19AA & The 3GA Programs (2018 Update)

Our Team at People Medical Consulting have a number of blogs surrounding the 3GA programs. Today, we want to clarify the changes that are coming through!

 

Let’s start by going over the legislation and what it means.

 

What is 19AA?

 

The Legislation

Section 19AA of the Health Insurance Act 1973 (the Act) was introduced in 1996 to recognise and support general practice as a vocational specialty, as well as to provide a framework for achieving long term improvements in the quality of doctors working in Australia. – Doctor Connect

 

All medical practitioners are subject to restrictions of section 19AA of the Act if they:

  • held medical registration by an Australian Medical Board on or after 1 November 1996 and
  • are Australian permanent residents or Australian citizens and
  • do not hold continued recognition by the Royal Australian College of General Practitioners or the Australian College of Rural and Remote Medicine, or by a recognised specialist college.

 

What it means

 

19AA requires any Non-Vocationally Registered Australia Permanent Resident or Citizen to be registered on an approved 3GA program prior to commencing work to be able to gain access to Medicare benefits.

 

This restricts both people born here in Australia and those who have become Australians.

 

Once you sit your fellowship exams and are recognized as a specialist doctor, this restriction no longer applies.

 

What do you mean ‘gain access’ to Medicare benefits?

 

General Practitioners in Australia have a provider number through Medicare that allows their patients to get a rebate back from Medicare after they have seen you. Some clinics 100% bulk bill, which means the patients don’t pay at all. Mixed Billing and Privately billing centres have the patient pay an upfront fee, and they will be refunded the set rebate amount by Medicare.

 

What are the 3GA programs?

Australian General Practice Training Programs (AGPT)

This program allows you to sit your fellowship exams via either RACGP or ACRRM.

 

This program has two streams- General & Rural. Doctors restricted by District of Workforce Shortage (DWS) are required to work on the Rural stream. It’s a great program that provides a lot of support to GP’s – Applications open each year in April and commence the following January and they take on about 1500 registrars each intake.

 

The benefit of working within AGPT is the level of support you’ll receive, and the standardised nature of the program. Clinics are thoroughly vetted, contracts are negotiated- everything is set out for you. You’re also eligible to bill A1 Medicare rates.

 

The challenging thing about the program is also the structure (a double-edged sword!). You’ll have strict requirements for where you are placed (You get granted a “region” placement) and it’s competitive to get onto the program, and it will require you to go through a stringent application process.

 

Check out your eligibility here: http://www.agpt.com.au/Junior-doctors/Australian-General-Practice-Training–AGPT–program/New-Applicants/Eligibility

 

ACRRM Independent Pathway

 

This pathway leads you to sitting the ACRRM fellowship exams.

 

It’s similar to AGPT in it’s application process and general structure, however provides more flexibility on the location of where you work (no rural and general stream). You are required to meet the experience requirements (i.e. you’ll be required to have certain experiences to be able to sit the exams).

 

The benefit to working on the program is the level of education- ACRRM provides a high level of study materials and training support. The program is flexible on the location you’re working (No RRMA requirement) and you’re eligible to bill A1 Medicare rates.

 

The challenge of this program is partly the cost- it’s a rather hefty sign up fee. It’s also got a few more requirements than the other programs, leading you to be more of a GP proceduralist.

 

Find the eligibility criteria here: http://www.acrrm.org.au/training-towards-fellowship/overview-of-fellowship-training/training-pathways/acrrm-independent-pathway/eligibility

 

Rural Locum Relief Program

 

This program allows you to sit your fellowship exams via either RACGP or ACRRM.

 

The program is different in every state. The key thing to remember about this program is that if you don’t have a minimum of 2 years of GP experience assessed by RACGP, then you will not be eligible for the 4 year program.

 

Several states have a shorter 2 year program which has requirements such as having Australian hospital experience. These programs will allow you a maximum of two years which will then require you to find another program when that is complete.

 

The benefit of this program is that it gives you more control over your career- you decide where you get to work (providing it falls in line with the program requirements, i.e. onsite VR mentor & in a RRMA 3-7). It also has no structure, which means you can work until you have the required time to sit your fellowship exams and complete the program.

 

The challenge of this program is the fact that it has no structure. You’ll gain all of your support from the mentor you have onsite. It also requires you to be working in a RRMA 3 – 7, which is outside of the CBD.

 

Remote Vocational Training Scheme (RVTS)

 

This program allows you to sit your fellowship exams via either RACGP or ACRRM.

 

It requires you to work in a rural area, have a minimum of 2 years of GP experience and be working in the practice you are applying for the program to approve.

 

Here is the link to the eligibility criteria: http://rvts.org.au/applicants/eligibility

 

After Hours Medical Deputising (AMDS)

 

This program allows you to sit your fellowship exams via either RACGP or ACRRM.

 

The program has recently experience quite a bit of change.

 

These services can either be clinic based or visiting patients in their homes. They are both in metro and regional areas. You’ll be working within the hours of 6pm – 8am weekdays, Saturday after 12pm, Sundays and public holidays.

 

The benefit of working with this program is that it allows you to bill higher rates within certain hours. It also allows you to work in a CBD location.

 

The challenge is that the time you work will be assessed at 50% of the actual time worked, and it’s capped at 2.5 years.

 

There are a few other challenges. Stay tuned for our blog next week which will shine some light on the main changes in after hours.

 

Special Approved Placement Program (SAPP)

 

SAPP is a program offering flexibility to General Practitioners with ‘extenuating circumstances’. The new SAPP guidelines offer a range of categories which will deem you eligible for this program.

 

It’s important to remember that this is a program intended to assist General Practitioners in becoming eligible for another program, unless you have a severe medical condition.

 

We’ve written a  blog about the key changes to SAPP, which you can read here: https://peoplemedical.com.au/19aa-changes-to-the-special-approved-placements-program/

 

Frequently Asked Questions:

QUESTION: Are the OMP’s programs like ROMPS and AHOMPS a 3GA Program?

No- Read why here: https://peoplemedical.com.au/what-is-the-difference-between-the-omps-and-the-3ga-programs-such-as-amds-or-rlrp/

 

QUESTION: Is there a difference between a clinic that is open after hours and an AMDS? Read here: https://peoplemedical.com.au/is-there-is-a-difference-between-after-hours-medical-deputising-service-amds-and-a-clinic-that-is-open-after-hours/

 

QUESTION: These programs want me to go rural or work after hours- I don’t want to/I can’t/Am I eligible to be exempt from this?

Read this blog to help with any questions surrounding this: https://peoplemedical.com.au/19aa-follow-up/

 

QUESTION: What if I don’t want to access Medicare?

If you’re billing 100% privately, and your patients do not expect to get a rebate from Medicare, this restriction doesn’t apply. It only applies to those who want to be able to bulk bill and/or for their patients have the ability to claim on Medicare.

 

Do you have other questions?

See if our Question of The Week answers them here: https://peoplemedical.com.au/blog/ or contact our team at admin@peoplemedical.com.au to submit a question.

 

Our previous blog about 19AA (see what changes there have been!): https://peoplemedical.com.au/19aa-oh-how-you-surprised-us-2/