Rural Relocation Incentive Grant guidelines

To be eligible for a relocation grant medical practitioners must:

• Apply prior to relocation. Retrospective applications will not be considered.
• Hold Fellowship of a recognised specialist college.
• Be an Australian citizen or permanent resident.
• Relocate to a location that is classified as being more remote than the location in which they have been practicing over the past 12 months. (See ‘RRIG Component – FPS Specific Eligibility’.)
• Have provided at least one service within the past 12 months (to determine the location from which the medical practitioner is relocating). (See ‘RRIG Component – FPS Specific Eligibility’.)
• Have not previously received a RRIG.
• Overseas trained medical practitioners must have completed the requirements under section 19AB of the Act (ie completed their 10 year moratorium). (See ‘RRIG Component – FPS Specific Eligibility’.)

Eligible locations are those within categories RA2-5 of the Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) system.

Check the RA category of the practice

Eligible services are listed as clinical services from the following sections of the Medicare Benefits Schedule Book:

• Category 1: Professional attendances
• Category 2: Diagnostic procedures and investigations
• Category 3 Therapeutic services
• Category 7: Cleft lip and cleft palate services

Eligible services do not include optometry, dentistry, pathology and diagnostic imaging. Bulk billing items 10990, 10991 and 10992 are also excluded.

Incentive grants are calculated according to the location which the medical practitioner relocates from and to, as well as their clinical workload (of eligible services) following relocation.

The table below identifies the maximum payments available to medical practitioners after relocation.

FROM	TO
RA Location	RA2 (Inner Regional)	RA3 (Outer Regional)	RA4 (Remote)	RA5 (Very Remote)
RA1 (Major Cities)	$15,000 ($7,500 p/a)	$30,000 ($15,000 p/a)	$60,000 ($30,000 p/a)	$120,000 ($60,000 p/a)
RA2 (Inner Regional)	-	$15,000 ($7,500 p/a)	$30,000 ($15,000 p/a)	$60,000 ($30,000 p/a)
RA3 (Outer Regional)	-	-	$15,000 ($7,500 p/a)	$30,000 ($15,000 p/a)
RA4 (Remote)	-	-	-	$15,000 ($7,500 p/a)

Payments are made in two instalments following approval and relocation. Each instalment is based on the preceding 4 quarters. The 4 quarters must meet the continuous service requirements. (See ‘Continuous service requirements’.)

Quarters under the RRIG are identified as:

Quarters	Months
March quarter	January, February, March
June quarter	April, May, June
September quarter	July, August, September
December quarter	October, November, December

Eligible services in ‘active’ quarters count towards annual service. An ‘active’ quarter is one where the value of Medicare billing provided in eligible locations meets the active quarter threshold of $4,000.

Where medical practitioners work across different categories within an active quarter following relocation, the payment rate is based on the category with the highest value of Medicare billed services.

The maximum annual payment is made to a medical practitioner whose clinical workload is confirmed by Medicare records as have met the annual payment threshold of $80,000.

The continuous service requirements are 4 active quarters in every 8 quarters. To maintain eligibility under RRIG, medical practitioners must meet these requirements.

The 2 year period (8 active quarters) commences from the time the first services are processed in the quarter nominated by the applicant (ie the quarter in which they apply to relocate or the quarter after).

Medical practitioners who are inactive for more than 4 quarters in 8 active quarters become ineligible for RRIG unless they have applied for and received approval for extended leave through the relevant Rural Workforce Agency (RWA). The Department of Human Services (DHS – formerly Medicare Australia) will inform medical practitioners should they lose eligibility.

Payments are calculated in three steps:

Step 1:	Calculate the medical practitioner’s Major Eligible Category for each active quarter and theMaximum Annual Payment Rate
Step 2:	Calculate the medical practitioner’s Activity Level Percentage
Step 3:	Multiply the Maximum Annual Payment Rate by the Activity Level Percentage. This equals the Payment Amount

Grants are calculated under two payment systems: the RRIG - Central Payment System (RRIG-CPS), and/or the RRIG - Flexible Payment System (RRIG-FPS).

Medical practitioners who bill Medicare services have their clinical workload automatically assessed each quarter while they are working towards their first or second instalment DHS will advise and provide payment to medical practitioners when an instalment is due.

The RRIG - FPS applies to medical practitioners who provide services outside the Medicare billing system that would not be adequately reflected in Medicare records eg Royal Flying Doctor Services.

The FPS assists medical practitioners in three broad categories.

