Bulk billing is a payment option under the Medicare system of universal health insurance in Australia. It can cover a prescribed range of health services as listed in the Medicare Benefits Schedule, at the discretion of the health service provider. The health service provider - usually a doctor - is paid 85% of the scheduled fee for outpatient services; and 75% of the scheduled fee for inpatient services, by billing the government via the patient's Medicare card. The service provider receives a fixed proportion of the scheduled fee but avoids the costs and risks of billing and debt collection. It could be described as a form of factoring. Bulk billing rebates may be collected and paid directly to the service provider, or the service provider may collect the equivalent fee from the patient; leaving the patient to claim the rebate online, over the telephone, by mail, or at a Medicare office. Increasingly, service providers offer electronic lodgement at the practice using EFTPOS. Under Medicare, it is not permissible to charge the patient a co-payment with bulk billing : a service provider who bulk bills for a service may not charge the patient further for that service. Service providers may choose whether or not to use bulk billing. Many general practitioner services are bulk-billed, but less so in rural, regional, and remote areas of Australia where there is a greater shortage of doctors and health care services. The key purpose of bulk billing is to provide an economic constraint on medical fees and charges.
2014 co-payment proposal
In the 2014 Australian federal budget, the Abbott Government proposed to impose a $7 co-payment for all bulk billed GP and medical test visits. The proposal was to reduce the medicare rebate payable to service providers by $5 with the additional $2 paid by patients also going to providers. The proposal was widely criticised. In March 2015 the Health MinisterSussan Ley announced that "we are not pursuing it at all" with Prime Minister Abbott declaring the co-payment was "dead, buried and cremated".
