COVID-19 resources

Last updated: 29 May 2020

If you are unsure how to handle a matter concerning COVID-19, you can contact MIPS for clinico-legal advice and support on 1800 061 113. See how MIPS is assisting members during COVID-19.

Government, AHPRA and industry updates

  • Australian Government Department of Health: Health alert, Coronavirus App, WhatsApp Channel, News and Resources
  • 1800 020 080 National Coronavirus Helpline (24/7)
  • State Government health department updates ACTNSWNTQLDSATASVIC and WA
  • AHPRA and National Boards updates
  • Refer to your college for craft specific guidance (eg RACGPACRRMRACS, ADA)

Telehealth

The recent expansion of Telehealth in Australia due to the outbreak of COVID-19 does not obviate the need for a face to face in person consult when a physical/direct examination is pivotal to support clinical decision making. See our telehealth FAQs for further information.

FAQs

Does MIPS' indemnity policy cover telehealth?

Yes, MIPS Membership benefits (including insurance covers) extend to technology based health services subject to the following guidelines:

  • You and the patient are located in Australia
  • Your practice is in accordance with AHPRA's and specialist colleges' requirements, guidelines and advice. See Telehealth FAQs
  • You hold current AHPRA healthcare practitioner registration
  • You have appropriate training, experience and qualifications for the healthcare activities undertaken by you
  • You have an appropriate MIPS membership classification for the healthcare activities undertaken by you

If you do not meet the above or have a query about telehealth and the services you provide, complete a Practice Assessment Questionnaire for individual assessment.

What are the temporary MBS telehealth items for COVID-19?

To limit the outbreak of Covid-19, new temporary MBS telehealth items have been introduced to ensure continued access to essential Medicare rebated consultation services. As of 30 March 2020, these items have become more general in nature. Updated details and lists can be found at MBS Online.

The numbers have been expanded to allow bulk-billed telehealth (phone or video) consultations by practitioners for ALL Australians where it is safe and clinically appropriate to do so. Effective 6 April, the Federal Government has changed the Australian COVID-19 telehealth legislation to allow for limited mixed-billing. From 20 April, specialists non GP providers are no longer required to bulk bill these new telehealth items. See ‘Can I apply my usual billing practices’ below. Criteria apply. For up to date details see the MBS online.

Can I apply my usual billing practices?

Effective 6 April, the Federal Government has changed the Australian COVID-19 telehealth legislation to allow for limited mixed-billing. Telehealth services must be bulk billed for Commonwealth concession card holders, children under 16 years old, and patients who are more vulnerable to COVID-19. See the MBS Online. From 20 April, specialists non GP providers are no longer required to bulk bill these new telehealth items.

Otherwise members can apply their usual billing practices to the telehealth items for patients who do not meet these criteria. The usual requirement to obtain informed consent remains and, in particular, an informed financial consent. Members would be aware that a person who is at risk of COVID-19 virus means a person who:

is required to self-isolate or self-quarantine in accordance with guidance issued by the Australian Health Protection Principal Committee in relation to COVID-19; or

  • is at least 70 years old; or
  • if the person identifies as being of Aboriginal or Torres Strait Islander descent—is at least 50 years old; or
  • is pregnant; or
  • is the parent of a child aged under 12 months; or
  • is being treated for a chronic health condition; or
  • is immune compromised; or
  • meets the current national triage protocol criteria for suspected COVID-19 infection.

Can I perform elective surgery?

Prior to 27 April non urgent Category 2 & 3 elective surgeries and certain other activities were restricted by the Government. From 27 April there is greater availability of elective surgery. The Government and the AMA support the gradual restart of category 2 elective surgeries and selected category 3 procedures, including: 

  • IVF 
  • screening programs where they have ceased 
  • post-cancer reconstruction procedures (such as breast reconstruction) 
  • all procedures for children under the age of 18 
  • all joint replacement including knee, hips and shoulders 
  • all cataracts and eye procedures 
  • diagnostic screenings such as endoscopy and colonoscopy. 

See the Government Announcement, Australian Health Protection Principal Committee (AHPPC) statement on restoration of elective surgery, AMA Media Release – Steps for resumption of elective surgery and the National Elective Surgery Urgency Categorisation Guidelines (PDF) to help in an assessment of urgency. 

