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News Bulletin : ADA News Bulletin August 2011
3 AUGUST 2011 MEETInG wITH THE HOn nICOLA ROxOn MP, THE MInISTER fOR HEALTH And AGEInG Following this year’s Federal Budget announcements pertaining to the dental profession, I, together with the CEO, Robert Boyd- Boland and the Manager Policy and Regulation, Eithne Irving met with Minister Roxon on Monday, 27 June 2011. Of particular significance with regard to the budget announcements was the Federal Government’s funding of dental care and the announcement of the creation of the National Advisory Council on Dental Health. The importance of the ADA in developing public policy on dental health was reinforced by Minister Roxon and I am now able to report to you that the ADA has been invited to participate on the National Advisory Council. I shall keep you informed of further developments. CHROnIC dISEASE dEnTAL SCHEME: MEETInG MEdICARE AUSTRALIA And THE MInISTER fOR HUMAn SERvICES Members are referred to the ADA members’ website and the entry there on correspondence with the Minister for Human Services, the Hon Tanya Plibersek (see www.ada.org.au). Following submission of the letter, both the CEO and I met with the Minister and representatives from Medicare Australia (MA) to discuss the ADA’s concerns with the way it was being reported to ADA that MA were conducting their audits of members regarding the utilisation of the Chronic Disease Dental Scheme (CDDS). During this meeting, I pointed out that there was a considerable discrepancy between the way in which MA were conducting their audits and the intent of the correspondence that had been sent to members by both ADA and MA after our earlier discussions with MA and the Minister. I stated that members had reported a ‘hard line’ being adopted by MA in their audit processes and that members were anticipating claims for full recovery of fees received by dentists where they had been non-compliant with the administrative requirements of the Scheme. It had been reported that despite member’s efforts to rectify defects in their compliance and thus demonstrating a change in administrative behaviour, little regard for this was being paid by MA. I pointed out that this was not in the spirit of the understanding previously reached. MA responded that it was exercising discretion in cases where the only concern with the claims had been administrative non- compliance and it could see rectification efforts in evidence. Where audits were based on patient complaints or where audits had commenced prior to the delivery of the ADA and MA messages in late April 2011, there could be no exercise of discretion as dentists had been non-compliant and thus had to refund fees where they had not been properly claimed. Both the Minister and MA stated that since meeting with the ADA, MA had in fact altered its approach to audits. MA indicated that it was now exercising discretion in suitable cases and that if dentists could demonstrate that they were now rectifying their conduct and had commenced this prior to receiving notification from MA that they were going to be the subject of an audit, those practitioners would be looked upon sympathetically and would be likely to have potential claims for refunds avoided. It was repeatedly emphasised to us that no global statement could be given as to how claims would be considered by MA. Each case would be looked at individually. All the ADA can do is encourage members to do as I stated in my May 2011 message, namely: “...all practitioners who have been involved with the CDDS should get their house in order, review their records and correct all administrative discrepancies...your ability to demonstrate a change in your behaviour with respect to the CDDS will hold you in good stead and allow MA the option of exercising some discretion in your favour...” F. Shane Fryer Federal President president’s comments “Please note that there are no absolute guarantees on offer. How you are considered by Medicare Australia, should you be the subject of an audit, will depend upon what you have done to ensure ongoing compliance.”
ADA News Bulletin July 2011
ADA News Bulletin September 2011