I rise to make my contribution to the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025. The bill seeks to accomplish a wide range of outcomes. It supports the automation of Medicare provider numbers. It realigns the registration and claim-processing system for private health insurance rebates. It modernises the assignment of Medicare benefits for bulked-billed and simplified billing. It ensures the consequences of breaching a condition and/or withdrawal from the Bonded Medical Program are fairly balanced. And it allows all work completed by a Bonded Medical Program participant in good faith, consistent with the program's objectives, to be counted towards their return-of-service obligation. The bill addresses several matters that will ensure better administration and delivery of key government systems and programs.

Firstly, the bill supports recommendation 2 of the Independent review of Australia's regulatory settings relating to overseas health practitioners to automate and streamline the issuance of Medicare provider numbers. It will amend the Health Insurance Act 1973 to establish the function of allocating Medicare numbers in the Health Insurance Act. It also establishes a power for the Chief Executive Medicare to approve computer programs to issue Medicare provider numbers. The bill will validate Medicare provider numbers previously issued by automation and any that were declined. Medicare provider numbers are currently allocated by the Chief Executive Medicare as one of their functions under the Human Services (Medicare) Act 1973. Amendments made by the bill will enable the Chief Executive Medicare to approve the use of a computer program to make appropriate non-discretionary decisions to allocate provider numbers. Any decision to refuse a provider number would not be made by the computer program but would be reviewed by a human service officer working at Services Australia. The bill will validate Medicare provider numbers that were previously issued by computer programs operated by Services Australia or by its predecessor, the Department of Human Services. The bill will also streamline the application processes for health practitioners, enabling them to receive a Medicare provider number more quickly and start providing health services sooner. The delegated legislation will map out the criteria that must be met in order for a Medicare provider number to be allocated by the use of a computer program to different classes of health professionals and any required transitional rules.

Secondly, the Australian government reimburses private health insurers for the portion of health insurance premiums that are reduced on behalf of the consumer for the private health insurance rebate under the premiums reduction scheme. Rebate payments in excess of $7 billion per year are paid in this manner. Services Australia and the Department of Health, Disability and Ageing became aware that some elements of the registration and claims processing system for the scheme had been administered inconsistently with the requirements of the Private Health Insurance Act 2007 since its introduction. That's why this bill will amend the Private Health Insurance Act 2007 to support the operation of the registration and claims system. This will be done through the introduction of a self-assessment model for claims by insurers for reimbursement of the rebate. The amendments will have a few effects. They streamline the registration requirement for individual participants to align with the current system requirements. They will introduce automated decision-making powers for the Chief Executive Medicare to administer scheme registration and claims. They will ensure any overpayments can be recovered where there are unintended system or process defects.

There are other amendments to support these changes, including requiring the insurer to correctly calculate their claim and provide supporting information or documents on request and allowing the Chief Executive Medicare to approve forms for use under the program. These amendments will support the objective of the premiums reduction scheme and ensure persons are validly registered as participants and that the payment of the rebate to insurers is lawful. The rebate supports the affordability of private health insurance and access to private healthcare services for participants. The delegated legislation will allow the minister to specify criteria that must be met in order for the Chief Executive Medicare to register a participant in the scheme and pay the claim. This is because the current system can conduct only a limited amount of checks. The criteria can be updated if the system is updated into the future to conduct wider ranges of checks. The minister will also be able to change the period which the Chief Executive Medicare takes to refuse a registration if the proposed timeframe does not work as intended. Currently, administratively it allows for 90 days, but this will be reduced to 30 days to provide the applicant with certainty sooner. Additionally, the minister will be allowed to include additional decisions in the Private Health Insurance Act that are considered appropriate to be undertaken using automotive administrative action. This provides allowance for future system upgrades when it may be possible to automate other actions.

