19AB DWS restrictions

So there has been a change to 19AB DWS Restrictions and the locations…

With the recent updating of 19AB DWS locations, we have had a deluge of requests from both doctors and practices about how they can understand the why, the where and the what of this particular piece of legislation. Being Medical Recruitment ninja’s – this is what we have to understand to recruit General Practitioners and Doctors into General Practice clinics every day!

Our team love to share information, interpret information and look at it from all angles to see what we can shake out of that information and how we can use it best to help you – our clients – get to where you need to be.

So, our blog today is about 19AB and DWS in General. This is just a quick overview so if you have specific questions or you need help, give us a call!

So, to get started…we need to start at the beginning!

The Act

Section 19AB of the Act applies to overseas trained doctors (OTDs) and foreign graduates of accredited medical schools (FGAMS) who gained their first medical registration or became permanent Australian residents or citizens on or after 1 January 1997. Section 19AB restricts their access to Medicare provider numbers and requires them to work in a district of workforce shortage (DWS) for their medical specialty in order to access Medicare benefits arrangements.

OTDs and FGAMS who are subject to section 19AB are generally required to work in a DWS for a minimum period of 10 years (referred to as the 10 year moratorium requirement) from the date of their first Australian medical registration.

From http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/medicareProviderNumberLegislation

What does this mean?

Basically, if you’ve:

  • completed your medical degree outside of Australia or New Zealand OR
  • You weren’t an Australian Citizen or hold permanent residency prior to the end of your degree in Australia OR
  • You were registered with AMC AFTER 01/01/1997 OR
  • You became an Australian Citizen / Permanent Resident AFTER 01/01/1997

Then to be able to have your patients collect a rebate from Medicare (or for you to bulk bill), you need to work in an area that has been defined by the Department of Health as a “District of Workforce Shortage” (DWS).

Note: You can work as a fee billing doctor where patients cannot collect a rebate from Medicare. Please know that this is very different from “Privately” billing, where patients pay a gap but still get a rebate back from Medicare.

How Long?

The short answer is 10 years.

To give you a bit more detail, it’s 10 years in a RRMA 1/RA 1 Location. You can actually reduce your moratorium by basing yourself in a rural location. Check out the information here: http://www.ruralhealthaustralia.gov.au/internet/rha/publishing.nsf/Content/OTDs_FGAMS_scaling_Factsheet

What if I can’t work in a DWS?

You have options – don’t despair.

There are a number of ways you can work with the system if you cannot meet the requirements of this act. A number of exemptions are in place to help you and the practice you’re hoping to settle into.

You can be exempt from 19AB in the following ways

  • Class Exemptions

    • If you have an academic appointment with an Australian medical school and are seeking Medicare access for the express purpose of discharging clinical teaching functions as part of their appointment;
    • If you’re applying for a role within hours considered as “After Hours” (If you’re non -VR, this will apply to you only if you are a temporary resident, or if you are a permanent resident the service must be an accredited AMDS – see our blog on 19AA)
    • If the practice is in the Northern Territory
  • General Exemptions

    • If you’re replacing a doctor leaving who held DWS (conditions apply)
    • If you commenced negotiations with the practice prior to DWS being lost
  • Spousal Exemptions

    • If your spouse is a doctor who holds a DWS exemption
    • If your spouse migrated to Australia on a skilled occupation visa (conditions apply)
  • ATSI Clinics

    • If the clinic you’ve applied to work at is an Aboriginal Medical Service that is commonwealth funded
  • Locum Service

    • If you’re a specialist GP or a non-VR GP on a temporary visa you’re eligible for a 6 month exemption from Medicare. Please note that it’s 6 continuous months from approval of the application – it can’t be paused or extended!

Anything Else?

This bit of legislation works closely with 19AA so if you’re a non-VR permanent resident or Australian Citizen then check out our 19AA blog here 

Otherwise, these basics should steer you right.

Doctor Connect is a brilliant website which actually explains most of what you need to know.

For their Fact Sheet on 19AB, check out this site

DocuHelp and the team at Aussie IMG also have a number or helpful video’s on 19AB, 19AB exemptions and other relevant information including some clinical case information for exams!

If you have any questions, call our team on 07 3503 1444. As I’ve said, we’re happy to help you wrap your head around the complexities of our beautiful country’s doctor recruitment legislation!


Signing off for now,


People Medical Consulting

Related Articles