Stay up to date with our latest COVID-19 updates here

Novel COVID-19

Update 3 May 2022

MIGA’s COVID-19 medico-legal and insurance Q&A covers the latest pandemic developments for our members and clients.

Categories include:

  • COVID-19 vaccinations:
    • Insurance cover
    • Availability and eligibility - primary and booster vaccinations
    • Assessment, precautions / contraindications and informed consent
    • Post-vaccine management
    • Medicare and billing
    • Advertising / Social Media
    • Mandatory vaccination and exemptions
  • Other COVID-19 matters
    • Insurance cover
    • Protecting yourself, colleagues and your patients
    • Managing COVID-19 in the community
    • Telehealth and Medicare requirements
    • Registration issues

Contact MIGA for advice or assistance
We encourage you to contact :
  • MIGA's Legal Service team it you need advice about how to manage COVID-19 medico-legal issues in your practice (1800 839 280 / claims@miga.com.au / contact form), or
  • MIGA's Client Services Officers if you have any questions about your insurance cover (1800 777 156 / miga@miga.com.au / contact form)
You can also use MIGA's contact form here.
 

Insurance cover for COVID-19 vaccinations

Note - the answers in this section only apply to MIGA policies issued to doctors, Eligible Midwives and healthcare businesses which are current as at the date of publication.  Your individual cover is subject to the terms and conditions of your policy with MIGA and your chosen category of practice.  If you are a doctor whose practice entity employs other doctors, eligible midwives or others who bill in their own name, you must ensure that they have their own insurance arrangements in place to cover administration of COVID-19 vaccinations.
  • Am I covered for services related to COVID-19 vaccinations including administering the vaccines? New 1 Feb 2021

    Yes.
    • You are covered with MIGA for claims and inquiries arising from COVID-19 vaccination services you provide
    • We cover you for healthcare services provided within your category of insurance/scope of practice or healthcare business that is consistent with with your qualifications, training, experience or the healthcare services provided by your practice/business
    • You should ensure you comply with all relevant requirements and guidelines - see Q&A - What do I need to do if I’m involved in the COVID-19 vaccination program?
    • If you are being asked to undertake, or are considering undertaking, a new or different role that may be outside your scope of practice and have any concerns around your medical indemnity insurance or any medico-legal implications, please contact us for assistance.  We’ll help to make sure that your cover is appropriate for what you are doing and guide you on potential medico-legal issues involved.
    • You should let us know as soon as possible if you become aware of any claim or potential claim arising from administering the vaccines.
  • Am I covered if I am working outside of my usual scope of practice to administer COVID-19 vaccines? New 1 Feb 2021

    Yes, if it is permitted by your Ahpra registration, you have appropriate qualifications, training and experience and you are in the appropriate category of insurance with MIGA.
    • You should only provide healthcare you are appropriately qualified and trained for and have sufficient experience to provide
    • Ahpra has provided the following information about medical practitioners moving into new roles in responding to the COVID-19 pandemic
    • If the work you are planning to undertake is outside of your usual area of practice, you should ensure you will meet your regulatory obligations with Ahpra
    • We recommend you take the following steps before starting your new work:
      • Ensure your Ahpra registration does not restrict or prevent you from engaging in the new scope of practice
      • Be comfortable that you have the necessary skills, training and experience to provide the level of care expected, and your hospital, practice or other workplace agrees
      • Ensure your proposed practice is consistent with your hospital/facility credentialing
      • Confirm with your hospital, practice or other workplace (preferably in writing) that you will have the benefit of any indemnity you are normally entitled to as an employee or contractor (e.g. as a visiting medical officer for public patients) 
      • Ensure you do not use a specialist title unless you have the appropriate qualifications – for more information see Ahpra’s guide on health titles
      • Contact MIGA to ensure you have the right category of insurance cover with us. 
  • Will my policy provide cover if my employees administer the vaccine and there is a complaint or claim? New 1 Feb 2021

    Yes

    • You are covered for your own vicarious liability as an employer but remember that you should ensure that your employees are working under your supervision and within the scope of their duties and responsibilities as you have agreed with them.
    • If you are:
      • a doctor, remember that your policy covers some but not all kinds of employees for claims made directly against them - refer to the important note at the top of this update regarding employees who need their own insurance
      • a midwife, remember that your policy covers you personally and not any employees
      • a healthcare company, remember that your policy only covers your employed doctors if the relevant optional extension is included in your Schedule.
  • If I'm asked to administer vaccines to public patients in a public hospital, am I covered for this New 1 Feb 2021

