Medicare RRMBS - Queensland Health

advertisement
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
Download