COVID-19 Latest information and frontline advice

GOT SYMPTOMS? 
Call your GP before you visit or Coronavirus Health Information Line 1800 020 080

 

FIGHTING COVID-19 TOGETHER

With tireless advocacy and ongoing support, AMA Queensland is your powerful ally against COVID-19.
Everything you need to know about COVID-19 in one place. Find out what help is available and get the latest updates.
 


Frequently Asked Questions

Latest AMA Queensland / AMA News

The COVID-19 crisis is fast moving. Keep up to date on issues facing doctors and what the AMA is doing to address these issues:

Advocacy

AMA Queensland and AMA Federal are working closely with Government to address the following key issues affecting our members at the frontline of the COVID-19 threat.

Member Feedback - We encourage members to continue to raise COVID-19 issues via Queensland Doctors' Community (QDC) or by emailing covid19@amaq.com.au< so that AMA Queensland can continue to advocate on your behalf.

Doctors' Wellbeing

Queensland Doctors' Health Programme’s help line - Call (07) 3833 4352 (available 24/7)

The challenges presented by Coronavirus are likely to lead to a busy and stressful period for doctors. It is important during such times that medical practitioners take time to care for themselves and take the opportunity to debrief with colleagues.

Confidential peer-to-peer support for trauma and stress is available free of charge to all doctors and medical students through Queensland Doctors' Health Programme.

COVID-19 Doctor Wellbeing Services

Frequently Asked Queensland

FREQUENTLY ASKED QUESTIONS - DOCTORS [UPDATED 30/04/2020]

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Are you a doctor and have questions about COVID-19? Contact the AMA Queensland  at covid19@amaq.com.au.


Information for the General Public

GOT SYMPTOMS?


FREQUENTLY ASKED QUESTIONS - GENERAL [UPDATED 09/04/2020]

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For more information call the Coronavirus Health Information Line on 1800 020 080


WHAT IS COVID-19?

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COVID-19 is an infectious disease caused by the coronavirus SARS-CoV-2. COVID-19 first originated in humans after being transmitted from animals and can now be transmitted from human-to-human via droplets.

HOW DOES COVID-19 SPREAD?

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Like the flu, COVID-19 can be transmitted from person to person. The scientific evidence confirms that COVID-19 is spread by droplets.

  • droplets being transmitted directly from an infected person to the mucous membranes (eyes, mouth, nose) of an uninfected person; or
  • droplets being transmitted from the respiratory system of an infected person onto an external surface and subsequently picked up by an uninfected person and transferred to their mucous membranes (usually when they touch their face). The virus can survive on external surfaces for approximately 48 hours at room temperature.

The incubation period (the time between exposure to the virus and the appearance of symptoms) is estimated at between 2 to 14 days.

WHAT ARE THE SYMPTOMS OF COVID-19?

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Once infected, the symptoms of COVID-19 can appear very similar to a common cold, but also extend to severe and sometimes fatal respiratory disease.

The most common symptoms are fever and a dry cough, and additional symptoms may include muscle aches, runny or stuffy nose, sore throat, shortness of breath, and in some cases breathing difficulties.

To date, approximately 80% of people with COVID-19 will only develop a mild infection, 14% will require routine hospitalisation, and 6-8% will require intensive care. It is important to understand that these are early numbers based on acute cases, and likely miss many asymptomatic infections.

WHEN IS TESTING FOR COVID-19 REQUIRED?

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Due to a global shortage of COVID-19 test kits, the current advice from the Australian Government is that tests for COVID-19 should be restricted to people who have developed symptoms within 14 days of having contact with a confirmed case, or within 14 days of arriving in Australia from overseas; healthcare workers who work directly with patients and develop respiratory illness and fever; and people with community-acquired pneumonia with no clear cause.

People presenting for COVID-19 testing should inform the medical facility before arriving, and provide clear and accurate information about their symptoms, travel history and recent contacts.

WHO SHOULD GET TESTED?

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Due to the global shortage of testing kits, the Department of Health has set clear criteria for those who should be tested for COVID-19. Tests are only conducted for people that:

  • Have arrived in Australia from overseas within 14 days and developed respiratory symptoms
  • Have been in close contact with a person who has been diagnosed with COVID-19 and has developed respiratory systems;
  • Have severe community-acquired pneumonia with no clear cause; and
  • Are healthcare workers working directly with patients and have developed both respiratory symptoms and a fever.

However, some states have expanded their testing criteria beyond the Australian Government criteria. See the state health websites for more detail:

  • The ACT is now testing those with symptoms that: have been admitted to hospital; live in high-risk settings; or have connections to COVID-19 outbreak settings.
  • Tasmania and South Australia are now testing interstate travellers who have developed symptoms within the last 7 days (SA) or 14 days (TAS).
  • Victoria is now testing those with symptoms that: are Aboriginal or Torres Strait Islander; live in an aged care facility, or have been admitted to hospital.

Health Direct's COVID-19 symptom checker provides useful advice on who should be tested for COVID-19, what a "close contact" means, and who should seek medical attention.

