After Hours Other Medical Practitioners (OMPs)
Programme Guidelines
After Hours Other Medical Practitioners (OMPs) Programme Programme Guidelines
Table of Contents
1.
Preliminary Matters .................................................................................................... 3
2.
Introduction ................................................................................................................ 3
3.
Eligibility Requirements ............................................................................................. 4
4.
Eligible Locations ....................................................................................................... 4
5.
Definition of After-Hours ............................................................................................ 5
6.
Enrolling in an Assessment Process for Fellowship of the RACGP or ACRRM .......... 5
7.
Application Process ................................................................................................... 6
8.
Assessment and Verification of Applications .............................................................. 6
9.
Delegate’s Discretion ................................................................................................. 7
10. Access to the Higher GP Medicare Rebate and Provider Numbers ........................... 7
11. Claimable item numbers ............................................................................................ 7
12. Extensions ................................................................................................................. 8
13. DVA LMO Scheme .................................................................................................... 9
14. Related Programmes ................................................................................................. 9
15. Contact Details ........................................................................................................ 10
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After Hours Other Medical Practitioners (OMPs) Programme Programme Guidelines
1.
Preliminary Matters
1.1.
These Guidelines may be cited as the After Hours Other Medical Practitioners
(AHOMPs) Programme Guidelines.
1.2.
These Guidelines provide policy directions and operational procedures for the
AHOMPs Programme. Every decision with respect to the AHOMPs Programme
must comply with this version of the Guidelines.
1.3.
While these Guidelines specify particular issues that will be considered by a
Delegate in making decisions regarding placing a medical practitioner on the
AHOMPs Programme, all applications will be assessed on individual merit.
1.4.
To be eligible for the AHOMPs Programme, potential participants must be a nonvocationally recognised general practitioner which means they are not
recognised as a Fellow of the Royal Australian College of General Practitioners
or the Australian College of Rural and Remote Medicine or not at any time
recognised as vocationally registered under section 3F of the Health Insurance
Act 1973 (the Act).
1.5.
The AHOMPs Programme is administered by the Department of Human
Services - Medicare on behalf of the Department of Health, in accordance with
these Guidelines.
2.
Introduction
2.1
2.2
2.3
The AHOMPs Programme provides access to the higher GP Medicare rebates
(Group A11 and A22) for after-hours general practice services provided through
an accredited general practice or an accredited Medical Deputising Service
(MDS) by eligible medical practitioners.
The intent of the AHOMPs Programme is to recognise the value of after-hours
services provided by non-vocationally recognised general practitioners and to
provide substantial financial benefits for their patients. The AHOMPs
Programme aims to provide an incentive for non-vocationally recognised general
practitioners to provide after-hours general practice services through an
accredited general practice or an accredited Medical Deputising Service (MDS).
The AHOMPs Programme also aims to improve the quality of after-hours general
practice services provided, by requiring Programme participants to enrol for the
Royal Australian College of General Practitioners (RACGP) or the Australian
College of Rural and Remote Medicine (ACRRM) assessment leading to
achievement of Fellowship of the RACGP or ACRRM within a specified period.
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After Hours Other Medical Practitioners (OMPs) Programme Programme Guidelines
3.
Eligibility Requirements
3.1.
To be eligible for the AHOMPs Programme, a medical practitioner must:
 be a non-vocationally recognised medical practitioner for Medicare billing
purposes with registration from the Medical Board of Australia; and
 have current access to Medicare benefits; and
 be providing after-hours general practice services through an accredited
general practice or an accredited MDS; and
 enrol for RACGP or ACRRM assessment and obtain Fellowship within six
years of registration on the AHOMPs Programme.
3.2.
Eligible medical practitioners may include:
 Australian trained medical practitioners;
 Overseas trained medical practitioners; and
 Temporary resident medical practitioners.
3.3.
Salaried medical practitioners providing general medical services outside
hospitals, who are eligible to obtain a provider number and attract Medicare
benefits for their services, and who provide after-hours services through an
accredited general practice or an accredited MDS, may also be eligible for the
AHOMPs Programme if they meet the eligibility criteria.
3.4.
Overseas trained doctors (OTDs) must fulfil immigration and Australian medical
board requirements to be eligible for the AHOMPs Programme. This Programme
does not provide access to Medicare benefits. Medical practitioners must
already be accessing Medicare prior to claiming the higher GP Medicare rebates
under the AHOMPs Programme.
4.
Eligible Locations
4.1.
To be eligible for the AHOMPs Programme, the location through which the
services are provided must be either an accredited general practice that provides
after hours services, or an accredited MDS.
4.2.
