Fact Sheet – Section 19AA of the Health Insurance Act 1973

What is section 19AA?

Section 19AA of the Health Insurance Act 1973 (the Act) was introduced in 1996 to recognise and support general practice as a vocational specialty, as well as to provide a framework for achieving long term improvements in the quality of doctors working in Australia.

Who is affected by section 19AA?

All medical practitioners are subject to restrictions of section 19AA of the Act if they:
  • held medical registration by an Australian Medical Board on or after 1 November 1996;
  • are Australian permanent residents or Australian citizens; and
  • do not hold continued recognition by the Royal Australian College of General Practitioners or the Australian College of Rural and Remote Medicine, or by a recognised specialist college.
Medical practitioners who were registered before 1 November 1996 will also be subject to section 19AA if:
  • on 1 November 1996 had not completed intern or supervised training;
  • on or after 1 November 1996 were not permanent residents or Australian citizens within the meaning of the Migration Act 1958 ;
  • are currently temporary resident or New Zealand citizens or permanent residents; and
  • do not hold continued recognition by the Royal Australian College of General Practitioners or the Australian College of Rural and Remote Medicine, or by a recognised specialist college.
Overseas trained medical practitioners who complete their commitment to section 19AB of the Act (also known as the 10 year moratorium) are subject to the restrictions under section 19AA of the Act. This means that if a doctor completes their 10 year moratorium but has not gained Fellowship or holds specialist recognition, they will still be subject to the restrictions of section 19AA of the Act.

Temporary resident or New Zealand citizen doctors are subject to section 19AA. However, if these doctors hold an exemption under section 19AB of the Act, they will be exempt from the requirements of section 19AA.

Training and workforce programs under section 3GA of the Act

All medical practitioners restricted by section 19AA of the Act who do not hold specialist qualifications are unable to access Medicare benefits unless they apply and participate on an approved training or workforce program under section 3GA of the Act.

There are placements in various approved training and workforce programs which satisfy the requirements of section 19AA of the Act. These allow doctors to access the Medicare benefits arrangements while undertaking vocational training to gain Fellowship of a recognised medical college.

List of approved programs under section 3GA of the Act

  • Rural Locum Relief Program
  • Queensland Country Relieving Program
  • Approved Medical Deputising Service Program
  • Australian General Practice Training Program
  • Approved Private Emergency Department Program
  • Special Approved Placements Program
  • Temporary Resident Other Medical Practitioners Program
  • Specialist Medical Colleges in Australia
  • Remote Vocational Training Scheme

What rebates can I claim if I do not hold continued recognition as a medical practitioner?

Medical practitioners who do not hold continued recognition by either RACGP, ACRRM or by a recognised specialist medical college, generally cannot access the higher Medicare Rebate - known as the A1 rebate.

However, non recognised medical practitioners can access the A2 rebates and other items in the Medical Benefits Schedule (MBS) book.

For more information regarding access to either the A1 or A2 rebates and other items in the MBS book, please contact the Department of Human Services (DHS) - Medicare (contact details below).

How can I get the higher rebate?

If you do not hold continued recognition as a specialist by the RACGP, ACRRM or another recognised specialist medical college, you will generally only be able to access the A2 rebate.

However, if you are working in a rural or remote area, or after hours, it may be possible to access the A1 rebate. Please contact the Department of Human Services (DHS) - Medicare to check your personal eligibility.

If I move practices, can I continue to access the higher rebate?

This will depend on a number of factors. If you are accessing the higher rebate through a location specific workforce program, you may lose this access if you move. If you are contemplating moving, please contact the Department of Human Services (DHS) - Medicare to check whether the new placement will be eligible.

Contact information

Department of Health
Access Policy Section
Email: 19AA@health.gov.au

OR

Department of Human Services (DHS) - Medicare
Call 132 150 (all States)
Email: PROVIDER.REGISTRATION@humanservices.gov.au