HOW DO I PROTECT MYSELF AND OTHERS?

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  • HYGIENE
  • SOCIAL DISTANCING
  • SOCIAL ISOLATION

HYGIENE

Practising good hand and general hygiene is one of the most effective methods of slowing the spread of COVID-19. This includes washing hands frequently before and after eating; after going to the bathroom; and after returning home. Appropriate handwashing should take at least 20 seconds and involve washing all surfaces on the hands. Commonly missed areas include fingertips, thumbs, in between fingers, and the back of hands. Coughs and sneezes should be covered with a tissue or elbow, and tissues disposed of immediately.

Hands should be washed with soap and water or alcohol-based hand sanitiser after blowing the nose or touching the face.

  • Handwashing

Regularly washing your hands with soap and water is one of the most effective ways to prevent the spread of disease. If running water is not available, alcohol-based hand sanitiser is a good alternative, but will only be effective if your hands are not visibly dirty. Washing your hands should take at least 20 seconds - don't forget to scrub your fingertips, between your fingers and the backs of your hands as well as your palms.

  • Surgical Masks

For uninfected people, wearing a surgical mask in public is unlikely to significantly reduce your risk of being infected with COVID-19. Healthy people do not need to wear surgical masks in public. However, people who have been diagnosed with COVID-19, as well as those that come into close contact with them and those with suspected cases, should wear surgical masks when they interact with others and in public spaces. More detailed advice on surgical masks is available from the Australian Department of Health here.

  • Touching your face

Avoiding touching your face is an important way to slow the spread of COVID-19. The infection can be spread when you pick up virus-containing droplets from an external surface with your hands, and then transfer them onto your mucous membranes (eyes, nose and mouth). Unfortunately, touching your face is a very common human instinct, and often a reaction to stress - so it can be hard to stop completely. Tactics to reduce face-touching include folding your hands in your lap, wearing gloves, and even post-it reminders. Healthline has produced a handy article on how to avoid touching your face here.

Other handy tips:

  • Avoid handshakes, hugging and kissing as greetings;
  • Cover sneezes and coughs with a tissue or the crook of your elbow;
  • Dispose of tissues immediately after using them;
  • Clean commonly-touched surfaces (door handles, desks, benches, keyboards) daily;
  • and Stay at home if you are sick.

SOCIAL DISTANCING

Social distancing is a proven method of stopping or slowing the spread of COVID-19 and involves reducing contact between people in both public and private spaces. Social distancing has proven a simple, powerful and effective tactic to slow the transmission of COVID-19. Useful social distancing measures include:

  • cancelling public events and large family gatherings;
  • reducing visits to public spaces like restaurants, libraries and shopping centres, and
  • working from home or not attending workplaces where possible.

When people do interact in public and private spaces, maintaining physical distance between each other can also make it harder for the virus to spread. Current advice from the Australian Government recommends maintaining a distance of at least 1.5 metres where possible. Avoiding handshakes or kissing as a form of greeting others is another important way to reduce physical contact.

Wearing a mask in public is unlikely to reduce your risk of being infected, but is recommended for those in close contact with confirmed or suspected cases.

SOCIAL ISOLATION

Social isolation occurs when people who are infected with COVID-19 or suspected of being infected with COVID-19, limit their contact with other people as much as possible. Currently, some people with mild cases of COVID-19, and those with suspected cases, are self-isolating at home or in other confined environments. Close contacts of confirmed cases, as well as people who have arrived in Australia from overseas, are required to quarantine themselves at home. Quarantine differs from self-isolation in that it is a precautionary measure taken by people who are currently healthy.

People who are required and able to self-isolate are advised to use private transport to travel to their isolation location, and cannot leave to visit public places other than a health facility. The Australian Government has produced detailed guidance for self-isolation, which can be accessed here.

WHAT SHOULD I DO IF I'M VULNERABLE?

Several groups of Australians are at a higher risk than the general population of being infected with COVID-19, and a higher risk than the general population of developing severe symptoms once infected.

The following people should take extra precautions against becoming infected, including staying at home if possible:

  • Older Australians: starting at age 60, there is an increasing risk of disease, and this risk increases with age. The highest risk of serious illness and death is in people older than 80.
  • People with compromised immune systems and/or existing chronic health conditions: these existing conditions, like diabetes, heart disease, lung disease, and autoimmune conditions, can make it harder for people's immune systems to fight the virus.
  • Aboriginal and Torres Strait Islander peoples are at a higher risk because of the higher rate of chronic conditions in these populations.
  • People living in group residential settings such as detention facilities and aged care facilities, where infections can spread quickly.

Additional measures that you can take include: 

  • If you are immune-compromised, avoid staying with a person who is self-isolating (because they are a close contact of a confirmed case of COVID-19 or have recently travelled to any country except those listed in the countries and areas of concern.)
  • You should stay at least 2 metres away from people who are unwell if you are immune-compromised.
  • It's also important that everyone helps to protect the safety of immunocompromised people living in our community. For example, if you’re unwell, avoid contact with someone who is immune-compromised.
  • At this time, it wouldn’t make sense for someone who is immune-compromised to wear a mask when in public to decrease the risk of catching COVID-19. However, if your health care provider advises you to wear a mask when in public areas because you have a particularly vulnerable immune system, follow that advice.
  • If you are taking immunosuppressive drugs, we advise that you do not stop this medication without first consulting your GP or specialist.

