit.
All other aspects of Requirement 2 and other requirements of the PIP and the PIP eHealth Incentive must still be met as outlined in the PIP eHealth Incentive guidelines.
The PIP eHealth Incentive guidelines are available on the Forms and guidelines page.
The commissioning requirements for Secure Message Delivery are available at nehta.gov.au/pip
Procedural GPs need to provide the required number of procedural services related to the appropriate tier for which PIP payments will be made. Those services must be claimed within the relevant six month reference period.
There are four possible tiers of procedural payments that show the number and extent of procedural activity of each GP. More information on the tiers and the required number of services for each level are outlined in the Procedural General Practitioner Payment guidelines.
If procedural GPs don’t provide the required number of procedural services in the six month reference period, your practice must tell us in writing no later than seven days before the relevant ‘point in time’ date.
Audits are done annually on selected practices to verify their eligibility for PIP/PNIP payments and to maintain program integrity.
If your practice is selected for an audit, you must be able to show you meet the eligibility criteria for payments you have received. This includes accreditation, public liability insurance and evidence that all GPs, registered/enrolled nurses, aboriginal health workers and allied health professionals employed at the practice have professional indemnity insurance. Note: practices must be able to provide documents for all GPs, registered/enrolled nurses, aboriginal health workers and allied health professionals employed at the practice during the dates outlined in the audit period, even if these professionals are no longer employed at the practice.
We’re obliged to start recovery proceedings under the Financial Management and Accountability Act 1997 where non-compliance has been identified.
On 1 October 2013, a kidney function test was added to the minimum requirements for eligible patients’ annual diabetes cycle of care under the PIP Diabetes Incentive. This test is an annual measurement of a patient’s estimated Glomerular Filtration Rate (eGFR).
To receive the PIP Diabetes Service Incentive Payment, GPs must include an eGFR measurement in the patient’s annual cycle of care.
When GPs have completed the minimum cycle of care requirements, they can claim the PIP specific diabetes MBS item numbers from Group A18 or A19. This allows us to check GPs have met the minimum requirements of the annual cycle of care.
Relevant MBS items will be updated to include the eGFR measurement.
We’ve updated the overall PIP application form and the PIP eHealth Incentive application form.
Our guidelines are also being updated and a revised version of the Indigenous Health Incentive guidelines clarifying the requirements for cultural awareness training is available.
All PIP forms and guidelines are available on the Forms and guidelines page.
We have a range of education products available to help health practitioners bill accurately under Medicare.
Some practitioners may not realise they are legally responsible for services billed to Medicare under their Medicare provider number or in their name, regardless of who does the billing or receives the benefit.
Practitioners can watch a new video which helps explain their legal responsibilities and what they need to know when billing under Medicare. The video is available at youtu.be/89ckoc0dA2o
Updated eLearning programs—Medicare for new health professionals and Medicare for dentists—are also available. The programs are a flexible, interactive and free of charge learning option. They’re available on the Online education services page.
For more information including case studies on billing accurately under Medicare, go to the Billing accurately under Medicare page.
You must tell us in writing, no later than seven days before the relevant ‘point in time’ date, if your practice details have changed. This includes if your practice has:
- changed its authorised contact person
- amalgamated with another practice
- had a change of ownership
- changed bank details, or
- changed circumstances and is no longer eligible for an incentive.
You must also tell us if your practice has a new GP, or if a GP has left.
The ‘point in time’ eligibility assessment dates and Standardised Whole Patient Equivalent (SWPE) reference periods for each quarterly payment are in the table below.
|Quarterly payment month||Point in time assessment of eligibility||SWPE value reference period|
|February||31 January||1 October to 30 September|
|May||30 April||1 January to 31 December|
|August||31 July||1 April to 31 March|
|November||31 October||1 July to 30 June|
PNIP is a separate program to PIP. You should lodge your PNIP forms separately to PIP wherever possible if using mail or fax.
Completing PNIP quarterly confirmation statements
The next PNIP quarterly confirmation statements will be issued in January 2014.
Practices that chose to get their quarterly confirmation statement online can access it through the HPOS mail centre on 6 January.
To make sure your practice’s payments aren’t withheld, complete all parts of the statement. Your practice’s authorised contact person or owner must sign the statement and return it to us on or before 31 January 2014.
If you use HPOS, the email we send you in the HPOS mail centre can be used to confirm your PNIP confirmation statement. You need to confirm on or before 31 January 2014.
With HPOS you can:
- change any incorrect details straight away
- update your health professional hours, and
- get instant confirmation that you’ve completed the statement to keep on file.
If you’re not registered for HPOS, your practice will get the next quarterly confirmation statement in the mail in mid January.
To register for HPOS, you must have a PKI Individual Certificate linked to your practice. If you haven’t got a PKI Individual Certificate, you can apply for one and register for HPOS by filling in the registration form.
- The fax number for all PNIP documents is 1300 587 696*.
- When you fax documents, you should keep proof that your fax has been delivered. Print the transmission report and make sure it shows your fax number, the number of pages you sent, and the date and time.
- You should set your fax machine to send your fax number with every fax you send, so we can quickly identify your paperwork.
- Email firstname.lastname@example.org if you have any questions about the program.
Note: we can’t accept scanned forms or documents sent to this email address.
Online: Practice Incentives Program
Mail: Incentive Programs
Department of Human Services
GPO Box 2572
ADELAIDE SA 5001
Call: 1800 222 032**
8.30 am to 5.00 pm Monday to Friday, Australian Central Standard Time
Fax: 1300 587 696*
*Call charges apply.
**Call charges apply from mobile and pay phones only.
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Last updated: 2 December, 2013