The Australian Commission on Safety and Quality in Health care provide an excellent overview. MIPS encourages you to engage with your hospital, employer, professional college or professional association for clarification to ensure appropriateness of the surgery. 

It is the responsibility of members to make an appropriate clinical judgement about the surgery performed and patients selected. This should always be based on the Federal and State/Territory government directions, AHHPC directives and requirements, your College or professional association advice.

As with any healthcare service members should consider the Good Medical Practice code of conduct.

Members are reminded these restrictions are mainly based on the conservation of personal protective equipment (PPE), the safety of all staff and patients and overall, conserving Australia's healthcare resources.

Where members proceed with such procedures it is important to carefully consider the therapeutic need, obtain consent and document accordingly in patient notes. Members may be required to substantiate surgical decisions to regulators.

Can I still perform cosmetic surgery?

Highly discretional services (those that require close and prolonged personal contact between the service provider and client) such as “Beauty and personal care services” are prohibited. Cosmetic medical services is not specifically stated, however, most such procedures are “highly discretional”. You should not provide treatments that use Botox, non-permanent dermal fillers and botulinum toxins unless it is used for therapeutic purposes. MIPS encourages you to engage with your professional college, professional association, state/territory public health service or the AMA for clarification.

Members are reminded these restrictions are mainly based on the conservation of personal protective equipment (PPE), the safety of all staff and patients and overall, conserving Australia's healthcare resources.

Where members proceed with such procedures it is important to carefully consider the therapeutic need, obtain consent and document accordingly in patient notes. Members may be required to substantiate treatment decisions to regulators.

What insurance cover do I need to treat COVID-19 public patients in private hospitals?

The Federal Government has announced that in conjunction with Commonwealth, State and Territory Health Ministers, private hospitals will support the COVID-19 response by providing hospital services and staff for public patients. For the most part the State and Territory governments would normally indemnify public patient healthcare. Members should check closely and be aware of the indemnity in place for the work to be undertaken.

If members are being asked to undertake different work (or sign a contract to undertake work) the following actions should be taken.

  • Confirm that your contract of employment clearly defines whether your employer is providing you indemnity or not
  • Ensure that your current MIPS membership classification accurately reflects the healthcare you provide, whether your indemnity is covered by the employer or not.

If you are not indemnified by the state, the hospital or another insurer, you need to declare to MIPS your non-employer indemnified (ie private) billings and/or salary for this work.

If a member is undertaking non employer indemnified work, MIPS does not differentiate between practice undertaken in a private setting and practice undertaken in a public setting. From MIPS's perspective there is, however, an assumption that members who provide services to public patients will do so with the same level of professionalism as if those patients were regular private patients. The responsibility for the provision of health services and period of ongoing care, monitoring, treatment and need for follow up remains with the practitioner/s that treat a patient unless appropriate transfer of care is undertaken.

Can I update my membership to change my membership fee?

You may be practising less or substantially changing your practice. This may change your risk profile and the applicable membership fee.

What if I have difficulty paying my MIPS membership?

We appreciate that some practitioners may be concerned about upcoming financial commitments. MIPS renewal documentation will be issued in May, one option available to members is to pay your membership fee by instalments at no additional cost. In the event you require assistance with your repayments, MIPS will consider any request for temporary financial hardship in a fair and appropriate manner. Complete a Financial Hardship Request form.


Practice and employee FAQs

What should I do if I, or one of my staff, might have COVID-19?

You should check the most recent Government update. The Australian Health Protection Principal Committee (AHPPC) has recommendations for health and aged-care workers. You should not go to work if you have respiratory/influenza like illness or meet the criteria for self-isolation or quarantine. MIPS suggests you check current recommendations.

There are no AHPPC work restrictions on healthcare workers who are casual contacts of COVID-19 patients and are well, including those who have provided direct care for confirmed cases with adequate personal protective equipment. In this instance, healthcare workers are advised to self-monitor for symptoms and self-isolate if they become unwell until COVID-19 is excluded.

If my staff are self-isolating do I need to continue to pay them?

This a complex legal area and the answer may vary depending on any awards employees may fall under or their employment contact conditions. MIPS’ advice is the self-isolation in accordance with Department of Health advice should be considered sick-leave, however, if the employee is well then a work-from home arrangement can be put in place if viable. Compensation does not apply to contractors.

