Medicare Australia Annual Report 2007-08 - Contents by xiangpeng

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									   Contents



1. Introduction
Letter of transmittal
                                                                                     2

Compliance Index                                                                                           3

Chief Executive Officer’s review                                                                           5

The Organisation                                                                                           8

Human Services portfolio                                                                                   9

Outcomes and output groups                                                                                12

Medicare Australia’s structure                                                                            13

The year in summary                                                                                       18


2. Providing accurate and reliable information and payments
Medicare                                                                                                  24

Pharmaceutical Benefits Scheme                                                                            42

Aged care                                                                                                 50

Australian Organ Donor Register                                                                           54

Australian Childhood Immunisation Register                                                                56

General Practice Immunisation Incentives Scheme                                                           58

Practice Incentives Program                                                                               60

Rural Retention Program                                                                                   62

General Practice Registrars’ Rural Incentive Payments Scheme                                              62

Training for Rural and Remote Procedural GPs Program                                                      64

Compensation Recovery Program                                                                             65

The Higher Education Contribution Scheme (HECS) Reimbursement Scheme                                      67

Family Assistance
                                                                                        68

LPG Vehicle Scheme
                                                                                       69

Hearing Services Program
                                                                                 70

National Bowel Cancer Screening Register
                                                                 71

Mental Health Nurse Incentive Program
                                                                    72

30% Rebate on Private Health Insurance
                                                                   74

Medical indemnity
                                                                                        76




                                                               Medicare Australia Annual Report 2007–08         i
 3. Delivery of great customer service to public and providers
 Medicare Australia’s stakeholders                                  82

 Service Charter                                                    85

 Balanced scorecard                                                 92

 Access and Equity                                                  93

 Medicare Australia’s Online Services                               95


 4. Ensuring the integrity of the Government programs
    Medicare Australia delivers
 External and internal scrutiny                                     98

 Program integrity assurance                                       101

 Program risk management                                           103


 5. Being a well run organisation
 Corporate Governance                                              114

 Corporate business continuity                                     118

 Financial framework                                               119

 Consultancies                                                     120

 National procurement                                              121

 National property                                                 122

 Access to personal information                                    123

 Privacy training                                                  125

 Environmental sustainability                                      126

 Information Technology                                            130


 6. Being a valued strategic partner in delivering agreed health
    and other Government initiatives
 Relationship with other agencies                                  134

 Funding arrangements                                              135

 Indigenous Australians                                            137

 Unique Healthcare Identifiers (UHI)                               141

 Access Card                                                       143


 7. Being a great place to work
 Staff matters                                                     146

 Occupational health and safety                                    152


 8. Financial Statements                                           155


 9. Appendices                                                     203




ii   Medicare Australia Annual Report 2007–08
Appendix A — Reports required by legislation                                                                   204
Appendix B — Freedom of Information                                                                            208
Appendix C — Staffing                                                                                          212
Appendix D — Consultants                                                                                       216
Appendix E — Advertising and market research                                                                   218
Appendix F — Contact details                                                                                   219
Glossary                                                                                                       222
Index                                                                                                          223

List of Tables
Table 1    Medicare enrolments, claims and benefits — key business results                                     24
Table 2    Medicare services by bill type                                                                      25
Table 3    Medicare cards and Medicare levy exemptions                                                         27
Table 4    Veterans’ Affairs activities — key business results                                                 28
Table 5    Medicare Australia Online                                                                           34
Table 6    Medicare Easyclaim                                                                                  35
Table 7    ECLIPSE                                                                                             38
Table 8    PBS — key business results                                                                          43
Table 9    PBS reform initiatives initiated by Medicare Australia                                              47
Table 10 Other PBS reform initiatives                                                                          47
Table 11 Payment types covered by Fourth Community Pharmacy Agreement                                          48
Table 12 Aged care — key business results                                                                      51
Table 13 Australian Organ Donor Register — key business results                                                55
Table 14 Australian Childhood Immunisation Register — key business results                                     57
Table 15 General Practice Immunisation Incentives Scheme payments —
           key business results                                                                                59
Table 16 Types of Practice Incentives Program payments                                                         60
Table 17 Practice Incentives Program — key business results                                                    61
Table 18 Rural Retention Program — key business results                                                        62
Table 19 General Practice Registrars’ Rural Incentive Payments Scheme —
           key business results                                                                                63
Table 20 Training for Rural and Remote Procedural GPs Program — key business results                           64
Table 21 Compensation recovery cases and benefits — key business results                                       66
Table 22 HECS Reimbursement Scheme — key business results                                                      67
Table 23 Family Assistance services — key business results                                                     68
Table 24 LPG Vehicle Scheme — key business results                                                             69
Table 25 Hearing Services Program services and payments — key business results                                 70



