The department delivers many health payments and rebates on behalf of other government departments:

• DVA health services payments
• the External Breast Prostheses Reimbursement Program
• the National Bowel Cancer Screening Program
• the Continence Aids Payment Scheme
• the Child Dental Benefits Schedule
• the Stoma Appliance Scheme
• the Hearing Services Program
• the Practice Incentives Program
• the Practice Nurse Incentive Program.

The department also administers three health registers:

• the National Bowel Cancer Screening Register
• AIR
• the Australian Organ Donor Register.

Department of Veterans’ Affairs health services payments

The department is responsible for making payments to health professionals for health services on behalf of DVA. The department assesses claims and processes payments for the treatment of eligible DVA clients for medical, specialist, diagnostic imaging, pathology, allied health and dental services, and for private hospital admissions and prostheses.

On behalf of DVA, the department produces DVA’s Gold Cards (for all clinically necessary health care needs and all health conditions, whether they are related to war service or not), White Cards (for care and treatment of war‑caused or service‑related specific conditions) and Orange Cards (for pharmaceuticals only) for eligible veterans.

In 2018–19, the department continued to highlight the benefits of electronic claiming to providers by promoting the DVA Webclaim channel. The DVA Webclaim offers an alternative to manual claiming and delivers significantly faster payments and reconciliation for health professionals.

As a result of ongoing promotion of electronic claiming channels, DVA electronic claiming across all services increased to 93.9 per cent in 2018–19. Electronic claiming for allied health services increased to 87.5 per cent, electronic claiming for medical services increased to 96.9 per cent and electronic claiming for hospitals increased to 89.8 per cent.

Manual claiming for DVA decreased to 6.1 per cent in 2018–19.

Table 21: Department of Veterans’ Affairs processing

Private Health Insurance Rebate

The Private Health Insurance Rebate reimburses or discounts the cost of private health insurance cover. It is available to all people who are eligible for Medicare and have a complying health insurance policy.

The rebate is income tested. The level of rebate that people are entitled to claim depends on their age and income. The rebate can be claimed in one of two ways:

• as an upfront reduction in the cost of premiums—the Premiums Reduction Scheme (administered by the department)
• as a tax offset in annual income tax returns (administered by the Australian Taxation Office).

Table 22: Private Health Insurance Rebate

Working with industry—improving services to private health insurers

In 2018–19, the department worked with private health insurers to identify opportunities to improve the customer experience of using the Private Health Insurance Premiums Reduction Scheme.

Our aim was to find ways to remove red tape and streamline our process. We listened carefully and, by collaborating with insurers, identified a way to improve customer service and still meet the rules of the premiums reduction scheme.

We removed the requirement for paper forms and can now collect information verbally and via mobile apps, Skype and instant messaging.

Within one month of agreeing on the new approach, the majority of health insurers had taken steps to stop using the paper forms.

The department also improved the way private health insurers transmit data for registrations, withdrawals and claims under the Private Health Insurance Premiums Reduction Scheme. As a result, insurers have been able to simplify data submission and no longer have to manage authentication certificates.

These changes will make it easier for private health insurance customers to receive the rebates to which they are entitled.

Hearing Services Program

The Hearing Services Program aims to reduce the incidence and consequences of avoidable hearing loss in the Australian community by providing high‑quality hearing services and devices to those who are eligible for assistance. The department processes and pays claims to accredited hearing service contractors via the HPOS eClaims facility.

Table 23: Hearing Services Program services and payments

Health Care Homes

The Health Care Homes program is designed to improve health care for patients with chronic and complex conditions by providing them with a medical practice ‘home base’ for the ongoing coordination, management and support of their treatment. The stage one trial of Health Care Homes began on 1 October 2017.

Health Care Homes medical practices receive a monthly bundled payment. There are three tiers of payments, which are linked to the level of patient complexity and need. The monthly payment is based on the tier levels of each of the practice’s registered patients. Payments are retrospective, allowing for regular patient review and, if necessary, adjustment of the patient’s Health Care Homes tier level.

External Breast Prostheses Reimbursement Program

The External Breast Prostheses Reimbursement Program reimburses up to $400 for each new or replacement external breast prosthesis for women who have had breast surgery as a result of breast cancer.

Claimants must be eligible for Medicare and must not have claimed under the program in the previous two years unless there is a medical reason.

In 2017–18, the department updated its website to advise customers that, if they receive an income support payment, they may be eligible for an advance payment under that program which they can use to pay for their prostheses before claiming a reimbursement. Any advance payment is subject to the income support advance payment rules.

Table 24: External Breast Prostheses Reimbursement Program

Continence Aids Payment Scheme

The Continence Aids Payment Scheme gives eligible people with severe and permanent incontinence yearly or twice‑yearly payments to help buy continence aids products.

