Cloud over telehealth rebates prompts concerns for island communities as Covid and flu cases soar

The federal government’s backflip on rebates for some telehealth services has drawn both praise and criticism but also concern for island communities after a massive spike in Covid and flu cases.

The federal government’s backflip this week to extend rebates on some telehealth services as influenza and Covid cases soar has drawn both praise and criticism.

Federal Health Minister Mark Butler delayed cuts to telehealth rebates for video consultations of less than 20 minutes following massive outcry from remote and regional areas, including those living on Moreton Bay islands.



The move followed the new federal government’s decision to extend the $750 Covid sick leave payment and after data showed telephone and video consultations had trebled in regional and rural areas during the pandemic.

Areas including Beenleigh, Springfield, Mackay and Caloundra, all in the top 10 Queensland spots for high telehealth demand, will still be able to access Medicare rebates on most video telehealth services until October.

But after that, Mr Butler said the government would review cutbacks to rebates on longer video calls of more than 20 minutes with doctors.

However, changes introduced on July 1, including cutting out rebates on some telephone consultations, raised concerns with Bowman LNP MP Henry Pike.

Mr Pike also slammed the government for ending free Rapid Antigen Tests for concession card holders.

He said cuts to more than 70 types of telehealth services would affect many Redlands residents living on the bay islands.

Bowman MP Henry Pike has criticised the government’s move to cut back some telehealth services, despite extending others.

“The government must explain why these items have been cut when surging case numbers and rising cost-of-living pressures have created more demand for these essential services,” he said.

“The government acknowledges we’re facing a dangerous winter wave of Covid, and yet it is pulling the rug out from under vulnerable Redlanders who need access to telehealth services over the phone.”

Since the start of the pandemic there have been 552,000 telehealth services delivered across the Redlands, he said.

Under the telehealth scheme, started during Covid, patients can still have a 20-minute consultation with a GP via an online video meeting for free, with Medicare covering the $39.45 fee.

For a consultation longer than 20 minutes, bulk billing doctors recoup $76.95, and for 45 minutes it is $131.15.

However, under new guidelines, doctors will have to abide by an 80:20 rule which limits them to 80 consultations, including telehealth visits, over 20 business days in a 12-month period.

Mr Butler decided against introducing another tough measure designed to deter doctors from holding more than 30 telephone consultations over 20 days.

Patients attending non-bulk billing doctors are likely to be charged more for a telephone consultation as opposed to a video consultation under the new guidelines.

Telephone consultations will remain an option for patients living in very remote regions.

Redland Bay general practitioner Dr Prem Adhar said it was possible the telehealth services rebate would become permanent, despite added costs to Medicare.

Redland Bay general practitioner Dr Prem Adhar said it was possible the online telehealth services rebate would become permanent despite added costs to Medicare.

“Covid is not going to end in September but there will be a cost to Medicare to keep these services on,” he said.

“Telehealth is popular in remote areas and there will be a big outcry if it is cut but in places such as Redland Bay, most patients like to come in and see the doctor face-to-face.

“Writing out a script on telehealth is really a cost that the doctor has to wear especially if the script has to be faxed or emailed to a pharmacist who will then want the original posted to them.

“However, it is not really a service that can be manipulated by either doctor or patient but there could be serious risks if the doctor cannot see the patient and is diagnosing over the phone.”

Brisbane-based former anaesthetist doctor Andrew Thompson joined online health practice InstantScripts to avoid catching Covid from patients while also allowing him to look after his six-month-old baby.

Telehealth InstantScripts Dr Andrew Thompson said the online service benefited many in rural and regional areas and those who were too sick to leave home.

InstantScripts, which started in 2018, has treated more than 400,000 Australians and is one of the country’s fastest-growing digital primary healthcare services with a team of 30 doctors available to patients every day from 7am to midnight.

Its consultations are $49, prescriptions $15, and scripts delivered to a patient’s door cost a $7 delivery fee.

Dr Thompson said there were 505,000 patients registered with InstantScripts, which had helped alleviate the state’s doctor shortage.

“I service a lot of patients who are unable to physically see a doctor, including those in regional and rural areas,” he said.

“Unlike clinics, where you often run a half-hour or an hour late, appointments always run on time, taking a lot of pressure off the doctor.

“Unlike in a medical practice or hospital, there is more time to interact with patients and hear their stories as InstantScripts consultations don’t come with time limits.”

Dr Thompson said another advantage was the fast and easy billing system developed specifically for telehealth purposes, cutting down on time spent worrying about payment admin issues.

InstantScripts does not bulk bill and does not use Medicare, which means each doctor takes away a percentage of a flat rate.

Complicated cases are referred straight into a clinic or a hospital emergency department for a face-to-face consultation in case the issue requires an examination or other testing.