Thirdly, the bill amends the Health Insurance Act to remedy identified legal issues and to delay commencement of changes introduced by the Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024. Assignment of benefits is a longstanding requirement of the Health Insurance Act. It provides the basis for government paying Medicare benefits when the patient assigns their right to a Medicare benefit to a medical provider, private health insurer or approved billing agent. The government's assignment of Medicare benefits act responds to the payment authority integrity risks by streamlining the assignment process for patients, medical providers, private health insurers and approved billing agents and enabling digital assignment options. This is rather than the paper based processes currently envisioned in the Health Insurance Act. This bill supports modernising the assignment of Medicare benefits by addressing limitations of the assignment of Medicare benefits act, the Health Insurance Act and supporting regulations. The ability for a patient to assign their Medicare benefits underpins bulk-billing. The bill will delay commencement of schedule 1 of the assignment of Medicare benefits act, which is due to commence on 9 January 2026. Deferring it to 1 July 2026 will support the industry and consumers to comply with new assignment-of-benefits requirements, particularly where this will occur through private sector software which must be updated to reflect the new assignment-of-benefits processes. In the meantime bulk-billing can continue under current processes and arrangements. This will include additional incentives for bulk-billed services which start from 1 November this year in line with the government's election commitment. The government has committed $14.2 billion in 2025-26 to fund the implementation of reforms outlined in the assignment of Medicare benefits act and subordinate regulations. This includes updates to Services Australia software systems and education and communication activities to ensure stakeholders are aware of and prepared for the new digital assignment arrangements. Passage of this bill will ensure that the government's 2025 election commitment of $7.9 billion in bulk-billing incentive payments to encourage increased bulk-billing rates will not be adversely impacted by noncompliant business software. The minister will have the power to create an instrument which categorises existing Medicare Benefits Schedule services. The intended use is in bulk-billing assignment agreements. This information will be shown as a basic service description to assigners when seeking their agreement to assign benefits before services are provided and before the exact Medicare benefit amount to assign is known.

Fourthly, the bill will amend the Health Insurance Act 73 to enhance the Bonded Medical Program. This will ensure the consequences of breaching a condition or withdrawal from the program fairly balance both the personal circumstances of the bonded participant and the broader interests of the community. It will also allow all work completed by the bonded participant in good faith and consistent with the program objectives to be counted towards their return-of-service obligation. Currently, former Medical Rural Bonded Scholarship Scheme participants who voluntarily opted in to the statutory program who failed to complete their return-of-service obligation within the allowed 18-year period or withdrew from the program earlier face repayment of their scholarship and a six-year Medicare ban. While this financial penalty is appropriate, subjecting these doctors to a Medicare ban, which will occur for some starting December 2025, will jeopardise continued service provision and access to care for Australians living in rural, regional and remote communities and perhaps in other areas of workforce shortages. Given broader workforce shortages, a six-year Medicare ban is not in the interests of either the individual bonded doctor or the Australian community.

Removing the ban will also ensure that the consequences of breaching the return-of-service obligation is more consistent for all bonded doctors. Students can currently withdraw from the program without consequences up to the HECS census date in their second year of study. If the student withdraws after that date, they incur a debt to the Commonwealth equal to the full cost of the Commonwealth supported place up to the date of withdrawal. This is in addition to their HECS or HELP liability. The proposed amendment will extend the existing grace period from the HECS census date in the second year of study to the award of a medical degree.

The bill will provide the Minister for Health and Ageing with the capacity to make additional rules to recognise work completed by bonded participants as part of their return-of-service obligation where this is consistent with the program objectives, including work completed prior to transitioning to the statutory Bonded Medical Program. Examples of work that cannot presently be recognised include work undertaken under legacy schemes that are or may become eligible under the program as well as work undertaken in locations erroneously advised by the government as eligible.

The Albanese Labor government continues to build and strengthen our healthcare sector. This legislation is an important step to protect health care and Medicare into the future. I commend the bill to the House.

Link to Hansard: Full Speech