• Medical practitioners who would have received CPS payments, but a period of acceptable leave has caused them to lose accrued eligibility.
• Medical practitioners providing eligible services through alternative forms of employment not captured under the CPS.
• Medical practitioners in isolated communities receiving minimal payments under the CPS that do not accurately reflect their workload.

To be assessed under the FPS, medical practitioners must contact the RWA in the State or Territory in which they provide services.

The FPS is available to medical practitioners seeking to relocate and access provisions in accordance with the following geographical locations:

Alternative employment
RA2-5	Medical practitioners working for the Royal Flying Doctor Services. Medical practitioners working for Aboriginal Medical Services.
RA4-5	State salaried medical practitioners providing primarily primary care services. Medical practitioners performing procedural services to private patients in a hospital setting
Top up provisions
RA4-5	Assists medical practitioners where their activity is not adequately captured under the CPS for reasons such as: excessive travel time to provide outreach services time spent providing population health work in Aboriginal communities the provision of essential services to a relatively small community.
Leave clustering
RA4-5	Medical practitioners working in remote communities under contract arrangements are entitled to cluster theirleave, up to 4 months at the end of their contract without compromising their accrued eligibility.

Certain groups of medical practitioners are eligible under the FPS and may be declined under the CPS. These groups of medical practitioners include:

Locums

Medical practitioners who have provided locum services (in the past 12 months) for up to 20 days (don’t have to be consecutive) in the same ASGC – RA category, or higher, to which they apply to relocate, and who meet all other eligibility criteria, may be deemed eligible for the RRIG under the FPS. This allows those medical practitioners who have been participating in locum placements, whether for employment purposes or to ‘try before they buy’ to be considered for the RRIG.

Overseas Trained Doctors (OTDs)

OTDs who have received a ‘non-location specific class exemption’ as a result of OTD scaling will be considered for the RRIG, as for all intents and purposes they have satisfied the requirements of section 19AB of the Health Insurance Act 1973. OTDs who have not completed their 10 year moratorium period nor received a scaled class exemption will continue to be ineligible for the RRIG until such time as they satisfy the requirements of 19AB.

New Zealand citizens

New Zealand citizen medical practitioners newly arrived in the country with no prior services in Australia to determine the ‘from’ location will be considered by the Departmental delegate on a case by case basis. Further to this, eligible medical practitioners who have provided no services in Australia during the 12 month period prior to applying for the RRIG will be considered on a case by case basis.

More information

These medical practitioners will be directed by DHS to their relevant RWA if their application requires assessment under the FPS.

Applicants seeking further information regarding the FPS should contact the RWA in their relevant State or Northern Territory.

Following relocation, all eligible services provided in RA categories more remote than the RA location from which the medical practitioner relocated will be taken into consideration in the calculation of payments.

Determining the relevant ASGC-RA Categories for RRIG eligibility depends on whether a medical practitioner has provided services in one or multiple RA categories over the past 12 months.

These two different circumstances are outlined below:
A. For medical practitioners who have provided services in one RA category over the previous 12 months:

• Check the RA category from which the medical practitioner is relocating.
  Go to the locator map
• The medical practitioner must move to a more remote RA category than the RA category in which they have provided services in order to be eligible.

Example: A medical practitioner who has only provided services in RA3 locations over the previous 12 months may be eligible to move to RA4 or RA5 locations.

B. For medical practitioners who have worked in multiple RA categories over the previous 12 months:
the location identified as the RA category ‘from’ which the medical practitioner is relocating is the RA category in which they have provided the majority of services over the previous 12 months

• the location identified as the RA category ‘from’ which the medical practitioner is relocating is the RA category in which they have provided the majority of services over the previous 12 months
• where a medical practitioner provides equal value of services in two different RA categories, the least remote is considered the ‘from’ location
• medical practitioners cannot relocate to a location within the same RA category in which they have provided services over the past 12 months – they must relocate to a more remote RA category in order to be eligible (unless Locum rule applies or approved by the GPRIP Advisory Body and Department)

Example 1: Over the previous 12 months, a medical practitioner has provided the majority of services in RA1 but also provided some services in RA2 locations. The ‘from’ location will be RA1, however, the medical practitioner is ineligible to apply for RA2 locations, but may be eligible for RA3-RA5 locations.

Example 2: Over the previous 12 months, a medical practitioner has provided an equal amount of services in RA3 and RA4 locations. The ‘from’ location will be the RA3 location (ie the least remote), however, the doctor will only be eligible to apply to relocate to RA5 locations, as services had been provided in RA4 over the previous 12 months.

