Gov't walks back proposed signed consent rule for bulk-billing

The Albanese government has walked back controversial changes to Medicare bulk‑billing consent rules following sustained pressure from aged care providers, GPs and crossbench MPs, who warned the reforms would disrupt care for some of Australia’s most vulnerable patients.

The original regulations, due to take effect on 1 July, would have required a signed assignment of benefit for every bulk‑billed service, including telehealth. Verbal consent, which has long been used in aged care facilities, home visits and remote settings, was to be abolished entirely.

Providers, peak bodies and clinicians argued the changes were unworkable and risked leaving aged care residents, people with dementia and patients with limited mobility unable to access GP services.

Ageing Australia chief Tom Symondson said the sector had been working urgently with Health, Disability and Ageing Minister Mark Butler to prevent a situation where residents could no longer be bulk‑billed because they were unable to physically sign consent forms.

“Requiring documented consent for each GP visit – including telehealth consultations – is completely impractical for many aged care residents,” Mr Symondson said.

“Access to doctors should be as easy as possible for older people, and any barriers to that access should be avoided at all costs.”

He welcomed the government’s decision to introduce a 12‑month transition period allowing verbal consent to continue, fast‑track enduring assignment of benefit arrangements, and allow residents to make multiple enduring agreements with different practitioners.

“This decision shows what can be achieved when the sector and government work together to find solutions,” he said.

Under the revised arrangements, verbal consent will remain available in all settings for 12 months; enduring assignment of benefit will be available from 1 July 2026 for MyMedicare‑registered patients, aged care residents and patients attending Aboriginal Community Controlled Health Organisations; and compliance activity will not begin until regulatory changes are complete, with an initial focus on education rather than enforcement.

Independent MP for Kooyong Dr Monique Ryan, who had raised concerns directly with Minister Butler earlier this month, also welcomed the reversal, calling it “a genuine win for patients and GPs”.

“When the RACGP and AMA both say a reform is unworkable, and when aged care residents and rural patients stand to bear the cost of poorly considered policies, the government should listen. In this case it did. I’m glad the Minister acted.” Dr Ryan said.

She said the impact on aged care residents would have been particularly severe, especially for those with dementia, limited English, or without family available to assist.

Under the original rules, a GP visiting a resident who lacked decision‑making capacity would have been unable to bulk‑bill the visit, potentially leaving the patient to pay the gap out of pocket.

“The transition period is welcome, but it is not a permanent fix,” Dr Ryan said, adding she would hold the government to its commitment to develop longer‑term regulatory solutions.

“The goal of 90 per cent bulk‑billing by 2030 requires an administrative architecture that helps GPs to bulk‑bill, not one that creates new barriers to claiming.”

The Royal Australian College of GPs (RACGP) also praised the government’s response, saying it directly addressed concerns raised by members about administrative burden and risks to vulnerable patients.

RACGP president Dr Michael Wright said GPs had been clear that the reforms, as originally designed, would have disrupted care for residents of aged care facilities and other patients unable to sign forms.

“These measures will provide immediate relief for GPs working in aged care and other sectors that would have been most impacted by the reforms, and help ensure continuity of care for patients,” Dr Wright said.

He said the government’s concessions recognised that “a one‑size‑fits‑all administrative approach does not work across all care settings”, but noted further work was needed to ensure that services such as home visits and disability care were not adversely affected once the transition period ends.

The RACGP said it would continue working with the government to ensure reforms protect Medicare integrity without imposing unreasonable administrative requirements that compromise timely access to care.