This bill became law on Sep 28th, 2023.
Health, care & disability
The Health Minister can now appoint the head of Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. without the Australian Medical AssociationThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. being able to block the choice, which strengthens the watchdog's independence over MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. billing investigations.
The Philip ReviewThe independent review that found problems in Medicare integrity and recommended the changes this bill makes. exposed that the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. could veto the MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. watchdog’s director, the PSRThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. could stall when its director had a conflict or was absent, and audit consultation rules slowed compliance work. This bill removes the veto, lets peak bodiesMajor representative organisations that speak for a profession or sector and are now consulted directly on some appointments. be consulted directly, creates associate directors and speeds audit document notices.
Before this bill, the Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. was already policing inappropriate MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. practice, but the law let the Australian Medical AssociationThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. block the appointment of its director, forced other appointments through the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments., and left key decisions vulnerable to delay if the director had a conflict, absence or heavy workload. After the Philip ReviewThe independent review that found problems in Medicare integrity and recommended the changes this bill makes. began in November 2022 and reported on 4 April 2023, the government moved legislation to remove the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. veto, allow direct consultation with peak bodiesMajor representative organisations that speak for a profession or sector and are now consulted directly on some appointments., create associate directors and speed audit document notices, with Parliament passing it in September 2023.
The main criticism was that the reforms were developed with too little consultation and could weaken ongoing engagement with doctors and other stakeholders as MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. compliance powers were streamlined. That concern came mainly from Coalition speakers, who still backed the bill and wanted closer Senate scrutiny rather than opposing the changes outright.
Ged Kearney MP introduced this bill. It passed on the voices.
Did it become law?
Yes
Became law 28 Sept 2023
Final passage
Passed without a counted vote
Members called out ‘aye’ or ‘no’ — no individual votes were recorded.
Passage speed
127 days
From introduction to the latest recorded parliamentary step
Meaning
The Health Minister can now appoint the head of Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. without the Australian Medical AssociationThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. being able to block the choice, which strengthens the watchdog's independence over MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. billing investigations.
Appointments of Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. medical deputies, panel members and authority members can now be discussed directly with relevant peak professional bodies instead of going through the Australian Medical AssociationThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments..
Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. can now use Associate Directors who can make the same key decisions as the Director in individual MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. compliance matters when needed.
The new Associate DirectorA new senior role that can step in and make the same decisions as the Director in some cases when needed. roles let Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. keep working when the Director has a conflict, is away, or workload pressures rise, and they also broaden the medical expertise available.
MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. auditors no longer have to consult stakeholder groups before issuing a notice to produce documentsA formal request requiring a person or provider to hand over papers or records for an audit or review., which speeds up audits while leaving audited providers able to respond and provide their own material.
Currently the Act prohibits the Minister from appointing a person as Director of the PSR unless the AMA agrees, effectively giving the AMA a ‘veto power’ over the appointment of the Director. The current arrangement is inconsistent with public expectations regarding the independence of the PSR and may undermine public confidence in its role as a regulator. Given the potential conflict between the PSR’s objective to safeguard Medicare and the AMA’s role in representing the interests of medical practitioners who may be subject to PSR review, it is appropriate for the veto power to be removed.Health Insurance Amendment (Professional Services Review Scheme) explanatory memorandum
The Bill will also enable direct consultation with relevant peak bodies regarding appointments of medical practitioners as Deputy Directors and Panel members of the PSR, instead of making arrangements for the AMA to provide advice, as is the current requirement. Similarly, the Bill removes the requirement to consult with the AMA on the appointment of the Chair and other members of the Determining Authority. Instead, the Minister is to consult directly with relevant peak bodies on appointments of medical practitioner members of the Determining Authority, which is consistent with current requirements for other health practitioners.Health Insurance Amendment (Professional Services Review Scheme) explanatory memorandum