    Generally, No
    • If you are employed in a public hospital (including if you are a medical student) you will generally be indemnified by the hospital for work you undertake
    • If you are insured as a Hospital Doctor with MIGA, cover is generally only for legal expenses for inquires and investigations for which you are not otherwise indemnified or insured and for some limited private practice you may undertake outside your public practice employment
    • If you work in the public health system and plan to undertake work in the private system to administer the COVID-19 vaccines, contact us to check the extent to which you may be covered for private work under your category of insurance
    • If in doubt, please check with your hospital’s administration to clarify your indemnity situation or call MIGA to clarify your position.
  • Is my practice or healthcare business covered by MIGA's Healthcare Policy if it contracts to be part of the COVID-19 vaccination program? New 1 Feb 2021

    Yes.

    • MIGA’s Healthcare Policy for entities will cover the business and its employees (excluding doctors and other who bill on their own right) for claims and inquiries arising from their involvement in the vaccination program
    • This is provided it is within their usual scope of practice/specified business and it is subject to them complying with all relevant requirements and guidelines (see Q&A - What do I need to do if I’m involved in the COVID-19 vaccination program?).
    • Employed medical practitioners are not covered by the policy (unless MIGA has agreed to this) and will need to be covered under an individual practitioner policy with MIGA.

COVID-19 vaccinations - medico-legal Q&As

Note - the answers in this section only apply to MIGA policies issued to doctors, Eligible Midwives and healthcare businesses.

COVID-19 vaccination - availability and eligibility

  • Which COVID-19 vaccines are available? Updated 3 May 2022

    The following vaccines are available for use in Australia:
    • Pfizer / BioNTech mRNA vaccine ‘Comirnaty’
      • For use as a primary vaccination in those aged 5 or over
      • For use as a booster vaccination for those aged 16 years and over (although its use as a booster for those aged 12 to 15 has been approved by the TGA, ATAGI does not recommend its use for this purpose)
    • The University of Oxford / AstraZeneca ‘VAXZEVRIA’ viral vector vaccine as a primary and booster vaccination for those aged 18 and over
    • The Moderna mRNA vaccine Spikevax (Elasomeran) for use as a:
      • Primary vaccination in those aged 6 and over
      • Booster vaccination for those aged 18 years and over
    • The Novavax protein vaccine Nuvaxovid as a primary and booster vaccination for those aged 18 and over.

    Although the TGA has provisionally approved the one dose vaccine as a primary vaccination for ages 18 and over, it is not included in Australia’s COVID-19 vaccination program and is not available here. 
  • When are people eligible for third, fourth and booster doses of COVID-19 vaccine? Updated 3 May 2022

    Third / booster doses

    ATAGI recommends anyone aged 16 and over who has received their primary COVID-19 vaccination 3 months ago or more (including severely immunocompromised who received a third primary dose and pregnant women / adolescents)  receive a booster vaccination as follows:

    • Pfizer vaccine for those aged 16 and over 
    • Moderna vaccine for those aged 18 and over 
    • AstraZeneca vaccine for those aged 18 years and over where there is a medical contraindication to mRNA vaccines (Pfizer or Moderna) or a person does not wish to receive mRNA vaccines
    • Novavax vaccine for those aged 18 years and over if no other vaccine is considered suitable.  


    Although the Pfizer vaccine has been approved for use by the TGA as a booster for those aged 12 to 15 has been approved by the TGA, ATAGI does not recommend its use for this purpose.  It cannot be used as a bosster for this age group under the Australian Government vaccination program. 

    ATAGI provides further guidance on vaccination timing, including following COVID-19 infection.

    Fourth dose / winter boosters
    ATAGI recommends an additional booster dose for:

    • Adults aged 65 years and older
    • Residents of aged care or disability care facilities
    • People aged 16 years and older who are severely immunocompromised
    • Aboriginal and Torres Strait Islander people aged 50 years and older.

    ATAGI advises additional booster doses can be given from four months after a person has received their first booster dose. 

    Persons who have been infected with COVID-19 following their first booster dose can receive their additional booster four months following infection. 