Accreditation
4.2.1 The Australian Government nominated accreditation bodies are currently
Australian General Practice Accreditation Limited (AGPAL) and GPA
Accreditation plus (GPA). Further information on accreditation can be
obtained from the accreditation agencies (contact details under Section 15).
4.3.
General Practice Locations
4.3.1 A general practice location must have full general practice accreditation
assessed against the RACGP standards for general practice by AGPAL or
GPA, and make after-hours services available to patients from within the
practice.
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After Hours Other Medical Practitioners (OMPs) Programme Programme Guidelines
4.4.
MDS Locations
4.4.1 An accredited MDS location must offer after-hours services to patients of
general practitioners, during the absence of, and at the request of, the general
practitioner. MDS locations need to demonstrate that minimum standards for
clinical supervision and support are provided for non-vocationally recognised
general practitioners participating in the AHOMPs Programme. MDSs that
provide after-hours services are required to have the after-hours clinic
accredited against RACGP standards for medical deputising services by
AGPAL or GPA.
4.4.2 Practitioners that provide after-hours services at a location that provides
medical services during both the business hours and after-hours cannot claim
the higher GP Medicare rebates for any services provided during business
hours at that location under the AHOMPs Programme.
5.
Definition of After-Hours
5.1.
For the purposes of the AHOMPs Programme, after-hours are defined as
between 6pm and 8am on weekdays, before 8am and from 12pm on Saturday,
all day Sunday and public holidays. Services provided by participants of the
AHOMPs Programme out of these hours will not attract the higher GP Medicare
rebates.
5.2.
Programme participants should note that items for non-urgent after-hours
consultations provided in consulting rooms may only be claimed from 8pm on
weekdays, from 1pm on Saturdays and all day on Sundays and public holidays.
6.
Enrolling in an Assessment Process for Fellowship of the
RACGP or ACRRM
6.1.
It is a requirement of the AHOMPs Programme that Programme participants
enrol for RACGP or ACRRM assessment and obtain Fellowship within six years
of registration on the Programme. If a Programme participant has not achieved
Fellowship within this time, their access to the higher Medicare rebates through
the AHOMPs Programme will, subject to Clause 6.2, cease. Please contact the
RACGP or ACRRM for further information about the Fellowship process (contact
details in Section 15).
6.2.
If extenuating circumstances exist, the six year threshold may be extended up to
a maximum of a further four years. Refer to Clause 12 for further information
regarding requests for extension to participate on the AHOMPs Programme.
6.3.
The Department of Human Services - Medicare or the Department of Health may
confirm the enrolment for assessment of Programme participants with RACGP or
ACRRM during their participation on the AHOMPs Programme.
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After Hours Other Medical Practitioners (OMPs) Programme Programme Guidelines
7.
Application Process
7.1.
Application Form
7.1.1 Application forms for the AHOMPs Programme are available on the
Department of Health website (for details refer to Section 15). Applicants
should return completed application forms to the Department of Human
Services - Medicare by emailing
PROVIDER.REGISTRATION@humanservices.gov.au .
Application forms will then be processed within 28 days of receipt.
The Department of Human Services - Medicare will advise successful
applicants of the commencement date of payment of the higher GP Medicare
rebates in the letter advising approval for the AHOMPs Programme. Payment
of the higher GP Medicare rebates will not be backdated.
7.2.
Practice Locations
7.2.1 Applicants will be required to provide details and verification of accreditation
of each general practice or MDS location through which they propose to
provide services under the AHOMPs Programme. A current general practice
or MDS accreditation certificate from an Australian Government nominated
accreditation body is appropriate for this purpose.
7.3.
Change of Details
7.3.1 Programme participants will be required to complete a new application form
each time there is any change to their details, for example, to register an
additional accredited general practice or MDS location, or if they have moved
to another eligible location and would like to continue providing services under
the AHOMPs Programme. As the AHOMPs Programme is location specific,
Programme participants will be required to have a provider number for every
new location and send to the Provider Liaison Section at the Department of
Human Services - Medicare in their State or Territory.
7.3.1 Programme participants will be required to notify the Department of Human
Services - Medicare within 14 days if they no longer plan to provide
after-hours services through an accredited general practice or an accredited
MDS, or are otherwise no longer eligible for the AHOMPs Programme.
8.
Assessment and Verification of Applications
8.1.
The Department of Human Services - Medicare is responsible for assessing
applications for the AHOMPs Programme, including provider eligibility.
8.2.
Once an application has been approved and the Programme participant has
received formal approval from the Department of Human Services - Medicare,
Programme participants will have access to the higher GP Medicare rebates and
will be able to claim the appropriate higher GP Medicare rebates listed in the
Medicare Benefits Schedule (refer to summary on page 10).
8.3.