I'M PREGNANT WHAT DO I NEED TO DO?

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Detailed information about the impact of COVID-19 on pregnant women and their babies is yet to be determined. Pregnant women are at risk of more severe symptoms from the flu, but thus far do not appear to be at higher risk than the general population of severe COVID-19 symptoms. RANZCOG has prepared detailed advice for pregnant women, which can be accessed here.

SHOULD I STAY AT HOME?

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If you don't meet the criteria for COVID-19 testing, but have symptoms of sickness or feel unwell, you should still stay at home and limit your contact with others. Your doctor can provide you with further advice. If you do meet the criteria for COVID-19 testing, you should self-isolate at home until you can attend a health facility to be tested, and remain self-isolated until you receive your test results.

Those who have come into close contact with a person who has been diagnosed with COVID-19, MUST quarantine themselves at home for 14 days after their most recent contact with that person. More advice on close contacts and quarantine is available from the Department of Health.

WHEN SHOULD I SEEK MEDICAL ATTENTION?

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If you meet the testing criteria for COVID-19, call your doctor or hospital to advise them you want to be tested. They will provide you with advice about timing and relevant precautions, like wearing a mask and distancing yourself from others at the health facility. It's important that you provide clear and accurate information about your symptoms, travel history, and recent contacts.

Some people will be eligible to talk to their doctor over the phone or via video-chat, under new telehealth provisions announced by the Australian Government.

WHAT DO I DO IF IM DIAGNOSED WITH COVID-19?

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Temporary MBS telehealth and phone consultation items were introduced on 13 March in response to the COVID-19 outbreak. These items allow doctors to deliver services via videoconference and phone to patients to reduce the risk of transmission of COVID-19. The Government has determined that these items can only be bulk billed, however, this may be relaxed soon.

The telehealth item descriptors mirror those of existing face to face consultation items (equivalent items can be found in a table here). The items for telehealth and telephone services have been generalised and expanded since they were first introduced on 13 March.

This means that the eligibility requirements restricting the COVID-19 telehealth items to patients diagnosed, self-isolating or more susceptible to the COVID-19 virus have been lifted. These services can now be provided to all Medicare-eligible Australians who are not admitted to hospital.

The previous requirement for patients to have had at least one face to face attendance with the doctor or a doctor in the practice in the past 12 months to be eligible has also be removed.

The new temporary MBS telehealth items will have similar requirements to the normal items on which they are based. For example, where an item is usually provided by a patients usual GP, such as a GP Management Plan, the replicant telehealth or telephone item would also need to be provided by the patient’s usual GP.

For information on patient eligibility criteria and regular updates go to MBS online.

WHAT ARE THE NEW TELEHEALTH MBS ITEMS AND WHO CAN USE THEM?

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Temporary MBS telehealth and phone consultation items were introduced on 13 March in response to the COVID-19 outbreak. These items allow doctors to deliver services via videoconference and phone to patients to reduce the risk of transmission of COVID-19. The Government has determined that these items can only be bulk billed.

The telehealth item descriptors largely mirror those of existing face to face consultation items (equivalent items can be found in a table here). The items for telehealth and telephone services have been generalised and expanded since they were first introduced on 13 March.

These services can now be provided to all Medicare-eligible Australians who are not admitted to hospital.

A telehealth service must only be provided where it is safe and clinically appropriate to do so.

The bulk billing incentive has been doubled to better support the bulk billing of General Practice, Diagnostic Imaging and Pathology Services.

While the Government is encouraging practitioners to utilise telehealth where it is appropriate and feasible to do so, it also expects that practitioners have in place arrangements to ensure that patients can access face to face consultation where it is clinically required. This does not necessarily have to be with the same practitioner – it can also be with another practitioner working in the practice.

Where a provider needs to conduct telehealth consultations from their home, they should also use their provider number for their primary location.

The new temporary MBS telehealth items will have similar requirements to the normal items on which they are based. For example, where an item is usually provided by a patients usual GP, such as a GP Management Plan, the replicant telehealth or telephone item would also need to be provided by the patient’s usual GP.

For information on patient eligibility criteria and regular updates go to MBS online.

WHY ARE ONLY SOME ITEMS AVAILABLE UNDER THE COVID-19 TELEHEALTH MBS ITEMS?

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The AMA has argued strongly that the Government should open up the MBS to allow telehealth to be used for a broad range of consultation items. The AMA welcomes the efforts of the Government to expand the GP telehealth items for COVID-19. The AMA is consulting with the Government on the process of expanding the available items for non-GP specialists.

The AMA will continue to speak directly to the Government and the Department of Health, highlighting issues with the current arrangements as they emerge and working towards broader telehealth access for consultation items for non-GP specialists.

