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 claimfact sheet

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