    In special circumstances some people may receive their winter booster sooner, however that should not be administered less than three months from a previous dose or infection.
  • What constitutes up-to-date vaccination status? Updated 3 May 2022

    Generally
    ATAGI has recently released a statement defining ‘up-to-date’ vaccination status and it recommends:

    • Individuals aged 16 years and over receiving a booster dose 3 months after completion of the primary schedule
    • Children and adolescents aged 5-15 years are up-to-date after a primary course of vaccination.  A booster dose is not currently recommended for this age group
    • Severely immunocompromised individuals: 
      • Aged 5 years and over require a booster dose from 2 months (and no later than 6 months) after dose 2 to remain up-to-date
      • Those aged 16 years and over are recommended a booster (4th) dose, 3 months after dose 3 of their primary vaccination course
    • Individuals who have had prior COVID-19 still require completion of the above vaccination schedule, but can defer receipt of their next dose for up to 4 months following infection.

    Severe immunocompromise
    ATAGI has also provided recommendations on a third primary dose of COVID-19 vaccination for patients with severe immunocompromise and it is now available for use in those groups.  It has also indicated that Novavax can be used as a third primary dose.
     
  • Who can be involved in delivery of COVID-19 vaccines? Updated 3 May 2022

    Ability to supervise, authorise and administer COVID-19 vaccinations is based on:

    • Having necessary training and experience to provide immunisation
    • Completing the Commonwealth Government’s online COVID-19 vaccination training program
      • There are specific modules for each vaccine
      • Separate training is required for those administering Pfizer and Moderna vaccination to those aged 5 to 11 years
      • There may also be other required / suggested training in individual states and territories, particularly in state immunisation clinics / hospitals
    • Being an authorised immunisation provider in your state / territory.

    Authorised immunisation providers generally include doctors, nurse practitioners and registered nurses. 

    For COVID-19 vaccination Medicare billing, activities associated with individual items can only be undertaken by suitably qualified and registered health practitioners working within their scope of practice and who have undertaken required COVID-19 vaccination training.  A range of Q&A below deal with Medicare billing requirements. 
     

COVID-19 vaccination - assessment, precautions / contraindications and informed consent

  • What advice is available on COVID-19 vaccination for certain conditions, contraindications and precautions? Updated 3 May 2022

    Indications, contraindications and precautions for Pfizer, Moderna, Novavax and AstraZeneca vaccines are detailed in:

    • ATAGI clinical guidance for COVID-19 vaccine providers
    • ATAGI COVID-19 vaccination statements
    • Summary table of ATAGI recommended vaccines and doses for age and population groups
    • TGA COVID-19 vaccine provisional registrations
    • Various colleges and associations also provide guidance for vaccination for specific conditions or in certain patient cohorts.
  • How can I provide informed consent for COVID-19 vaccines? Updated 3 May 2022

    Appropriate informed consent for COVID-19 vaccination is similar to that for other vaccinations.

    Generally you are required to disclose risks which are ‘material’ to a reasonable person in the patient’s position, or which are ‘material’ to that particular patient.  This will depend on how the patient’s condition and how much information they seek. 

    COVID-19 vaccination – informed consent generally
    ATAGI has produced a guide to obtaining informed consent for COVID-19 vaccination. There is also guidance to help patients make informed decisions.

    Generally you should consider:
    • Whether there are any potential contraindications / precautions which should be raised
    • Potential adverse events
    • Previous experiences with vaccinations, particularly adverse reactions
    • Personal and public health benefits of vaccination
    • Any particular concerns which the patient may have. 

    There is no requirement for written consent from the patient, but MIGA recommends:
    MIGA’s resource What is informed consent provides more information about general requirements for informed consent.   

    For situations when a patient lacks capacity to provide informed consent, see MIGA’s resources Substitute consent and Q&A How do I seek consent for vaccination if my patient is under guardianship or has no substitute decision-maker?
  • What information is available about COVID-19 vaccine adverse events? Updated 9 April 2021

    Weekly reporting on Australian COVID-19 vaccine adverse events is available from:

  • How can I provide informed consent for children’s vaccination? Updated 25 February 2022

    Providing informed consent for COVID-19 vaccination in children involves a similar process to that which you would follow for any vaccination for children.  

    Recommended consent forms
    For children, MIGA recommends use of the Australian Government a COVID-19 vaccine information and consent form – separate forms are available for Pfizer and Moderna vaccination.

    For adolescents aged 12 years and over, MIGA recommends using the Australian Government Consent form for COVID-19 vaccination.