COVID-19 Temporary MBS Telehealth Services as at 20 April 2020

Additional changes to the COVID-19 Temporary MBS Telehealth Services commenced today.

Bulk-billing incentives and arrangements

Non GP specialists are no longer required to bulk-bill COVID-19 telehealth (video conference) and telephone consultations where the service is provided to a concessional or vulnerable patient or a child under 16.

For GP specialists, two new bulk-billing incentive items are now available where a medical service is provided to a 'vulnerable' patient:

  • item 10981 mirrors the current item 10990 metropolitan
  • item 10982 mirrors the current item 10991 regional

The new bulk-billing incentive items 10981 and 10982 can be claimed with face-to-face attendances or with the new COVID-19 telehealth and telephone services, where the conditions of the bulk-billing incentives are met.

This means that for GPs, the recently doubled bulk billing incentive(s) applies to services provided to a concessional patient, child under 16 and has now been extended to 'vulnerable' patients. This is for both in rooms the telehealth/telephone services.

The Government has decided, having made extra funding available to general practice, to retain the requirement to bulk-bill COVID-19 telehealth (video conference) and telephone consultations where the service is provided to a concessional or vulnerable patient or a child under 16.

Other GP patients can be billed for a telehealth/telephone consultation as per a GP's normal billing policies and there is no requirement to bulk bill in rooms GP consultations.

New telehealth items

24 new telehealth items are now available for specialists:

  • Six (6) new items for consultant psychiatrists (mirroring the existing items 342, 344 and 346);
  • Eight (8) new items for public health physicians (mirroring items 410, 411, 412 and 413); and
  • Ten (10) new items for neurosurgeons (mirroring items 6007, 6009, 6011, 6013 and 6015).

Four (4) new telehealth items are now available for a practice nurse or an Aboriginal and Torres Strait Islander health practitioner (mirroring items 10987 and 10997)

CAN I TRIAGE ALL PATIENTS WHO CALL WITH COVID-19 SYMPTOMS?

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Yes. Now that you can see all patients, you may triage all patients. There are still limited testing requirements in place. These criteria are updated regularly and may vary from state to state.

THE MBS ITEMS I USE ARE NOT AVAILABLE OR HAVE IMPRACTICAL RULES ASSOCIATED - WHAT CAN I DO?

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If you feel you and your speciality has been ignored or there are other issues with the COVID-19 telehealth items, please email covid19@amaq.com.au with your feedback so that we can follow up on your concerns.

CAN I CHARGE A GAP FEE WITH THESE TELEHEALTH ITEMS?

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The AMA has been informed that the bulk billing requirement will be relaxed in the near future. However, until it is formally announced, practitioners who wish to use the COVID-19 MBS telehealth items must agree to bulk bill these consults.

I'M HAVING DIFFICULTY SECURING PPE OR OTHER CONSUMABLES WHAT SHOULD I DO?

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First, please make sure you and your practice are safe. The health of our medical and health workforce is a key priority for the AMA. If you are a GP, please contact your PHN for supplies. If you do not have access to the correct PPE do not treat or conduct testing on patients with potential COVID-19. Contact your local public health unit for advice on where to direct patients. If the issue is not resolved, please let us know at covid19@amaq.com.au.

IMPORTANT UPDATE 17/04: The Commonwealth successfully secured 500 million personal protective equipment (PPE) items for delivery between now and December (surgical and P2 masks, gowns, gloves). They are also working with local producers to ensure sustainability of stock.

The Australian Government already distributes masks through PHNs to general practices and pharmacies. In addition, they are now distributing PPE to:

Commonwealth-funded RACFs; E: agedcarecovidppe@health.gov.au

NDIS providers (service commenced this week); Email: NDISCOVIDPPE@health.gov.au

WHAT IS THE MECHANISM FOR THE PATIENT TO ASSIGN THEIR BENEFIT TO THE PRACTITIONER FOR BULK BILLED TELEHEALTH OR TELEPHONE SERVICES?

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The process for a patient to assign their benefit for a telehealth or telephone consultation is outlined here.

AM I COVERED BY MEDICAL INDEMNITY INSURANCE FOR MY COVID-19 TELEHEALTH ITEMS?

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The AMA understands that medical indemnity insurance will cover telehealth activities under practitioner cover, provided you deliver the service in accordance with relevant guidelines and observe any specific requirements for telehealth set by your Medical Defence Organisation.

If you have any specific questions, please call your indemnity provider for individual advice.

The following medical indemnity insurers have provided medico-legal advice in response to COVID-19 for doctors and practices on their website:

WHAT SUPPORT IS AVAILABLE FOR MEDICAL PRACTICES DURING THE COVID-19 OUTBREAK?

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  • SUPPORT MEASURES FROM THE FEDERAL GOVERNMENT
  • AUSTRALIAN TAXATION OFFICE - TAX RELIEF
  • SUPPORT PACKAGED FROM AUSTRALIAN BANKS

SUPPORT MEASURES FROM THE FEDERAL GOVERNMENT

JobKeeper payment

Employers can claim a fortnightly payment of $1,500 per eligible employee from 30 March for a maximum of six months.