Do I have to pay my staff if I am forced to close my practice?

If you are forced to close your practice for valid reasons such as a COVID-19 infection/s, fire, flood, or breakdown of critical equipment, you can stand down employees who are unable to do useful work. You can only do this in certain circumstances. See Fairwork guidance. You do not need to pay an employee during a stand down. It may be better to consider offering employees the chance to take paid leave.

If I close my practice what do AHPRA require me to do?

In the code of conduct of the Medical Board at 3.15 and the Dental Board at 3.16 , it states when closing or relocating your practice, good medical practice involves giving advance notice where this is possible and facilitating arrangements for the continuing medical care of all your current patients, including the transfer or appropriate management of all patient records. You must follow the law governing health records in your jurisdiction. See also Retiring or ceasing your practice in Australia or the checklist in How to: Retiring from healthcare practice.


JobKeeper FAQs

What is the JobKeeper Payment?

JobKeeper is a wage subsidy payment provided by the government to help employers retain employees during COVID-19.

The JobKeeper Payment is $1,500 per fortnight (before tax) for each eligible employee to subsidise the eligible employee’s wages.

The JobKeeper Payment is only available from 30 March 2020 to 27 September 2020 to eligible employers who have elected to participate in the scheme.

As an employer am I eligible to receive the JobKeeper Payment?

Australian healthcare practices, including companies, partnerships, trusts and sole traders, not-for-profit entities and charities, are eligible if they meet the following criteria:

  • have business turnover of less than $1 billion (for income tax purposes) which has been reduced, or is likely to be reduced by more than 30% (of at least a month) compared to a period a year; or
  • have business turnover of $1 billion or more (for income tax purposes) which has been reduced or is likely to be reduced by more than 50% (of at least one month) compared to a period a year.

If you are an eligible healthcare practice and you have stood down employees after 1 March 2020, you can claim the JobKeeper Payment for those employees, if they are eligible employees. To be eligible to receive the payment for these employees, you will need to pay them a minimum of $1,500 per fortnight (before tax) for the JobKeeper Payment periods.

Eligible healthcare practices must register online with the ATO for the JobKeeper Payment on behalf of their eligible and nominated employees (including themselves) and provide monthly updates to the ATO.

As an employee am I eligible to receive the JobKeeper Payment?

If you are employed by an eligible healthcare practice, you will be considered as an eligible employee if you:

  • were employed by your employer at 1 March 2020
  • are currently employed by the employer (including if you are stood down or re-hired)
  • are full-time or part-time (including fixed term), long-term casual (a casual employed on a regular and systemic basis for longer than 12 months as at 1 March 2020 and not a permanent employee of any other employer) or a sole trader
  • are at least 18 years of age on 1 March 2020
  • are 16 or 17 years of age on 1 March 2020 and are independent or not undertaking full time study;
  • are an Australian citizen, the holder of a permanent visa, a protected special category visa, a non-protected special category visa who has been residing continually in Australia for 10 years or more, or a special category (subclass 444) visa holder
  • were an Australian resident for tax purposes on 1 March 2020
  • are not receiving government paid parental leave, ‘dad and partner pay’, or payment under workers’ compensation law for total incapacity to work, and
  • are not receiving the JobKeeper Payment from another employer.

For more information see the JobKeeper Payment advice for employees

I am an employer who receives JobKeeper Payments for my employees. When do I have to pay my employees?

You must pay the minimum $1,500 per fortnight (before tax) to each eligible employee to claim the JobKeeper payment for that fortnight.

You should pay your employees for each JobKeeper fortnight for which you plan to claim the payment. The first fortnight was from 30 March 2020 to 12 April 2020 and each JobKeeper fortnight follows after that.

I am an employer who is receiving the JobKeeper Payment for my employees. I want my employees to perform other duties and/or work from a different location. Can I do this?

On 9 April 2020, temporary changes were made to the Fair Work Act 2009 (Cth) (Act) which apply to employers receiving the JobKeeper Payment for their eligible employees. The temporary changes remain in place until 28 September 2020.

The temporary changes to the Act provide increased flexibility for employers to give directions to employees who are receiving the JobKeeper Payment, including for stand down, changes to duties and location of work, changes to days or times that work is performed and/or the taking of annual leave by the employee, including at half pay.