Medical practitioners who have not billed Medicare in the past 12 months should contact the RWA in the State or Northern Territory to which they intend to relocate for further information.

Under normal circumstances, up to 12 months leave out of every 24 months (4 quarters out of every 8 quarters) is permitted under GPRIP without requiring permission.

Provision for extended leave in excess of 12 months is possible under the FPS. Applications for extended leave should be made to the RWA in the relevant State or Territory.

Payments under RRIG are made retrospectively. Each instalment is based on the preceding 4 active quarters, which are required to meet the continuous service requirements.

Medical practitioners should apply for extended leave through the RWA to ensure their ongoing eligibility for leave in excess of 4 quarters.

Medical practitioners requiring leave for a period greater than 12 months for upskilling and secondary training, or maternity leave may apply for extended leave through their RWA.

These leave provisions enable medical practitioners who miss out on CPS payments to access their incentive payments through the FPS.

The table below sets out the length of time medical practitioners may be eligible for leave under the FPS.

Payment System	Length of leave	Justification
Central Payment System	4 quarters (12 months)	None required
Flexible Payment System	4 quarters (12 months)	None required
	6 quarters (18 months)	Upskilling and secondary training
	8 quarters (24 months)	Maternity leave

Where permission for extended leave has been granted, periods of leave in excess of 18 months for upskilling and secondary training, and 24 months for maternity leave will result in the medical practitioner becoming ineligible for further grant payments.

Where exceptional circumstances exist, applications for periods of leave in excess of 8 quarters (24 months) must be submitted through the relevant RWA to the Department of Health and Ageing for consideration.

Exceptional circumstances will be reviewed on a case-by-case basis in order to ensure that medical practitioners are not unfairly disadvantaged due to occurrences beyond their control. Such circumstances will be reviewed by the Department, and may be referred to the GPRIP Advisory Body for consideration.

Payments under GPRIP are not subject to Pay As You Go (PAYG) withholding tax.

Recipients must, however, declare these payments for tax purposes, and are advised to seek advice from their financial adviser, accountant or the ATO regarding their own tax arrangements.

Medical practitioners must:

• open a new provider location ID
• apply for the RRIG within 90 days prior to the nominated relocation date
• nominate the quarter in which they would like DHS to begin to assess activity. This can be the quarter in which their application is approved, or the following quarter
• once approval has been received, relocate within 90 days of approval from Medicare Australia or the relevant RWA.

There are 2 ways a medical practitioner can apply for a relocation grant.

• Get an application form (PDF 91 KB)
• or you can apply through DHS’s Health Professional Online Services (HPOS). HPOS access requires the user to have a Public Key Infrastructure (PKI) certificate.
  Medicare Australia website

Medical practitioners who have not billed Medicare items in the past 12 months

Medical practitioners who have not billed Medicare items in the 12 months preceding their application will be considered ineligible (in the first instance) and will be advised to contact the RWA in the relevant State or Territory they intend to relocate to for further assessment.

Medical practitioners may apply directly to the RWAs if they fall into this category. The relevant RWA will assess their application form and evidence of clinical workload (as requested by the RWA). The RWA will advise Medicare Australia of the applicant’s eligibility.

To be eligible for the GP Component, medical practitioners must be providing eligible services in RA2-5 locations.
See the GP Component guidelines

If a medical practitioner is declined for the RRIG, they may request a review of their case by the GPRIP Advisory Body. In these circumstances the Department of Health and Ageing will make the final decision, and can choose to accept or reject the Advisory Body’s recommendation.

Requests for review can be sent directly to the Department or via DHS. Please note, the Advisory Body meets quarterly, hence any request for review by the group will be subject to these timelines.

For more information or help on GPRIP: RRIG:

• call Medicare Australia on 1800 010 550
• or email the Department of Health and Ageing at GPRIP@health.gov.au
• or contact the relevant Rural Workforce Agency:
  • Northern Territory - General Practice Network Northern Territory (08) 8982 1000
  • South Australia – Rural Doctors Workforce Agency South Australia (08) 8234 8277
  • Western Australia – Rural Health West (08) 6389 4500
  • Tasmania – Health Recruitment Plus Tasmania (03) 6334 2355
  • New South Wales - New South Wales Rural Doctors Network (02) 4924 8000
  • Queensland – Health Workforce Queensland (07) 3105 7800
  • Victoria – Rural Workforce Agency Victoria (03) 9349 7800