A business is eligible if they:

  • have a turnover of less than $1 billion and their turnover will be reduced by more than 30 per cent relative to a comparable period a year ago (of at least a month); or
  • have a turnover of $1 billion or more and their turnover will be reduced by more than 50 per cent relative to a comparable period a year ago (of at least a month); and
  • are not subject to the Major Bank Levy.

Non-for-profits (including charities) and self-employed individuals without employees that meet the turnover criteria above are eligible to apply.

Employees are eligible if they:

  • are currently employed by the eligible employer (including those stood down or re-hired);
  • were employed by the employer at 1 March 2020;
  • are full-time, part-time, or long-term casuals (a casual employed on a regular basis for longer than 12 months as at 1 March 2020);
  • are at least 16 years of age;
  • are an Australian citizen, the holder of a permanent visa, a Protected Special Category Visa Holder, a non-protected Special Category Visa Holder who has been residing continually in Australia for 10 years or more, or a Special Category (Subclass 444) Visa Holder; and
  • are not in receipt of a JobKeeper Payment from another employer.

Employers can register their interest in applying for the JobKeeper Payment.

The first payment will be received by employers from the ATO in the first week of May. Payments will be backdated to 30 March.

Employers must identify employees eligible for the payment and provide monthly updates to the ATO.

Participating employers will be required to ensure eligible employees will receive, at a minimum, $1,500 per fortnight, before tax.

It will be up to the employer if they want to pay superannuation on any additional wage paid because of the JobKeeper Payment.

SUPPORT MEASURES FROM THE FEDERAL GOVERNMENT

The Federal Government has announced two major economic rescue packages worth $83.6bn to support businesses and households in addition to over $100bn in emergency banking measures.

Cash payments for small and medium-sized businesses

  • The Boosting Cash Flow for Employers payment is available to eligible small and medium-sized businesses, and non-for-profits (including charities).
  • Businesses can receive up to $100,000 to cover the cost of rent, bills and employee wages and salaries. Payments will be automatic.
  • The initial payments from 28 April will equal to 100 per cent of the salary and wages withheld as reported in Business Activity Statements. The maximum payment is $50,000 with a minimum payment of $10,000.
    1. Businesses are eligible if they have an aggregated annual turnover of under $50m and employ workers.
  • Additional payments are being introduced in July – October 2020. Businesses that are still active will receive an additional payment equal to the total of all of the Boosting Cash Flow for Employers payments received. i.e. if you received $50,000 in the first payment, you would receive a $50,000 for the second payment, for a total $100,000 payment.
  • A fact sheet for this payment is available here.

Support for business asset investment

  • The government has provided incentives to encourage businesses with a turnover of less than $500m to spend by:
    1. Increasing instant asset write-offs by lifting the threshold to $150,000 (from $30,000) until June 2020.
    2. Introducing a time-limited 15-month incentive to invest by accelerating depreciation deductions. Businesses will be able to deduct 50 per cent of the cost of an eligible asset on installation, with existing depreciation rules applying to the balance of the asset cost.

Temporary relief for financially distressed businesses

  • The Government is temporarily increasing the threshold at which creditors can issue a statutory demand on a company and the time companies have to respond to statutory demands they receive.
  • The package also includes temporary relief for directors from any personal liability for trading while insolvent. The Corporations Act 2001will be amended to provide temporary and targeted relief for companies to deal with unforeseen events that arise as a result of the Coronavirus.

Support for lending to small and medium-sized businesses

  • The Coronavirus SME guarantee scheme will support lending to small and medium-sized businesses with a turnover of less than $50m.
    1. The Commonwealth will guarantee 50 per cent of an eligible loan through participating banks and non-bank lenders to businesses disrupted by the coronavirus.
    2. Loans will be used for working capital purposes and be unsecured and it will be for loans granted within six months starting 1 April 2020.
    3. Lenders will not be charged a fee for accessing the guarantee scheme.
    4. Loans will be repayment-free for six months (as per the support package from Australian banks—see below).
    5. The maximum that can be borrowed under the guarantee facility will be $250,000 on terms up to three years.
  • A fact sheet for this measure is available here.

Australian Taxation Office – tax relief

  • Businesses impacted by COVID-19 are being encouraged to contact the ATO to discuss relief options tailored to their needs and circumstances.
  • Options available to assist businesses impacted by COVID-19 include:
    1. Deferring by up to six months the payment date of amounts due through the business activity statement (including Pay As You Go (PAYG) instalments), income tax assessments, fringe benefits tax assessments and excise.
    2. Allow businesses on a quarterly reporting cycle to opt into monthly GST reporting in order to get quicker access to GST refunds they may be entitled to.
    3. Allowing businesses to vary PAYG instalment amounts to zero for the March 2020 quarter. Businesses that vary their PAYG instalment to zero can also claim a refund for any instalments made for the September 2019 and December 2019 quarters.
    4. Remitting any interest and penalties, incurred on or after 23 January 2020, that have been applied to tax liabilities.
    5. Working with affected businesses to help them pay their existing and ongoing tax liabilities by allowing them to enter into low-interest payment plans.
  • Call the ATO Emergency Support Infoline 1800 806 218 to discuss COVID-19 support options.