    Advice for discussing benefits and risks
    ATAGI’s recommendations on Pfizer vaccination use in children aged 5 to 11 years and its recommendations on Moderna vaccination for ages 6 to 11 can be used to discuss benefits and risks of paediatric vaccination.  

    NPS MedicineWise provides information on discussing COVID-19 vaccination in children with hesitant parents and carers.  

    When children / adolescents can make their own decisions about vaccination
    For more information on when those aged under 18 can make their own decisions about healthcare, including vaccination, and what to do when disputes arise and issues of confidentiality, see MIGA’s resource Consent for minors.   

    What to do when parents don’t agree or are separated
    Each parent can make decisions about their child’s vaccination and access information about it subject to any parenting / court orders in place.  This includes when parents are separated / divorced.  

    As for any healthcare for children of separated parents, it is important to check whether any parenting / court orders are in place covering healthcare decision-making.  If they are you should ask for a copy and keep it on the child’s records.  

    Generally speaking, if there are no parenting / court orders about a child’s healthcare one parent can make decisions about their child’s healthcare, even without involvement of the other parent.  

    Depending on the circumstances it may be wise to try and involve both parents in decisions, particularly if there is a history of disputes or different views about care between parents, or suggestions of hesitation about vaccination.
  • Do I need to get informed consent again before the second or booster dose? Updated 3 November 2021

    If circumstances have changed between first and second doses (e.g. updated ATAGI advice, adverse events following first dose) an informed consent covering those changed circumstances should be obtained prior to the second dose. 

    For booster doses, MIGA recommends:

    • Following a similar process for informed consent as used for the first dose of COVID-19 vaccine, tailored to the booster vaccine context
    • Use of ATAGI recommendations on booster doses to inform discussions with patients
    • Use of the Australian Government Consent form for COVID-19 vaccination, which includes specific information on, and scope to record information about, booster doses. 
  • What advice is available on providing COVID-19 and flu vaccines at the same time? Updated 3 March 2022

    ATAGI advises both influenza and other vaccines can be administered on the same day as COVID-19 vaccines.

COVID-19 vaccination - post-vaccine observation, reporting and second doses

COVID-19 vaccination - Medicare and billing

  • When can I bill Medicare COVID-19 vaccination items? Updated 3 May 2022

    Medicare provides COVID-19 Vaccine Suitability Assessment Service FAQs and scenarios, explaining when items can and cannot be billed, and how they should be billed.

    Key things to remember:

    • These items are only available for use in GP clinics participating in the Australian Government COVID-19 vaccine roll-out. 
    • The standard assessment items can be billed at each vaccination appointment, so long as the item requirements are met.  They can be used for both primary and booster doses of a vaccine.   The first dose has a separate item, and the same item applies to second and booster doses – for more information see item descriptors and explanatory notes and detailed factsheet
    • The in-depth assessment items can only be billed once for each patient in association with one of the standard assessment items – for more information see in-depth item descriptors for GPs and other medical practitioners in general practice and detailed factsheet
    • No co-claiming is permitted, such as additional MBS items for pre-vaccination assessments or time spent administering a vaccination following use of the suitability assessment items
    • As is the case for bulk billing generally, there should be no charges associated with COVID-19 vaccination, such as new patient registration or consumables charges
    • Items are billed in the name of the supervising GP (or other doctor working in general practice), who must be present at the location where the assessment is being undertaken and accept “full responsibility” for the service. 
    • Activities associated with each item can be undertaken by a GP, other doctors working in general practice, registered nurse or other suitably qualified registered health practitioner working within their scope of practice who have undertaken required COVID-19 vaccination training.  For more information on who can undertake COVD-19 vaccination generally, see Q&A Who can be involved in delivery of COVID-19 vaccines? 
    • If a patient chooses not to go ahead with vaccination following assessment, the relevant MBS item can still be billed if its requirements are met. 
    • If a patient decides not to receive a COVID-19 vaccination, but later chooses to receive it, the relevant standard assessment item numbers can still be billed at each consultation.
  • Does Medicare require the claiming doctor to see the patient personally? Updated 3 May 2022

    It depends on which type of item is being claimed. 

    For the in-depth COVID-19 vaccination patient assessment items for patients aged 50 and over, a personal attendance of at least 10 minutes is required, involving:

    • In-depth clinical advice on the individual risks and benefits of vaccination
    • One of both of the following, where clinically relevant
      • A detailed patient history
      • Complex examination and management. 