The Bill also creates a new statutory office of Associate Director of the PSR. Associate Directors would be able to exercise the same powers as the Director for particular cases as necessary. Under the current Part VAA of the Act, the majority of the Director’s functions, duties and powers cannot be exercised by another person. This includes key aspects of the PSR Scheme, including the threshold question of whether to undertake a review, and if a review is undertaken, whether to negotiate a written agreement with the person, to refer them to a Committee of peers, or to take no further action. There are currently no provisions in the Act in the event that the Director has a conflict of interest or is otherwise unable to make decisions on a case.Health Insurance Amendment (Professional Services Review Scheme) explanatory memorandum
The appointment of Associate Directors will assist with managing conflicts of interest, unexpected absences and workload pressures. The Minister will be able to appoint one or more Associate Directors at the same time, depending on the operational needs of the PSR. Having multiple full and/or part-time appointments will also allow for recruitment of more wide-ranging medical expertise.Health Insurance Amendment (Professional Services Review Scheme) explanatory memorandum
The Bill also removes the requirement for reasonable steps to be taken to engage with stakeholder groups prior to issuing a notice to produce documents during an audit of whether Medicare benefits should have been paid. Consulting with a non-regulated entity about a regulated entity does not demonstrate clear and accountable natural justice to the regulated entity. This amendment will streamline the audit process without limiting the documents or other information that a person may provide. There will be no impact on procedural fairness requirements during an audit. A person being audited will continue to have the opportunity to make submissions about their matter and to provide any information or documents they consider relevant.Health Insurance Amendment (Professional Services Review Scheme) explanatory memorandum
Context
Before this bill, the Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. was already policing inappropriate MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. practice, but the law let the Australian Medical AssociationThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. block the appointment of its director, forced other appointments through the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments., and left key decisions vulnerable to delay if the director had a conflict, absence or heavy workload. After the Philip ReviewThe independent review that found problems in Medicare integrity and recommended the changes this bill makes. began in November 2022 and reported on 4 April 2023, the government moved legislation to remove the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. veto, allow direct consultation with peak bodiesMajor representative organisations that speak for a profession or sector and are now consulted directly on some appointments., create associate directors and speed audit document notices, with Parliament passing it in September 2023.
Independent MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. integrity review begins
The government commissioned Dr Pradeep Philip to examine MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. integrity and compliance arrangements, including how the Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. and audit processes were working.
Health Insurance Amendment (Professional Services Review Scheme) explanatory memorandum ↗Philip ReviewThe independent review that found problems in Medicare integrity and recommended the changes this bill makes. report identifies problems in the watchdog scheme
The final report recommended priority changes after identifying the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. veto over the PSRThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. director, bottlenecks when the director could not act, and slower compliance work caused by existing consultation rules.
Health Insurance Amendment (Professional Services Review Scheme) explanatory memorandum ↗Government introduces the bill to change the PSRThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. scheme
The bill was introduced to implement those priority recommendations by removing the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. veto, allowing direct consultation with relevant peak bodiesMajor representative organisations that speak for a profession or sector and are now consulted directly on some appointments., creating associate directors and streamlining audit document notices.
Parliamentary timeline ↗Parliament passes the bill
Both houses passed the bill in the same form, clearing the way for the MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. watchdog and audit changes to become law.
Parliamentary timeline ↗Royal Assent makes the changes law
Royal Assent turned the bill into an Act, completing the legal step needed for the PSRThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. independence and operational changes to take effect.
Parliamentary timeline ↗Legislative route
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
Introduced and read a first time
A minister or sponsoring member moved the second reading, opening the main debate on the bill's purpose and principles.
Second reading moved
The bill reached this recorded parliamentary step.
The chamber agreed to the bill at second reading, meaning it accepted the bill in principle and allowed it to continue.
Second reading agreed to
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Third reading agreed to
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
Introduced and read a first time
A minister or sponsoring member moved the second reading, opening the main debate on the bill's purpose and principles.
Second reading moved
Referred to Committee (15/06/2023): Senate Community Affairs Legislation Committee; Committee report (23/08/2023)
Referred to committee
APH bill page notesThe bill reached this recorded parliamentary step.
The chamber agreed to the bill at second reading, meaning it accepted the bill in principle and allowed it to continue.
Second reading agreed to
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Third reading agreed to
Both houses passed the bill in the same form, completing parliamentary passage.
Finally passed both Houses
The Governor-General gave Royal Assent, turning the bill into an Act.