Support packages from Australian banks

  • The Australian Banking Association (ABA) has announced a small business relief package to support small business during COVID-19. All ABA member banks can participate.
  • Broadly, the package includes a deferral of principal and interest repayment for all term loans and retail loans for 6 months, for small businesses with less than $3 million in total debt owed to credit providers. At the end of the deferral period businesses will not be required to pay the deferred interest in a lump sum. Either the term of the loan will be extended, or the level of loan repayments will be increased.
  • All small businesses have been encouraged to contact their banks about the small business relief package. Fast-track approval processes are in place to ensure support is available as soon as possible.

Individual major banks have announced measures as follows:

Commonwealth Bank of Australia

  • 100 bps (basis points) interest rate reduction for all existing cash-linked small business loans.

Westpac

  • Overdrafts will be reduced by 200bps for new and existing small business customers, effective 6 April.
  • Small business customers with cash flow issues can defer principle and interest repayments of business term loans for six months.
  • 100bps reduction to variable interest rates on small business cash-based loans, effective 6 April.

NAB

  • Defer principle and interest for up to six months on a range of business and equipment finance loans.
  • Receive a 200bps rate cut on new loans and all overdrafts on QuickBiz, effective March 30.
  • Receive a further 100bps reduction on variable rates for small business loans, effective March 30.
  • Access up-to $65bn of additional secured limits to pre-assessed customers, with $7bn currently available for the fast assessment process.
  • Defer business credit card repayments.

ANZ

  • Decrease variable interest rates by 0.25%pa, effective 27 March.
  • Enable impacted customers to request a six-month payment deferral on loan repayments for term loans, with interest capitalised.
  • Make available temporary increases in overdraft facilities for 12 months.
  • Institute a reduction by 0.80%pa to a new two and three-year fixed rate of 2.59%pa for secured small business loans up to $1m, effective 3 April 2020.

MY PATIENT HAS ASKED IF THEY CAN GET A PRESCRIPTION THAT ENABLES THEM TO STOCKPILE THEIR MEDICATION – WHAT SHOULD I DO?

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The Therapeutic Goods Administration (TGA) at this time has advised that stockpiling medicines is not necessary. It is essential that the public does not stockpile medicines to ensure there is equitable access for everyone. If individuals stockpile medicine, there is a risk that the unused medication will become out of date and therefore cannot be used.

Doctors have an important role to ensure their patients understand the risks of stockpiling and its impacts on the community. It is likely that doctors will receive requests from their patients to be able to receive higher quantities of medications.

Regulation 49 (previously regulation 24) prescriptions allow a PBS medication’s original and repeat to be supplied at the same time (i.e. higher quantities of medication are received by the patient in one transaction). Regulation 49 prescriptions can only be prescribed in certain circumstances, as specified by the Department of Health.

More information on Regulation 49 prescriptions is available at the Department of Health PBS website – Prescribing Medicines – Information for PBS Prescribers, here.

The AMA is calling on all members and the wider profession to ensure that only those patients who are eligible and meet the criteria are provided with Regulation 49 prescriptions.

WHAT ARE THE NEW PHARMACY SALE AND DISPENSING LIMITS?

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A number of restrictions on medication supply were announced on 19 March 2020 as a result of patient stockpiling and demand during the COVID-19 crisis. Details include:

Pharmacists will be required to:

  • limit particular prescription products to one month’s supply (at the prescribed dose),
  • limit a maximum of one unit per purchase for particular over the counter medications,
  • Pharmacists are strongly encouraged to limit dispensing and sales of all other medicines to one month’s supply or one unit,
  • Salbutamol inhalers will require confirmation of the patient’s diagnosis, the supply recorded and the inhaler labelled with the patient’s name,
  • Paracetamol paediatric formulations will be placed behind the counter to assist in equitable supply.

A full list of the medicines, including more detail on the restrictions, are available on the TGA’s website, here.

WHAT ARE THE RESTRICTIONS ON HYDROXYCHLOROQUINE?

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As of 24 March 2020, there are new restrictions for prescribing hydroxychloroquine. Initial treatment of hydroxychloroquine must be authorised by a medical practitioner under the following specialties: 

  • Dermatology
  • Intensive care medicine 
  • Paediatrics and child health
  • Physician
  • Emergency medicine

These restrictions are outlined in the Poisons Standard Amendment (Hydroxychloroquine and Salbutamol) Instrument 2020.

More information on the restrictions, hydroxychloroquine and COVID-19, are available on the TGA website, here.

IS THE PBS AUTHORITIES LINE NO LONGER ACTIVE, OR BROKEN?

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The PBS authority line has experienced an increased number of calls on 25 March 2020 which has caused an emergency message to be activated. The Department of Health are aware of the issue and are working to resolve it.

I'M A DOCTOR AND I WANT TO HELP OUT - WHERE CAN I GO TO OFFER MY SERVICES?

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You should first contact your PHN or local hospital and health service. You can find your local PHN here.