    For other COVID-19 vaccination assessment items:
    • The claiming doctor is not required to see or assess the patient in person in order to claim those items
    • A claiming doctor will need to be on-site during vaccination (telehealth availability is insufficient) and take ‘full’ responsibility for other team members (e.g. registered nurses) assessing patients and delivering vaccinations to them
    • Doctors need to be available to see COVID-19 vaccination patients as clinically appropriate
    • There are no limitations on doctors seeing patients for COVID-19 vaccination. 


    MBS items 93600 & 93661 allow qualified health professionals to bill vaccine suitability assessment services provided in a patient's home (including aged / disability care facility) without a doctor being on-site at the patient's home.

    If you are not seeing the patients yourself for vaccination you should ensure:

    • Only appropriately qualified staff are managing the patients – see Q&A - 'Who can be involved in delivery of COVID-19 vaccines?' 
    • You have appropriate processes in place for triage, assessment and observation
    • Any issues requiring attention of a doctor are referred promptly to you as clinically appropriate.  Depending on individual circumstances, this might include patients with suspected contraindications, certain precautions or who have complex or many questions about vaccination. 
  • Does the Medicare 80/20 rule apply to COVID-19 vaccination items? New 1 April 2021

    No - Medicare COVID-19 vaccination items are exempted from the ‘80/20’ rule (the Medicare “prescribed pattern of service”), triggering a compliance process and Professional Services Review referral.

  • Can I see a patient for other medical issues at the same time as COVID-19 vaccination and use my usual billing practices for those other issues? Updated 3 August 2021

    For standard COVID-19 vaccine assessment items, this is permitted where there is a clinical need to provide care for the other medical issue and there is no ‘cross-over’ between the COVID-19 MBS assessment item and the other MBS item/s being claimed.

    The in-depth assessment items can only be claimed together with a standard assessment item and a flag-fall item (where relevant). 

    The Commonwealth Health Department indicates:

    • Standard MBS multiple same-day attendance rules apply for co-claiming including
      • The other GP service must be unrelated to the vaccine assessment item
      • The subsequent attendances are not a continuation of the initial or earlier attendances.
    • Before billing, there is a need for informed financial consent for the patient so they understand there is no cost with the Covid vaccine component, and understands how the other service is billed – this should be recorded in the patient records
    • There should be no triage or screening for COVID-19 vaccination using existing MBS items before an MBS vaccination suitability assessment
    • No items can be claimed for time spent administering a vaccine following assessment
    • If a patient suffers a significant adverse reaction to a COVID-19 vaccine, the provider can bill another MBS item in order to provide appropriate treatment – this would include systematic reactions such as syncopal episodes, severe allergic reactions (e.g. anaphylaxis) and a strong, adverse mental / emotional reaction to vaccination – these additional services should be bulk-billed
    • COVID-19 vaccination assessment items cannot be co-claimed with certain other bulk billing incentive items.

    See the Department’s detailed fact sheet for more information, which includes a range of scenarios involving co-claiming.
  • I / my practice is not providing COVID-19 vaccinations, but I am advising my patient on whether they should receive a vaccination. Can I bill Medicare? Updated 3 May 2022

    Relevant non-COVID-19 vaccine assessment items may be used by GPs and other specialists who are not part of the Australian Government COVID-19 vaccine roll-out and who are advising their patients about COVID-19 vaccinations, so long as the individual requirements of the MBS item number in question are met.

    The specific COVID-19 vaccination assessment items cannot be used by those who are not part of the COVID-19 vaccine roll-out program.

  • My patient has experienced an adverse reaction to COVID-19 vaccination. What can I bill? New 20 August 2021

    The Commonwealth Health Department indicates that if a patient suffers a significant adverse reaction to a COVID-19 vaccine, the provider can bill another MBS item in order to provide appropriate treatment.  This includes systematic reactions such as syncopal episodes, severe allergic reactions (e.g. anaphylaxis) and a strong, adverse mental / emotional reaction to vaccination.  Additional services should be bulk-billed.

COVID-19 vaccination - advertising / social media 

  • Can I advertise COVID-19 vaccination to my patients or post about it on social media? Updated 3 May 2022

    Yes, you can advertise / promote COVID-19 vaccination to your patients and the community, within limits set out below.  This includes on physical signage, websites and social media.

    The National Boards / Ahpra proactively monitor advertising and social media, and may take action even if no notification / complaint has been made to them. 

