What is the 19AB replacement exemption?
If you replace a doctor that had an unrestricted 19AB exemption and is not working in the location anymore, you are allowed to receive Medicare benefits in any area as stated under the 19AB Exemptions.
Assessed criteria for replacement rules
According to the Department of Health (DoH), the doctor that will be replaced must meet the following criteria:
- Practised at a non-DPA/DWS location
- Had an indefinite s19AB(3) exemption that allowed unlimited access to Medicare benefits at the medical practice.
- Gave consistent Medicare-subsidised services at the medical practice within the past year
- Note: DoH does not provide a definition of consistency, but we have noticed that a minimum of 3 months, and a minimum of 3 days per week is a successful application.
- Stopped practicing any locations in the catchment area, having closed each of the related provider numbers
- Wrote a statement to verify that they have stopped, and have no plans of returning to, private practise within the catchment area.
How do I apply for a 19AB replacement exemption?
To apply for an exemption, you must send a completed Medicare provider number application to Medicare. You will be notified of the results of the exemption within 28 calendar days. Once approved, Medicare will issue a Medicare provider number and will be delivered via email.
Please note that a statutory declaration or written undertaking is acceptable from a departing doctor, and is a requirement for a new doctor to be considered under the replacement provision. The departing doctor should also have ceased practise, and indicate that they will not return to private practise in the catchment area that they are departing for the duration of their moratorium.
Note: The information presented above has been sourced from RACGP web pages and the new guidelines have been updated as of 01.07.2023.
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