                                                                    Medicare Australia Annual Report 2007–08         iii
 Table 26 National Bowel Cancer Screening Register — key business results              71
 Table 27 Mental Health Nurse Incentive program — types of payments                    72

 Table 28 Mental Health Nurse Incentive program — key business results                 73

 Table 29 30% Rebate for Private Health Insurance — key business results               75

 Table 30 United Medical Protection Support Payments                                   76

 Table 31 Incurred-But-Not-Reported Indemnity Claims Scheme — key business results     77

 Table 32 High Cost Claims Indemnity Scheme claims processed — key business results    77

 Table 33 Run-off Cover Scheme Support Payment                                         78

 Table 34 Run-off Cover Scheme                                                         78

 Table 35 Premium Support Scheme participation and revenue — key business results      79

 Table 36 Overall stakeholder satisfaction levels 2005–06 to 2007–08                   84

 Table 37 Feedback register                                                            91

 Table 38 Balanced scorecard                                                           92

 Table 39 Summary of face to face and online education activities in 2007–08          104

 Table 40 Distribution of information on Medicare or PBS                              105

 Table 41 Compliance Program — publications and advertising                           105

 Table 42 Artificial intelligence analysis                                            108

 Table 43 Random compliance audit programs                                            109

 Table 44 Summary of successful prosecutions 2007–08                                  110

 Table 45 Medicare Participation Review Committee determinations                      112

 Table 46 Recovery identified and amount to be repaid                                 112

 Table 47 Environmental sustainability — key performance indicators                   129

 Table 48 Statutory report under Section 42                                           207

 Table 49 Occupational health and safety report                                       207

 Table 50 Freedom of Information requests                                             210

 Table 51 Freedom of Information standards                                            211

 Table 52 Staff by classification and location                                        212

 Table 53 Performance pay                                                             213

 Table 54 Ongoing and non-ongoing staff by classification                             213

 Table 55 Full-time and part-time staff by classification                             213

 Table 56 Staff by gender and location                                                214

 Table 57 Salary ranges for staff covered by the Certified Agreement

             and Australian Workplace Agreements                                      214

 Table 58 Equity and diversity groups                                                 215

 Table 59 Consultancy services let during 2007–08 of $10 000 or more                  217

 Table 60 Advertising and market research                                             218




iv   Medicare Australia Annual Report 2007–08
Table 61 Office locations                                                                                     219
Table 62 Enquiry lines open during business hours                                                             220
Table 63 Enquiry lines open 24 hours a day                                                                    220
Table 64 Email addresses for enquiries                                                                        221

List of figures
Figure 1 Human Service portfolio structure 30 June 2008                                                       11
Figure 2 Senior executive management structure as at 30 June 2008                                             17
Figure 3 Medicare services by bill type                                                                       25
Figure 4 All practitioners – all Medicare services June 2008                                                  32
Figure 5 General practitioners – patient claimed Medicare services – June 2008                                32
Figure 6 Practices with online claiming                                                                       34
Figure 7 Medical services claimed via online July 2004–June 2008                                              35
Figure 8 Medicare services claimed via Medicare Easyclaim July 2007–June 2008                                 36
Figure 9 Medical services claimed using ECLIPSE 2005–06 to 2007–08                                            38
Figure 10 ECLIPSE in-hospital medical claim services 1 July 2007–30 June 2008                                 39
Figure 11 ECLIPSE Online Patient Verification transmissions 1 July 2007–30 June 2008                          40
Figure 12 Comparison of Medclaims and Medicare Online/ Medicare Easyclaim
          bulk bill services July 2007–June 2008                                                              41
Figure 13 Stakeholder satisfaction 2002–03 to 2006–07                                                         84
Figure 14 Areas of risk and related compliance activity                                                       102
Figure 15 Medicare Australia’s Corporate Management Committee framework                                       116
Figure 16 2007–08 revenue                                                                                     135




                                                                   Medicare Australia Annual Report 2007–08         v

								
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