Key criticism
The main criticism was that the reforms were developed with too little consultation and could weaken ongoing engagement with doctors and other stakeholders as MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. compliance powers were streamlined. That concern came mainly from Coalition speakers, who still backed the bill and wanted closer Senate scrutiny rather than opposing the changes outright.
No party represented in the debate opposed the bill, and criticism was limited and procedural.
Poor consultation and stakeholder engagement
Critics said the government had not consulted enough on the reforms and warned that removing some consultation requirements from the audit process should not mean less practical engagement with affected professional groups.
Reforms seen as too limited
One independent MP argued the bill made sensible fixes but was only a small step, and that much stronger and faster MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. integrity reforms were still needed beyond these technical changes.
Further sources
Votes
The bill passed both chambers on the voices, so there is no list of individual Aye and No votes for final passage.
House agreed to the bill's third reading on the voices, so there is no list of individual Aye and No votes for final passage in that chamber.
Passed on the voices
In a voice vote, members call out Aye or No and the presiding officer judges which side has it. Individual names are only recorded if a formal division is called.
Senate agreed to the bill's third reading on the voices, so there is no list of individual Aye and No votes for final passage in that chamber.
Passed on the voices
In a voice vote, members call out Aye or No and the presiding officer judges which side has it. Individual names are only recorded if a formal division is called.
Parliamentary debate
Start here — lead voices
Ged Kearney supports the bill, saying it will modernise and strengthen the MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. compliance and Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. system to protect public money and keep the scheme independent and effective.
Read in Hansard ↗Ryan supports the bill and says it makes sensible changes to the Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. Scheme, especially by reducing the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments.'s veto role and streamlining appointments and audit processes.
Read in Hansard ↗Watt supports the bill and says it will strengthen MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. integrity by modernising the Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. scheme, removing the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments. veto over key appointments, and speeding up compliance processes.
Read in Hansard ↗McBride strongly supports the bill, saying it is essential to protect MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services.’s integrity by removing the AMAThe main doctors' lobby group, which the old law gave a blocking role in some Professional Services Review appointments.’s veto over appointments to the Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. and improving the scheme’s independence.
Read in Hansard ↗All speeches by bloc
7 speakers · 8 contributions · 7 support
“The Government is committed to protecting the integrity of Medicare. This Bill makes a number of priority amendments in response to recommendations from the Review.”Read the full speech in Hansard ↗
“I am very pleased to support the member for Cooper and the legislation that we're putting through the House. As I mentioned earlier, it is absolutely critical that all Australians have confidence in Medicare, in our universal system of care. That's so they know they're receiving the right kind of care and that all health practitioners will conduct themselves professionally and behave in a way in accordance with the professional standards of their discipline and the community expectations of healthcare workers. So I'm very pleased today to be able to support this legislation.”Read the full speech in Hansard ↗
“The measures in this bill will strengthen the operation of the PSR, as well as improving the current process for the auditing of Medicare payments.”Read the full speech in Hansard ↗
“This bill will benefit all Australians by supporting the integrity of Medicare. It is very important that we, as politicians, understand the importance of making sure that Medicare remains the centrepiece of our healthcare system in Australia.”Read the full speech in Hansard ↗
Hansard records 2 separate contributions by Ged Kearney on this bill. They are grouped here so the speaker is listed once.
Second reading speech
Ged Kearney supports the bill, saying it will modernise and strengthen the MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. compliance and Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. system to protect public money and keep the scheme independent and effective. She argues the changes remove conflicts of interest and speed up audits without reducing fairness.
“The government is committed to protecting the integrity of Medicare. This bill makes several priority amendments in response to recommendations from the review.”Read this contribution in Hansard ↗
Second reading speech
Kearney supports the bill, saying it is a timely response to the MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. integrity review and will make the Professional Services ReviewThe watchdog scheme that checks whether health professionals have used Medicare appropriately and can investigate or sanction poor practice. Scheme more independent, faster, and better able to protect MedicareAustralia's public health insurance program, which pays benefits for many doctor and other health services. compliance. She argues it strengthens the regulatory framework without stopping audited people from making submissions or providing documents.
