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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