    What you can and cannot do for COVID-19 vaccinations is set out in:


    More information on advertising / social media generally is available in:


    If you receive communications from Ahpra about your advertising / social media, contact MIGA’s lawyers.

  • My patient seeks a certificate exempting them from COVID-19 vaccination. What should I do? Updated 3 May 2022

    Requests for ‘exemption certificates’ might be based on compelling medical contraindications or personal choice.

    It is requests for certificates based on personal choice only, not based on clear clinical grounds, that are generally precluded and are more likely to cause concern to professional regulators, governments and other bodies about doctors issuing them.  For example,
    • The Medical Board / Ahpra have indicated:
      • Doctors who provide inappropriate exemption certificates will be investigated
      • Although considering each case on its individual facts, an investigation could lead to restrictions on registration, including ability to provide exemptions, managed COVID-19 patients
      • Where there is significant continuing risk or if it is in the public interest, a doctor could be suspended.


    The Medical Council of NSW has indicated that “A Covid-19 vaccination exemption is strictly limited and must be related to a health contraindication for which evidence is required to ensure a doctor is satisfied and can appropriately sign an exemption”.

    In providing any certificate or other letter for a patient declining COVID-19 vaccine, you should:
    • Be up-to-date with current requirements and guidance on COVID-19 vaccinations exemptions:
      • ATAGI guidance on temporary medical exemptions for COVID-19 vaccines – ATAGI indicates that “COVID-19 vaccines have been demonstrated to be safety and effective and as such are recommended for all Australians from 12 years of age. There are very few situations where a vaccine is contraindicated and as such, medical exemption is expected to be rarely required
      • Vaccination requirements and scope for vaccine exemption vary by state and territory – see for NSW, Victoria, Queensland, SA, WA, Tasmania, ACT and NT
    • Limit your certificate / letter to clinical issues within your expertise
    • Undertake an appropriate clinical assessment of the patient’s reasons for requesting exemption, such as detailed history-taking, physical examination or further testing / assessment as required
    • Consider seeking specialist immunisation service advice, or colleague / specialist opinions as appropriate
    • Avoiding being perceived to support patient decisions which are not based on clinical grounds (e.g. not based on recognised contraindications)
    • Consider providing your patient with further information on COVID-19 vaccination from appropriate sources, or arranging appropriate specialist referral to discuss their concerns
    • There is no requirement for you to provide a certificate / letter if you do not feel comfortable in doing so.

    The Commonwealth Health Department COVID-19 vaccine exemptions fact sheet can be given to patients to explain exemptions that can / cannot be issued (subject to specific state / territory requirements).  The Melbourne Vaccine Education Centre also provides a Discussion guide for medical exemptions.
  • What are the current healthcare worker mandatory COVID-19 vaccination requirements? Updated 3 May 2022

    States and territories have varying requirements for mandatory healthcare worker vaccination and scope for exemption – see for NSW, Victoria, Queensland, SA, WA, Tasmania, ACT and NT.

  • Should I keep a copy of COVID-19 digital vaccination certificates for my staff? New 18 March 2022

    Given COVID-19 digital certificates contain an Individual Healthcare Identifier (IHI) number, the OAIC advises these certificates:

    • Should not be collected if unnecessary (e.g. a record could be made of having sighted it)
    • If collection is required under state / territory mandatory vaccination requirements, the IHI should be removed / redacted from collected certificates.

Insurance cover for other COVID-19 matters

Note - the answers in this section only apply to MIGA policies issued to doctors, Eligible Midwives and healthcare businesses about their insurance cover in relation to COVID-19.
* Your individual cover is subject to your chosen category of practice and the terms and conditions of your policy with MIGA.  If you are a doctor whose practice entity employs other doctors, eligible midwives or others who bill in their own name, you must ensure that they have their own insurance arrangements in place to cover any disease that they might carry and transmit to others in your practice.
  • Am I covered for treating COVID-19 patients? Updated 12 November 2021

    Yes. Claims and inquiries arising from services provided to patients who are, may be or are suspected of being infected with COVID-19 are covered by MIGA’s insurance policies. *

    We cover you for healthcare services provided within your insurance category / scope of practice or healthcare business irrespective of the patient’s condition.

    If you are being asked to undertake, or are considering undertaking, a new or different role that may be outside your scope of practice and have any concerns around your medical indemnity insurance or any medico-legal implications, please contact us for assistance. We’ll help to make sure that your cover is appropriate for what you are doing and to guide you on potential medico-legal issues involved.


