What are 19AB, DPA and 19AB Exemptions?

This blog is to help you understand what 19AB is, what DPA is, how to reduce your 10 year moratorium and what exemptions there are from the 19AB restrictions.

WHAT IS THE 19AB RESTRICTION? 

19AB of the Health Act requires Medical Practitioners who did not complete their degree in Australia or New Zealand, and who wish to access Medicare rebatable services for their patients (allow them to get a Medicare rebate) to work in a DPA for a period of 10 years, referred to as the 10 year moratorium.  

Basically- if you want your patients to get a rebate from Medicare and you did not complete your degree in Australia or New Zealand, this 19AB requirement applies to you! 

WHO IS RESTRICTED BY 19AB?

Medical Practitioners who did not complete their degree in Australia or New Zealand, and who wish to access Medicare rebatable services will be restricted. 

It will also apply to Doctors who enrolled into their degree in Australia whilst they were a temporary resident. 

WHAT DOES DPA MEAN?

DPA stands for Distribution Priority Area. 

This is an area where the general population’s need for medical services is not being met and they require more doctors within the area.

The classification of DPA areas is updated yearly and these changes are implemented in the first few months of the year. 

If you need to check the DWS status of a practice or area, you can do so at DoctorConnect – http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/locator

HOW IS A DPA LOCATION DETERMINED? 

The DPA system takes into account gender and age demographics, and the socio-economic status of patients living in an area.

An area is automatically classified as DPA when it is: 

Other areas are classified as DPA when the level of health services available to the population does not meet a service benchmark.

REDUCING OR ‘SCALING DOWN’ THE 10 YEAR MORATORIUM

There are two ways to reduce your moratorium. 

Scaling means that the more rurally you work, the quicker your moratorium reduces. This works on the RA model rather than the MMM model. To be eligible you’ll need to have a rebatable provider number and be billing over $5000/month. See the table below. 

The 5 year OTD Scheme is an initiative initiated by the Rural Workforce Agencies. You will reduce your moratorium to between 3 – 5 years based on what category you’re eligible for. 

  • Category A is for RA 5 locations, and will reduce your moratorium to 3 years. 
  • Category B is for practices who are in an RA 4, or who can demonstrate that they have had a high turnover of GPs or have had a vacancy for a considerable period of time. Other factors taken into consideration is whether they have less than 3 Doctors in the community, difficult community attributes or extreme climates. This will reduce your moratorium to 5 years, 
  • Category C is within locations which are RRMA 4 – 7 and can demonstrate difficulty with recruiting. This will reduce your moratorium to 5 years. 

To be eligible, you’ll need to be working at least 7 sessions per week, be eligible to sit Fellowship within 2 years of commencing on the program and identify that you’re intending to become a resident of Australia. 

Be aware though, that working on this scheme will make you ineligible for the scaling credits which means you do one or the other. If you start the OTD 5 year scheme, prepare to be there for the entire time required! 

HOW TO KNOW WHEN YOUR MORATORIUM ENDS

You can call Medicare, check your PRODA account or email the team at 19AB. 

19AB EXEMPTIONS

Unlike 19AA, you can receive an exemption from 19AB and be allowed to work in a Non-DWS area.

There are various 19AB exemptions, so it is important to check your eligibility. We have outlined the available exemptions below:

General 19AB Exemption

A General 19AB exemption is available in 2 different circumstances. If you have commenced negotiations for employment at the practice prior to the area losing DWS status, you will be eligible for a 19AB exemption. For this, you will need to provide proof to Medicare of the negotiations. 

You will also be eligible for a General Exemption if an OTD who previously held a General 19AB Exemption leaves the practice/area and closes their Medicare Provider Number. The previous GP will need to sign a Statutory Declaration confirming they do not plan to return to the area and the new GP will need to commence within 12 months of the Medicare Provider Number closing.

Provision of Services at Commonwealth funded Aboriginal and Torres Strait Islander Health Care Services

If a GP is providing medical services or has commenced negotiations to provide a medical service at an Aboriginal and Torres Strait Islander Primary Health Care Services, they may be eligible for a 19AB exemption. 

The Department aims to increase the number of medical practitioners working with Aboriginal and Torres Strait Islander populations, so despite the area of the practice this exemption will be available.

Spousal Exemption

You will be eligible for a spousal exemption if your partner is a medical practitioner that is not restricted by 19AB or if your partner holds a General Skilled Migration Visa and is currently employed within this occupation. 

To be granted a Spousal Exemption you will need to be working within a close proximity to your partner- the same Catchment area from the Health Workforce Locator Map is a strong indicator of success. 

Locum Exemption

A 19AB exemption will be available if you are providing locum services at a practice. 

The GP will be granted a 19AB exemption for the practice for a maximum of 6 months, as long as they have not previously provided services at the practice. After 6 months, you can commence locum services in another practice or change to a DWS practice.

Class Exemptions

Class exemptions are available when you are providing medical services either through a relevant 3GA program (i.e. SAPP) or through an Academic Class Exemption. 

You will be eligible for an Academic Class Exemption if you are employed in an academic appointment with an Australian Medical School if the medical services are performed through their academic appointment.

After Hours Exemption

If you are working in an after-hours clinic or during the after-hours periods only, you will be eligible for a 19AB exemption during these periods. This means you will be able to work before 8am and after 6pm on Weekdays, after 12pm on Saturdays and all-day Sundays and on Public Holidays.

HOW WE CAN HELP YOU:

If you are looking for further guidance on 3GA Programs or would like to ask further questions about the information mentioned, this is something our team can help you with. Contact us directly on [email protected].

Information for this blog has been taken directly from:

People Medical Consulting are a team of professionals with a passion for guiding those specialising in the Medical industry to find their career pathway and settle into Australia. Working with both Australian trained and Overseas trained professionals, we have extensive experience in Recruitment of General Practitioners and Document Assistance for those requiring support with RACGP, AHPRA, 19AA and 19AB Medicare Exemptions.

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