The rural workforce agency in your state will also be able to help you. Their websites are listed here.

WHAT IS THE MEDICAL BOARD DOING IN RESPONSE TO THE COVID-19 PANDEMIC FOR CPD, INTERNS AND IMGs?

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In a further response to the COVID-19 pandemic, the Medical Board of Australia (the Board) has agreed to a series of new measures that apply to medical practitioners the full release can be found here.

Continuing professional development (CPD)

Medical practitioners are to continue to do CPD that is relevant to their scope of practice. However, the Board will not take action if you cannot meet the CPD registration standard when you renew your medical registration this year.

Requirements for interns

The Board recognises that much education is likely to be ‘on the job’ and will, therefore, waive the usual rotation requirements for interns in 2020. The Board will accept a range of supervised clinical experience for general registration.

Registration requirements for international medical graduates (IMGs)

Streamlined change of circumstances processes for hospital-based IMGs - The Board will streamline processes to enable IMGs within hospitals with limited and provisional registration to be redeployed more easily without a formal application.

Difficulties demonstrating progression towards general or specialist registration - For 2020, the Board will not refuse to renew an IMG’s registration or refuse to re-register an IMG solely because they have not been able to sit an AMC or college examination or assessment.

IS THE MEDICAL BOARD LIKELY TO ANNOUNCE FURTHER CHANGES?

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Alternative approaches to demonstrating English language proficiency

The Boards and AHPRA are developing alternative approaches to demonstrating English language proficiency (due to the disruption to testing).

Return to practice for recently retired practitioners

The Board and AHPRA are working to streamline the return to work process for practitioners who have been off the Register of practitioners or who have held non-practising registration for less than three years.

LIFE INSURANCE FOR DOCTORS DURING COVID-19?

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Most life insurance policies have no ex­clu­sions for pan­demics. That is that if you took out a pol­icy be­fore COVID-19 and also meet the other T&Cs, you are cov­ered.

For new applications, there is most likely to be an exclusion for Covid 19 - they’d need to make sure they ask this and check T&Cs.

Some super funds do have exclusion for pandemics already in past (ie prior to Covid19) – you need to check the PDS for the super fund for exclusions.

IS THERE ANY FINANCIAL ASSISTANCE AVAILABLE FOR DOCTORS WORKING AS INDEPENDENT CONTRACTORS WHO HAVE EXPERIENCED A DECREASE IN PATIENT CONSULTS DUE TO COVID-19?

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JOBKEEPER PAYMENT FOR EMPLOYERS AND EMPLOYEES

Employers will be eligible for the subsidy if:

  • their business has a turnover of less than $1 billion and their turnover has fallen by more than 30 per cent (of at least a month); or
  • their business has a turnover of $1 billion or more and their turnover has fallen by more than 50 per cent (of at least a month); and
  • the business is not subject to the Major Bank Levy.

Businesses without employees

Businesses without employees, such as the self-employed, can register their interest in applying for JobKeeper Payment via The Australian Taxation Office (ATO) from 30 March 2020.

Businesses without employees will need to provide an ABN for their business, nominate an individual to receive the payment and provide that individual’s Tax File Number and provide a declaration as to recent business activity.

People who are self-employed will need to provide a monthly update to the ATO to declare their continued eligibility for the payments. Payment will be made monthly to the individual’s bank account.

Source: https://www.business.gov.au/risk-management/emergency-management/coronavirus-information-and-support-for-business/jobkeeper-payment

WHAT IS THE NEW PRACTICE INCENTIVE PAYMENT FOR GENERAL PRACTICES?

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The Government is temporarily doubling the next two Practice Incentive Program (PIP) Quality Improvement (QI) Incentive for general practices. This means that practices will receive $10 per SWPE to a maximum quarterly value of $25,000. These payments will be made on 1 May and 1 August.

To qualify for this, practices must provide face-to-face services for a minimum of four hours a day, or for 50 per cent of normal practice opening hours for part-time practices. This increase is to encourage practices to continue to provide face to face services.

More details are available in this fact sheet.

WHAT ARE THE BULK-BILLING INCENTIVES THAT HAVE BEEN DOUBLED?

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The Government announced that bulk billing incentives have been doubled. This is for all telehealth services and all face-to-face services too. The items are still only able to be claimed for unreferred services and for patients with concession cards or who are under 16. The incentives have increased to $12.75 per service in major cities, and to $19.30 per service in areas outside metropolitan centres.

The announcement does not mean that the rebate for regular bulk-billed COVID-19 telehealth items has been doubled.

DO I NEED TO BE LOCATED IN MY PRACTICE TO PROVIDE TELEHEALTH SERVICES?

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Providers do not need to be in their regular practice to provide telehealth services. Providers should use their provider number for their primary location and must provide safe services in accordance with normal professional standards.

DO I NEED MY PATIENTS SIGNATURE FOR PROVIDING A TELEHEALTH SERVICE?

