Medicare - Rural & Remote Medical Benefits Scheme.

Medicare - Rural & Remote Medical Benefits Scheme

Learning objectives Understand the reasons for the

development of the Rural and Remote Medical Benefits Scheme

Understand the Rural and Remote Medical benefits Scheme

Be familiar with claimable items

History of RRMBS Lower expenditure for MBS and PBS

Aboriginal and Torres Strait Islander people

Strategies introduced to increase access to primary health care

Allows Qld Health and RFDS under contract to Qld Health to claim Medicare rebates

History In Qld, (apart from Inala), the first

exemption granted in 1997 Initially the funding was known as

the North Qld Bulk Billing project It has been extended and there are

now 58 eligible communities in Queensland (however not all are accessing funds under the scheme)

Aims and policy of the scheme

Increase and improve access to primary health care services

No out of pocket expenses for clients

To work within Medicare guidelines and comply with audit requirements

Intent of the scheme

Funds generated are to be

directed to the community where

they were generated and can:

Be used for additional positions

Spent on local health priorities

Criteria for access to RRMBS

Community has limited access to services which would normally be provided by Medicare

Agreement is required if an Aboriginal Medical Service is providing Medicare services to a community

Revenue In 1997 when the program was

established it was estimated that Medicare billing in the sites would generate approximately $3M

Recent revenue – less than $3M (approx $2.8M 08/09)

RRMBS eligible districts Cape York Cairns Central Queensland Darling Downs Metro South Mt Isa West Moreton South West Torres & NPA Townsville

What items can be billed GP type service items as per the

Medicare Benefits Schedule Nurse Practitioner items provided on

behalf of the GP Allied Health Professional items

provided under Enhance Primary Care Chronic Disease and Care Planning

items

Claimable items

The fact sheet included in this unit provides a series of tables outlining what items are claimable under RRMBS and an explanation on the conditions of the claim

Who ensures Medicare is billed

Full team approach including administration and clinical staff

If claim is not completed all is not being done for the client and community

Learning Activity

Please complete the following

learning activity