Yes, you are able to direct your employees who are receiving the JobKeeper Payment to perform other duties and/or to work at a different location– provided that you consult with your employee prior to giving the direction, and provided that you give them at least three days written notice of your intention to give the direction. A shorter notice period may apply if your employee genuinely agrees to a shorter notice period.

If you direct your employee to perform other duties, the duties must be reasonable and within the scope of healthcare practice operations, and within the employee’s scope of practice, skill and competency.The employee must also have any relevant licence or qualification required to perform the duties.

If you ask your employee to work from a different location, including the employee’s home, you need to ensure that alternate location is suitable for the employee’s duties. The direction must not require the employee to travel an unreasonable distance.

I am an employee who is receiving the JobKeeper Payment and my employer has notified me that my hours will be reduced. Are they allowed to reduce my hours?

The temporary changes to the Act noted above allow your employer to direct you:

  • not to work on a day you would usually work,
  • to work for a lesser period on a day, or
  • to work a reduced number of hours overall (which can be nil).

Your employer can only give you the direction if you cannot be usefully employed for your normal days or hours because of changes to the healthcare practice that are linked to COVID-19 or linked to government initiatives introduced to deal with COVID-19 pandemic.

Your employer must consult with you prior to the direction taking effect and provide you with at least three days written notice of their intention to give the direction. A short notice period may apply if you genuinely agree to a shorter notice period.

I am an employer who is receiving the JobKeeper Payment for my employees. I have reduced my employees’ hours. How much do I have to pay them?

This question will differ for each individual employee and it is recommended that you seek independent advice in relation to individual circumstances.

However, as a general rule:

  • You must comply with the JobKeeper Payment rules and pay the minimum $1,500 per fortnight (before tax) to each eligible employee, even if your employee currently earns less than $1,500 per fortnight (before tax).
  • If your employee is currently earning above $1,500 per fortnight (before tax) even with the reduced hours, you must top up the difference so that your employee receives their full entitled amount for all hours worked.
  • You must not vary your employee’s hourly rate of pay in accordance with any relevant contract of employment, Modern Award or Enterprise agreement.

I am an employer who is receiving the JobKeeper Payment for my employees. Do I have to pay superannuation on the whole JobKeeper Payment amount?

If your employee is paid more than $1,500 per fortnight, your superannuation obligations will not change.

If you are topping up your employee’s wages to $1,500 per fortnight by the JobKeeper Payment, it will be up to you if you want to pay superannuation on any additional wages paid by the JobKeeper Payment.


Patient FAQs

Can I refuse to see patients with respiratory conditions?

Yes, you can refuse to treat a patient, except in an emergency or within your Emergency Department practice The AHPRA code of conduct advises that a “patient should not be denied care, if reasonable steps can be taken to keep you and your staff safe.” It is MIPS advice that if a patient cannot be seen then they should at least be provided with advice as to how to seek alternative help Lack of appropriate PPE may be a reason for not treating a patient in the current climate. If you cannot adequately protect yourself or you know you are vulnerable, then MIPS recommends you refer the patient to a more appropriate environment where they can be examined safely.

Members can choose to end a doctor-patient relationship, for example where the patient is aggressive, has been forging certificates or consistently fails to follow medical advice. Appropriate measure should be put in place to ensure continuity of care.

Can I give a COVID-19 patient a medical certificate to return to work?

If the patient has returned a negative test, or is not exhibiting any symptoms and or has appropriately self-isolated in accordance with Department of Health advice if necessary then a carefully worded letter of support can be issued stating that the patient has told you this is the case.

What do I do if a patient demands testing or refuses to be tested?

Patients can’t demand that doctors undertake testing. This is a clinical decision based on the circumstances of each patient and the guidelines for testing and available resources at the time.

If you have first-hand knowledge of patients refusing to be tested, isolate or lying about travel, you should contact your state or territory Department of Health and document accordingly. Various State and Territory penalties are now in place for the offending individuals and companies.

Can I prescribe Hydroxychloroquine due to COVID-19?

This drug may be effective against COVID-19 (still unproven) and to avoid shortages the federal Department of Health have restricted the medical practitioners who are authorised to prescribe it.

