Doctors warn federal bulk billing is being ‘killed’ as states increase tax burden on physician practices

The federal government’s $3.5 billion effort to revive bulk billing rates is being “killed” by states pocketing the money, doctors warn.

The government in November tripled the payment GPs receive for bulk billing patients in a bid to reverse falling rates of bulk billing – with practices accepting a fee from Medicare as payment in full and charging nothing to patients.

But almost simultaneously, a number of state governments adopted a new interpretation of payroll tax laws that meant that primary care physicians would now be counted as employees rather than contractors for tax purposes, increasing the taxes states collect on medical practices.

The Royal Australian College of General Practitioners said states are pocketing the billions poured into practices by the federal government and stopping GPs from cutting their patients’ fees.

“Unfortunately, these reforms will not have a significant impact because the money put into general practice will be taken away by the states through the application of payroll taxes to Medicare,” said RACGP Chairman Dr. Nicole Higgins. said.

“We can’t bill someone in bulk and pass on an amount because the law doesn’t allow us to do that. So if payroll tax is charged for every consultation, who pays it? Is it the patient, is it the practice?

“What we hear (from primary care physicians) is, ‘I can’t afford to bill people who really need it for big bills because I have to pay this state tax.’”

States have argued that primary care physicians should be counted for purposes of the tax, and that special exceptions would undermine the broader regime.

Health Minister Mark Butler has expressed concern that the state tax could undo efforts to improve bulk billing.

And the changes have caused concern among GPs.