Table 25: Continence Aids Payment Scheme

Stoma Appliance Scheme

The Stoma Appliance Scheme provides support to people with a stoma by improving access to stoma‑related products.

The products are distributed through 21 regional stoma associations to their members across Australia.

The scheme operates under the National Health Act 1953.

Practice Incentives Program

The Practice Incentives Program (PIP) pays incentives to medical practices and individual providers to encourage improvements in general practice.

The PIP consists of 11 incentives, shown in Table 26 below.

In 2018–19, the department undertook a range of activities, including publication of articles in the quarterly Incentives News, to raise awareness of the PIP Indigenous Health Incentive (IHI), which helps to improve the health of Aboriginal and Torres Strait Islander people who are at risk of developing a chronic condition. As a result of these activities, the number of eligible practices participating in the PIP IHI and the number of outcome payments made increased.

Table 26: Practice Incentives Program payments

Table 27 below contains data on practice participation in the PIP.

Table 27: Practice participation in the Practice Incentives Program

Practice Nurse Incentive Program

The Practice Nurse Incentive Program makes incentive payments to practices to support an expanded and enhanced role for nurses working in general practice.

General practices across Australia, including those in urban areas, as well as Aboriginal Medical Services and Aboriginal Community Controlled Health Services, may be eligible for an incentive to help with the costs of employing a practice nurse. To be eligible the practice must be accredited under the Royal Australian College of General Practitioners Standards for general practices.

In 2018–19, the number of practices participating in the program increased by 4.39 per cent, continuing the trend seen in previous years.

Table 28: Practice Nurse Incentive Program

Child Dental Benefits Schedule

The Child Dental Benefits Schedule provides families, teenagers and approved care organisations with financial support for basic dental services for eligible children. Dental services include examinations, X‑rays, cleaning, fissure sealing, fillings, root canals and extractions.

Benefits for basic dental services are capped at $1,000 per child over two consecutive calendar years.

To be eligible, children must:

• be aged between two and 17 years on any one day of the calendar year
• receive (or their family, guardian or carer must receive) certain Australian Government benefits such as Family Tax Benefit Part A for at least one day of the calendar year
• be eligible for Medicare.

In 2018–19, the department processed 5.4 million services and paid $324.9 million in benefits under the Child Dental Benefits Schedule.

National Bowel Cancer Screening Register

The Department of Health’s National Bowel Cancer Screening Program aims to reduce illness and death from bowel cancer through early detection or prevention of disease in Australia.

The department administers the National Bowel Cancer Screening Register. The department:

• identifies and invites eligible people to participate in the program
• makes payments to medical professionals for providing information on the register about consultations and medical procedures for people who have received positive test results
• operates the information phone line for the general public and health professionals.

Under the National Bowel Cancer Screening Program, the department invited eligible people who turned 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72 and 74 years in 2018–19 to undertake screening.

Table 29: National Bowel Cancer Screening Program

Australian Immunisation Register

The AIR is a national register that records vaccinations given to people of all ages. It covers all vaccines, including:

• all National Immunisation Program (NIP) vaccines on the childhood, adolescent and adult schedules
• vaccines given in schools
• travel vaccines
• flu vaccines.

The AIR is administered under the Australian Immunisation Register Act 2015 on behalf of the Department of Health.

Individuals may require an up‑to‑date immunisation status on the AIR for their education, employment or overseas travel or to be eligible for some family assistance payments.

The AIR has over 26 million registrations.

In 2018–19, the AIR was expanded to record:

• human papillomavirus (HPV) vaccines—previously held by the National HPV Register
• vaccines given in state/territory school immunisation programs
• historical vaccines held by each state/territory health department system.

Table 30: Australian Immunisation Register registrations

Australian Organ Donor Register

The Australian Organ Donor Register is a national register that records people’s decisions about becoming organ and/or tissue donors for transplantation after death.

The register enables authorised medical personnel to verify a person’s decision about donating their organs and/or tissue for transplantation. People can register their donation decision online using their Medicare online account through myGov or the Express Plus Medicare mobile app on the department’s website. The website also has general information about organ and tissue donation for transplantation.

There are two types of registrations for organ donation:

• consent registration
• intent registration.

A legally valid consent registration occurs when a person aged 18 years or older provides a signed registration form or submits a registration using their Medicare online account through myGov or the Express Plus Medicare mobile app.

Intent registration occurs when a person registers their decision to donate through a channel that does not require a signature or electronic authentication—for example, by phone or email. Whether registration is by consent or intent, approval will always be sought from the person’s family before proceeding with the donation process.

The department promotes and raises national awareness of the Australian Organ Donor Register by supporting DonateLife week and the annual Gift of Life Walk.

The number of registrations on the Australian Organ Donor Register has seen steady annual growth. Table 31 shows the cumulative totals of the numbers of consent and intent registrations since the inception of the register.

Table 31: Australian Organ Donor Register registrations