It is the responsibility of individual Programme participants to ensure they are
registered and have received notification from the Department of Human
Services - Medicare that they are enrolled on the AHOMPs Programme before
billing at the higher GP Medicare rebate level. The Department of Human
Services - Medicare will send a letter to all applicants informing them of the
outcome of their application. The Department of Human Services - Medicare will
advise approved applicants in writing of the commencement date for payment of
the higher GP Medicare rebates.
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After Hours Other Medical Practitioners (OMPs) Programme Programme Guidelines
Delegate’s Discretion
9.
9.1.
The Department of Health Delegate has full discretion to make decisions on all
matters in relation to the administration of the AHOMPs Programme, including
but not limited to requirements for participating medical practitioners under the
AHOMPs Programme
9.2.
If it is identified that the Programme participant is not on the pathway to
Fellowship of either ACRRM or RACGP, notification will be provided of the
Delegate’s decision to remove the Programme participant from the AHOMPs
Programme.
10.
Access to the Higher GP Medicare Rebate and Provider
Numbers
10.1.
The AHOMPs Programme does not provide access to Medicare benefits.
Medical practitioners must already be accessing Medicare prior to claiming the
higher GP Medicare rebate under AHOMPs.
10.2.
The Department of Human Services - Medicare will use the provider number
entered on each claim to determine the level of Medicare rebate applicable.
10.3.
For the purpose of the AHOMPs Programme, in order to receive the higher GP
Medicare rebates, the provider number that is entered on a claim must be linked
to a location that is an accredited general practice or an accredited MDS.
10.4.
It is important to note that the AHOMPs Programme does not reduce or waive
any provider number restrictions that would apply to a medical practitioner
practising in Australia.
11.
Claimable item numbers
11.1.
The following Medicare Benefits Schedule (MBS) item numbers can be claimed
by Programme participants for consultations provided in the after-hours period 597, 599, 5000, 5003, 5010, 5020, 5023, 5028, 5040, 5043,5049, 5060, 5063
and 5067.
11.2.
MBS item numbers for urgent after hours consultations (597, 599) are applicable
as follows:
 MBS item 597 is applicable from 7am to 8am and 6pm to 11pm weekdays,
7am to 8am and 12pm to 11pm on Saturdays and 7am to 11pm on Sunday
and/or public holidays.
 MBS item 599 is applicable between 11pm and 7am on any day.
11.3.
MBS item numbers for non-urgent after-hours consultations provided in
consulting rooms (5000, 5020, 5040 and 5060) are applicable on Sunday and/or
public holidays, before 8am and after 1pm on Saturday and before 8am and after
8pm on any other day.
11.4.
MBS item numbers for non-urgent home visits and consultations at institutions
(other than a hospital or a residential aged care facility) (5003, 5023, 5043, 5063)
are applicable before 8am and after 12pm on Saturday, all day on Sunday and/or
public holidays and before 8am and after 6pm on any other day.
11.5.
MBS item numbers for services provided at residential aged care facilities (5010,
5028, 5049, 5067) are applicable before 8am and after 12pm on Saturdays, all
day on Sundays and/or public holidays and before 8am and after 6pm on any
other day.
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After Hours Other Medical Practitioners (OMPs) Programme Programme Guidelines
Summary of the GP after hours MBS items and the after-hours periods they relate to
Attendance
Period
Attendanc
e Group
Urgent Afterhours
Attendance
A11
Urgent Afterhours
Attendance
A11
Non-urgent
after-hours in
consulting
rooms
A22
Non-urgent
after-hours at a
place other
than consulting
rooms
11.6.
A22
Item(s)
Applicable
time
Monday to
Friday
Applicable
time
Saturday
Applicable
time
Sunday
and/or Public
Holidays
597
7am to 8am
and 6pm to
11pm
7am to 8am
and 12 noon
to 11pm
7am to 11pm
599
11pm to
7am
11pm to
7am
11pm to 7am
5000, 5020,
5040, 5060,
Before 8am
and after
8pm
Before 8am
and after
1pm
All day (24
hours)
5003, 5010,
5023, 5028,
5043, 5049,
5063, 5067
Before 8am
or after 6pm
Before 8am
and after 12
noon
All day (24
hours)
Changes to GP item claiming requirements
11.6.1
The item descriptors for level B, C and D items in the A22 and A11 group
allow for the provision of preventative health care and for treatment of more
than one health related issue, with appropriate documentation.
11.6.1
For more information on the MBS after-hours items, see
(www.health.gov.au/mbsprimarycareitems)
12.
Extensions
12.1.
All requests to extend participation on the AHOMPs Programme are assessed by
the Department of Health. Programme participants who wish to extend their
participation on the AHOMPs Programme beyond the initial six year period must
submit a formal request prior to their participation expiry date to the departmental
delegate responsible for the AHOMPs Programme.
12.2.