Only AHPRA recognised specialists in dermatology, intensive care medicine, paediatrics, child health, emergency medicine or a physician may prescribe Hydroxychloroquine to new patients as part of an initial treatment plan. Following this, patients can then attend upon their general practitioners for ongoing prescription of Hydroxychloroquine or medicines containing the substance.


Returning to practise

If I return to practise during the COVID-19 pandemic, what indemnity insurance do I need?

AHPRA requires a professional indemnity insurance arrangement for all practitioners including those returning through the Pandemic Response Sub Register. If you are returning to the public sector, your employer will most likely cover you. Have this confirmed in writing. If you are returning to private practice, you will need to arrange your own cover which you can with MIPS. Both scenarios require a change of your MIPS membership to a practising classification. Please advise us by completing a Return to Practise form. Further details about the Sub Register from AHPRA.

Do I lose my run-off cover if I return to practise?

AHPRA clearly state “The Commonwealth Government has confirmed that if you were covered by the Commonwealth Run-off Cover Scheme (ROCS) and you return to the workforce to support healthcare initiatives for COVID-19, you will continue to be covered by ROCS for claims that may arise in relation to your prior medical practice before you retired. You will still need to ensure you are insured for medical services you provide once you return to practise.” In such circumstances, should you return to practise, your ROCS cover for past practice through MIPS remains unchanged.

The Department of Health states: "The Amending Regulations amend the Medical Indemnity Regulations 2003 by inserting a temporary exemption that applies to any practitioner who is eligible for the ROCS and who returns to private practice. This temporary exemption allows retired doctors to return to private practice in order to provide treatment during the COVID-19 pandemic without the practitioner losing their eligibility under the ROCS. The exemption operates on the basis that these practitioners have the requisite registration to practice, and only applies on a temporary basis for the duration of the declaration of the Human Biosecurity Emergency Declaration and a grace period of one further month."

I want to return to work and do more than COVID-19 related work?

Your circumstances will need to individually assessed by MIPS. Please complete the Practice Assessment Questionnaire.


Student

I'm a medical student performing a role to assist with COVID-19, what insurance do I need?

MIPS' free student membership classification is appropriate if you are performing a role to assist with COVID-19:

  • Where the role is employer indemnified (ie the hospital agrees to provide cover)
  • irrespective of whether the role is volunteer or paid

As with all membership you must have appropriate training and experience for the healthcare services you provide including appropriate supervision (a registered healthcare practitioner). If you are undertaking a role that doesn't meet these guidelines, refer to placements for further information or complete a Student Placements, Healthcare Activities form for assessment.


Dental

What is the expectation of the Dental Board for dental practitioners?

On the 8 May 2020 the Dental Board confirmed the AHPPC's latest advice, agreeing to a move to level 1 restrictions. This means you can now move to level 1 restrictions.

However, you must check with your respective state or territory health department for directives that apply to dental practice, as these may vary in response to local prevalence or hot spots of COVID-19.

You must also still screen patients and assess the risk of transmission in your practice context and apply infection prevention and control precautions that address the level of risk of transmission.

AHPRA provide an overview of its response to COVID-19 at AHPRA COVID-19 Response.

See the news item published by the Dental Board on 22 April 2020 for further information: Adapting to COVID-19: Teledentistry, clinical training, CPD and PII.

Does my MIPS membership cover teledentsitry?

Yes, teledentistry is another form of telehealth. See our telehealth FAQs.

In its 6.28 Teledentistry Position Statement, the ADA supported the further development of teledentistry and teleradiology services and recommended these should be monitored and assessed as they are put into effect in Australia. A summary of the main recommendations for its implementation is given below.

There is no explicit statement from the Dental Board or ADA that limits or prohibits any particular aspect of the teledentistry in response to the outbreak of COVID-19. Before deciding to carry out a procedure in person, eg after a teledentistry diagnostic evaluation, members should give full consideration to the current requirements of the Australian Government , regulators and your associated professional association, taking full account of the level 2 restrictions outlined in the ADA guidelines.


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The materials provided are for educational purposes only. Whilst all reasonable care has been taken in preparing these materials, including the accuracy of the information supplied, MIPS does not accept any liability whatsoever arising out of the use or reliance of the information provided. Contact MIPS 24/7 Clinico-Legal Support 1800 061 113 or education@mips.com.au for specific advice.