On 1 October 2022, Medicare introduced a new ‘prescribed pattern of service’ for telephone attendances, known as the “30/20 Telephone Rule” (the Rule).
A breach of the Rule is prima facie ‘inappropriate practice’ under the Health Insurance Act (the Act) and will lead to sanctions being imposed.
The HWLE Health Team regularly assists medical practitioners who have misunderstood the Rule or due to inadvertent administrative errors, have technically breached the Rule.
What is the 30/20 Telephone Rule?
The Rule states that a medical practitioner who provides 30 or more telephone consultations on 20 or more days in a consecutive 12-month period will be deemed to have engaged in ‘inappropriate practice’ unless there are exceptional circumstances.
The Rule does not apply to consultations that occur via videoconferencing.
The Rule aims to encourage practitioners to engage with their patients, primarily in person. Telehealth should be used only when it is clinically appropriate to do so and when the patient understands the limits of same.
The Rule is consistent with the Guidelines – ‘Telehealth consultations with patients’ released by the Medical Board of Australia.
So, what are the key considerations practitioners should keep in mind?
- The Rule applies to professional telephone attendances only (not in person or video consultations).
- Medical Practitioners should closely monitor their number of telephone attendances and check what is being claimed under their provider number.
- Medical Practitioners with concerns or queries are encouraged to consult their medical indemnity insurer or contact the HWLE Health Team for assistance.
This article was written by Scott Chapman, Partner and Megan Priestley, Special Counsel.