“The Medicare program provides universal access for all Australians to most healthcare services. The Health Insurance Amendment (Professional Services Review Scheme) Bill 2023 is a timely and appropriate response to issues raised in the independent review of Medicare integrity and compliance. The bill removes the veto power of the Australian Medical Association over the appointment of the Director of Professional Services Review, known as the PSR. The bill also amends consultation requirements for appointing other statutory office holders of the PSR, enabling direct consultation with relevant peak bodies. This will ensure the regulator can operate with impartiality and independence and will improve public perceptions of the fairness and integrity of Medicare. The bill also allows for the appointment of associate directors of the PSR, which will provide for the alternative decision-makers to manage conflicts of interest, unexpected absences and workload pressures for the director. This will allow PSR matters to be finalised more quickly in some cases. One of the key issues identified in the review of Medicare integrity and compliance was the length of time the compliance processes currently take. Both practitioners under review in the community will benefit from faster resolution of compliance issues.”Read this contribution in Hansard ↗
“I rise to speak in support of the Health Insurance Amendment (Professional Services Review Scheme) Bill 2023. This is a classic Labor bill. It's a classic Labor bill because it seeks to strengthen Medicare, which every year enables millions of Australians to access our country's world-class health care. And it's a classic Labor bill because it seeks to improve integrity and trust in our public institutions. This bill will do that by enabling direct consultation with peak bodies when it comes to the appointment of statutory office holders of the PSR, rather than consulting through the AMA. It does that by creating the position of associate directors to make the director of the PSR more accountable. And it does that by removing the veto power of the Australian Medical Association over the appointment of the Director of Professional Services Review. In short, it means more accountability and more transparency through more independence.”Read the full speech in Hansard ↗
“The Health Insurance Amendment (Professional Services Review Scheme) Bill 2023 is a timely and appropriate response to issues raised in the independent review of Medicare integrity and compliance.”Read the full speech in Hansard ↗
2 speakers · 2 support
“Once again, the coalition will support this bill and the proposed changes, in the interests of increasing transparency of the Professional Services Review scheme; however, we put on record our concerns about the removal of consultation and engagement with stakeholders.”Read the full speech in Hansard ↗
“The opposition will support the passage of this legislation through the House but we will take the time to explore these reforms properly in the Senate.”Read the full speech in Hansard ↗
1 speaker · 1 support
“nator STEELE-JOHN () (): I am speaking on behalf of the Greens in support of this bill, the Health Insurance Amendment (Professional Services Review Scheme) Bill 2023. The bill removes the requirement for the AMA to agree to the appointment of the Director of the Professional Services Review, PSR, on the basis that the current arrangement is inconsistent with public expectations regarding the independence of the PSR.”Read the full speech in Hansard ↗
1 speaker · 1 support
“Sunlight is the best medicine, and we need it now to ensure that our Medicare system and our health system more broadly remain an international exemplar for what modern health care should look like. I commend this bill to the House.”Read the full speech in Hansard ↗
Record
House · Introduced and read a first time
Introduced
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
House · Second reading moved
Second reading opened
A minister or sponsoring member moved the second reading, opening the main debate on the bill's purpose and principles.
House · Second reading debate
Second reading debate
The bill reached this recorded parliamentary step.
House · Second reading agreed to
Second reading agreed
The chamber agreed to the bill at second reading, meaning it accepted the bill in principle and allowed it to continue.
House · Third reading agreed to
Third reading agreed
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Senate · Introduced and read a first time
Introduced
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
Senate · Second reading moved
Second reading opened
A minister or sponsoring member moved the second reading, opening the main debate on the bill's purpose and principles.
Senate · Second reading debate
Second reading debate
The bill reached this recorded parliamentary step.
Senate · Second reading agreed to
Second reading agreed
The chamber agreed to the bill at second reading, meaning it accepted the bill in principle and allowed it to continue.
Senate · Third reading agreed to
Third reading agreed
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Parliament · Finally passed both Houses
Passed both houses
Both houses passed the bill in the same form, completing parliamentary passage.
Assent · Assent
Assent
The Governor-General gave Royal Assent, turning the bill into an Act.
Senate Community Affairs Legislation Committee; Committee report (23/08/2023)
Referred to committee
Referred to Committee (15 June 2023): Senate Community Affairs Legislation Committee; Committee report (23 Aug 2023)
APH bill page notes
