The Department of Health, Disability, and Ageing (DoHDA) is streamlining Medicare billing for bulk billed services and simplified billing services, with amendments made to the Health Insurance Act 1973. 

Under the Act, for a service to be bulk billed, the patient must agree to give their Medicare benefit to the clinician, and this must be recognised as full payment for the service. Currently, AoB is carried out via a standard form and received verbally in some cases, such as telehealth. However, from 1 July 2026, major changes are occurring to how patients’ AoB is captured and stored.

These changes may require practices to review their billing, consent, software and record-keeping workflows ahead of 1 July 2026.

Changes occurring from 1 July 2026:

• Verbal AoB will no longer be available.
• Patients will be able to assign a benefit before (episodic pre-service assignment) or after a service (episodic post-service assignment) is received, so long as patient agreement is made prior to an MBS claim being lodged.
• Practitioners, billing agents, and private health insurers will no longer need to use an ‘approved form’, so long as agreements include the information required for each type of episodic agreement, as set out in subsection 65C(4) of the Health Insurance Amendment (Assignment of Medicare Benefits and Other Measures) Regulations 2025 (the ‘data set’).
• Practitioners will no longer need to sign the agreement.
• An electronic or physical signature will be required from the patient or responsible person on an AoB agreement. A signature must be identifiable, auditable, and compliant with the Electronic Transaction Act 1999.
• Practitioners will be required to keep a copy of the completed AoB agreements for two years and must provide a copy to the patient upon request.
  

Why are these changes occurring?

In January 2023, the Australian National Audit Office released a report called Expansion of Medicare Telehealth Services. The report identified potential legal risks with assigning Medicare benefits verbally.

In response, the Australian Government has updated the Assignment of Benefit process for bulk billed Medicare services. The changes are intended to provide a clearer and more consistent process for documenting patient agreement before a Medicare claim is lodged.

Key dates:

• Bulk billed episodic assignment of benefit will commence on 1 July 2026.
• Bulk billed enduring assignment of benefit will commence in 2027, subject to final regulations.
  

Next steps:

• Review the updated Department FAQs
• Consider how pre-service and/or post-service assignment will work within day-to-day practice workflows
• Contact their software provider to understand how this will be supported
• Consider how completed AoB agreements will be stored and accessed for the required two-year period
• Ensure relevant team members, including reception and billing staff, understand the upcoming changes.

Services Australia is expected to release templates to assist providers. It is not required to use the templates; however, it may provide examples of how to present information.