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While it is still preferred that a physical signature is obtained for an assignment of benefit, the rules have been relaxed for COVID-19 telehealth items only. The new guidelines state that “a practitioner’s documentation in the clinical notes of the patient’s agreement to assign their benefit as full payment for the service would be sufficient.” 

HOW DO I PROVIDE A SCRIPT OR MAKE A REFERRAL FROM A TELEHEALTH CONSULT?

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You may use mail, email or fax for prescriptions and referrals. Doctors are also authorised to take photos of scripts, however, schedule 8 drugs are not included in this. The AMA supports that fast-tracking of e-prescribing and e-referring underway by the Department of health.

CAN MY PRACTICE STAFF PROVIDE COVID-19 TELEHEALTH SERVICES

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There are currently no MBS telehealth items that will allow GP nurses cannot provide telehealth on behalf of GPs.

Allied health professionals can provide telehealth under the Workforce Incentive Program arrangements.

WHICH NEW TELEHEALTH MBS ITEMS CAN BE CLAIMED FOR TELEHEALTH SERVICES TO RACF PATIENTS

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The expansion of temporary MBS telehealth items in response to COVID-19 enables GPs and other practitioners to provide MBS funded services to patients in residential aged care facilities (RACFs) via video-conferencing or by telephone.

Telehealth consultations must only be provided where it is clinically safe and appropriate to do so.

Medicare rebates for the temporary telehealth items are currently only available when the service is bulk billed.

There are no specific RACF telehealth items. However, GPs or other medical practitioners will be able to claim the corresponding general MBS consultation telehealth item(s) for the service provided.

For example, a GP Level B attendance (MBS Item 23) provided to a RACF patient conducted by video-conference or telephone would attract a 91800 (video-conference) or 91809 (telephone) item.

The new temporary MBS telehealth items will have similar requirements to the normal items on which they are based. You can look up the exact detail of these items are www.mbsonline.gov.au

To see the equivalent telehealth items refer to the GPs and OMPs items Fact Sheet.

WHAT ARE THE LATEST CHANGES TO MBS TELEHEALTH SERVICE ITEMS - AS AT 6 APRIL 2020?

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  • COVID-19 Temporary MBS 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.
  • Health providers may apply their usual billing practices to the telehealth items for patients who do not fit the above criteria.
  • Health providers are expected to obtain informed financial consent from patients prior to providing the service; providing details regarding their fees, including any out-of-pocket costs.
  • The Government has indicated that they intend to make further amendments to regulations next week that will allow non-GP specialists to determine who they will bulk bill without compulsion.
  • The Department of Health is currently considering over 500 specialist items for possible inclusion in the COVID-19 Temporary MBS telehealth items.
  • AMA has been advocating strongly to have these changes put in place, and will continue to advocate on behalf of our members to ensure you are able to continue to provide quality care to your patients.

CAN A PATIENT ASIGN A BENEFIT WITHOUT A PHYSICAL SIGNATURE IF THEY COME INTO THE PRACTICE?

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Yes, with Medicare Easyclaim, a patient assigns their right to a Medicare benefit to the practitioner by pressing the OK or YES button on the EFTPOS terminal in the practice. Additionally, a patient can assign their benefit to an eligible provider by email or through the signature of a ‘responsible’ third party.

Up until 30 September 2020, a practitioner can record the agreement for assignment of benefit in the patient’s clinical notes then mark the box on the DB020 form that indicates a patient is ‘unable to sign’. The reason for a signature not being obtained can be given as ‘COVID-19/highly infectious pandemic/risk of exposure to COVID-19/etc’.

I AM A RECENTLY RETIRED DOCTOR CAN I RETURN TO PRACTICE

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Registration

The Australian Health Practitioner Regulation Agency (AHPRA), the Medical Board of Australia, the Nursing and Midwifery Board of Australia and the Pharmacy Board of Australia are establishing a short-term pandemic response sub-register for the next 12 months.

This sub-register will enable doctors, nurses, midwives and pharmacists who previously held general or specialist registration and left the Register of practitioners or moved to non-practising registration in the past three years to return to practice. Only those who were properly qualified and suitable will be returned to the register, which will operate on an opt-out basis. Further details can be found on the AHPRA website.

You do not need to contact AHPRA nor do you need to fill in any forms. AHPRA will be contacting the over 40,000 practitioners who meet the criteria to alert them that they will be added to this new sub-register.

Medical Indemnity Insurance

Retired medical practitioners returning to work for the during the COVID-19 pandemic will not lose their Run Off Cover (ROCs). The AMA has been engaging with the Commonwealth Government regarding the introduction of amended the regulations to ensure that retired doctors who return to do any type of medical service will retain their ROCS cover.

Medical practitioners will still require current indemnity insurance. The AMA expects that some medical indemnity insurers will offer products tailored to the current situation, but practitioners should contact their last medical indemnity insurer for individual advice.

JobKeeper Payment - Eligible employees – What is the advice from the ATO?

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The ATO has updated their advice to clarify that:

If you decide to participate in the JobKeeper Payment scheme, you must nominate all your eligible employees. You cannot choose to nominate only some employees. However, individual eligible employees can choose not to participate.

The updated advice is available here.

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