Telehealth - background

Medicare rebates for telehealth services have helped many Australians with ME/CFS to have better access to medical care. However, access to telehealth services has been reduced by both the previous Coalition and current Labor governments.

None of these changes have taken into account the impact on people with serious chronic illnesses like ME/CFS.

Telehealth rebates are something our community has been lobbying for since before the pandemic. These rebates offer access to medical care for the most vulnerable in our community. It’s devastating that a country like Australia is denying access to healthcare to very sick patients. Prior to its election, the government promised that there would be #NoOneLeftBehind. We think they should keep their promise.

How are telehealth rebates being made less accessible to people with chronic illnesses like ME/CFS?

Existing relationship rule

To be eligible for telehealth rebates, patients must have had a face-to-face appointment with their GP (or a GP at their regular clinic) in the previous 12 months. There are some exemptions to this rule (eg: children under 12, people who are homeless, and patients accessing specific services such as smoking cessation or pregnancy counselling), but being house- or bedbound with chronic illness is not one of them.

Short phone consultations

Medicare rebates are available for short phone consultations (less than 20 minutes) or for video consultations of any duration. The government argues that this means that telehealth is still widely available. However video consultations are not suitable for many ME/CFS patients (either they don’t have access to the technology or they can’t tolerate video calls), and ME/CFS patients have complex health care needs that often require appointments which exceed 20 minutes.

Proposed 80/20 and 30/20 rules

These rules are designed to actively discourage GPs from utilising telehealth services with patients, by restricting how many Medicare claims for telehealth services a GP lodges. GPs found to have been undertaking what is considered “too many” telehealth appointments will be deemed to be “practising inappropriately”.

What’s considered “too many” telehealth appointments? More than 80 phone or video consults per day on 20 days in a 12 month period, or more than 30 phone consults per day on 20 days in a 12 month period. With standard appointment times of 10-15 mins, it wouldn’t be difficult to exceed these limits.

These rules were proposed by the previous government and have been approved by the current government. The 80/20 and 30/20 rules were due to commence on July 1, but have been delayed for 3 months. This delay is not because the Health Minister doesn’t agree with the rules, but simply because of the high rate of COVID cases during winter.