All requests for extension after the six year period are assessed according to the
provision of evidence that demonstrates the Programme participant is actively
working towards Fellowship.
12.3.
The initial six year period may be extended for a further four years. Please note
that five year participants will generally be granted a 12 month extension so they
are afforded the same benefits as other approved participants who have been
granted six years.
12.4.
Participation on the AHOMPs Programme is limited to a maximum period of ten
years from commencement on the AHOMPs Programme. At the end of the
additional four years, no further extensions will be granted and medical
practitioners are unable to reapply at the conclusion of the ten years.
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After Hours Other Medical Practitioners (OMPs) Programme Programme Guidelines
12.5.
Requests for extension after the initial six year period must include the following
information:
 the reason the Programme participant requires an extension;
 evidence of progress towards attaining FRACGP or FACRRM;
 the name and address of the practice the Programme participant is seeking
the extension at;
 additional information or documentation to support the Programme
participant’s request for extension.
12.6.
Evidence includes, but is not limited to:
 the RACGP assessment of general practice experience; and/or
 confirmation of enrolment in the Fellowship examinations; and/or
 a copy of the examination results.
12.7.
The RACGP assessment of general practice experience (or the ACRRM
equivalent) should be less than 6 months old.
12.8.
As per Clause 6.2, Programme participants may apply for extensions on the
grounds of extenuating circumstances. Extenuating circumstances include, but
are not limited to:
 failure to complete the Fellowship examination, requiring additional time to
resit components of the examination after the six year end date; or
 a delay in receiving confirmation of Fellowship after successfully completing
the examination within the six year timeframe; or
 illness or unforeseen personal circumstances that require rescheduling the
examination to a date after the six year end date.
12.9.
Each request for extension will be assessed on its own merit and the Delegate
has the final say with regards to the outcome.
12.10.
Applications for extensions are generally processed in date order and within 28
working days of receipt of a full and complete application.
12.11.
Requests for extension to participation on the AHOMPs Programme must be
addressed to:
Assistant Secretary
Access and Incentives Branch
Department of Health
MDP 152
GPO Box 9848
Canberra ACT 2601
Email: AHOMPs (OMPS@health.gov.au)
13.
13.1.
14.
14.1.
DVA LMO Scheme
Medical practitioners participating in the Department of Veterans’ Affairs Local
Medical Officer Scheme are able to apply for this Programme, provided they
meet the AHOMPs Programme eligibility requirements outlined in these
Guidelines.
Related Programmes
Participation on this Programme does not exclude doctors from applying for
other Programmes for non-vocationally recognised GPs.
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After Hours Other Medical Practitioners (OMPs) Programme Programme Guidelines
15.
Contact Details
15.1.
Application Forms and Programme Guidelines can be obtained from the
Department of Health website: (www.health.gov.au/omps)
15.2.
For enquiries regarding the AHOMPs Programme contact the Department of
Human Services - Medicare on 1800 032 259.
15.3.
For information on Fellowship requirements contact:
The Royal Australian College of General Practitioners
RACGP House
100 Wellington Parade
East Melbourne VIC 3002
Telephone: 1800 331 626 or (03) 8699 0414
Facsimile: (03) 8699 0400
Website: The Royal Australian College of General Practitioners.
(www.racgp.org.au)
The Australian College of Rural and Remote Medicine (ACRRM)
GPO Box 2507
Brisbane QLD 4001
Telephone: 1800 223 226 or (07) 3105 8200
Facsimile: (07) 3105 8299
Website: The Australian College of Rural and Remote Medicine
(www.acrrm.org.au)
15.4.
General practices and MDSs who wish to apply for accreditation from AGPAL or
GPA, or to receive information on NAMDS, AGPAL or GPA standards on clinical
supervision and support, should contact one of the following:
National Association for Medical Deputising Australia Ltd
Suite 2/2 Salisbury Street, Richmond
Melbourne VIC 3121
Website: National Association for Medical Deputising (www.namds.com)
Email: National Association for Medical Deputising Australia
(nicrichardson@medic.aust.com)
Australian General Practice Accreditation Limited (AGPAL)
PO Box 2058
Milton Business Centre
Milton QLD 4064
Telephone: 1300 362 111
Fax: 1300 362 110
Website: Australian General Practice Accreditation Limited (www.agpal.com.au)
Email: Australian General Practice Accreditation Limited (info@agpal.com.au)
GPA Accreditation Plus (GPA)
Quality Practice Australia Pty Ltd
PO Box 83
Gundagai NSW 2722
Telephone: 1800 188 088 or (02) 6944 4042
(03) 8888 9988
Website: GPA Accreditation Plus (www.gpa.net.au)
Email: GPA Accreditation Plus (gpa@gpa.net.au)
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