    * Your individual cover is subject to your chosen category of practice and the terms and conditions of your policy with MIGA.  If you are a doctor whose practice entity employs other doctors, Eligible Midwives or others who bill in their own name, you must ensure that they have their own insurance arrangements in place to cover any disease that they might carry and transmit to others in your practice.

  • Am I covered for providing telehealth? Updated 6 Aug 2020

    Yes. Claims arising from healthcare services provided to patients in Australia via telehealth consultations are covered by MIGA’s insurance policies *

    Within your scope of practice, our policies do not place limitations on how you provide your care.

    Telehealth is a well-recognised way of providing care in a wide variety of situations and can include consultations via a wide range of video platforms and telephone.

    You need to ensure that you conduct telehealth in accordance with applicable professional guidelines - see our various Q&A on telehealth.

    * Your individual cover is subject to your chosen category of practice and the terms and conditions of your policy with MIGA.  If you are a doctor whose practice entity employs other doctors, Eligible Midwives or others who bill in their own name, you must ensure that they have their own insurance arrangements in place to cover any disease that they might carry and transmit to others in your practice.

  • Am I covered if I am unknowingly infected and I infect patients resulting in a claim? Updated 17 Jul 2020

    Yes. Claims arising from healthcare services provided whilst you are infected with COVID-19 are covered by MIGA’s insurance policies *

    Your policy requires you to ensure that you take adequate precautions to prevent the transmission of a virus, bacteria or disease, which means that the steps that you take to prevent transmission must be accepted as competent practice by your peers.

    This would mean that you follow professional obligations for infection control, keep up to date with the potential signs and symptoms of COVID-19, know when to be tested (including the criteria for healthcare worker testing) and follow government requirements for quarantine and isolation (e.g. following travel overseas or to a COVID-19 hotspot, close contact with a confirmed COVID-19 case etc.)

    We recommend that you keep up to date with advice and other information on these issues from Commonwealth Department of Health’s COVID-19 advice for the health sector, your local health department and professional college / association (a range of relevant links are provided on MIGA’s COVID-19 web resources.

    If in doubt about any of these issues, seek advice from your local public health unit.

    If you are aware you are infected or suspect you may be, you should notify your hospital / health service, immediately cease practice, follow public health and other medical advice and complete the necessary isolation period before returning to practice.  

    * Your individual cover is subject to your chosen category of practice and the terms and conditions of your policy with MIGA.  If you are a doctor whose practice entity employs other doctors, Eligible Midwives or others who bill in their own name, you must ensure that they have their own insurance arrangements in place to cover any disease that they might carry and transmit to others in your practice.

  • Am I covered if I change my scope of practice? Updated 1 May 2020

    Yes, if you need to change your scope of practice you are covered provided it is permitted by your Ahpra registration and you are in the appropriate category of cover with us.*
     
    We recommend you take the following steps before starting your new work:
    • Ensure your Ahpra registration does not prevent you from the new scope of practice - the Medical Board has confirmed that doctors with general and specialist registrations are not restricted in their scope of practice because they have specialist registration
    • Be comfortable that you have the necessary skills, training and experience to provide the level of care expected, and your hospital, practice or other workplace agrees (see below Q&A ‘What if am asked to work outside my usual scope of practice to help my hospital deal with COVID-19 cases?’ for further guidance)
    • Confirm with your hospital, practice or other workplace (preferably in writing) that you will have the benefit of any insurance cover you are normally entitled to as an employee or contractor (e.g. as a visiting medical officer for public patients) 
    • Contact MIGA to ensure you have the right category of insurance cover with us. 

     

    * Your individual cover is subject to your chosen category of practice and the terms and conditions of your policy with MIGA.  If you are a doctor whose practice entity employs other doctors, Eligible Midwives or others who bill in their own name, you must ensure that they have their own insurance arrangements in place to cover any disease that they might carry and transmit to others in your practice.

Protecting yourself, your colleagues and your patients

  • Can I make COVID-19 vaccination a requirement for seeing patients face-to-face? Updated 3 May 2022

    Requiring patients to be fully vaccinated against COVID-19 as a condition of a face-to-face consultation could be open to criticism from medico-legal, professional, ethical and discrimination perspectives unless there are clear and compelling justifications for it in specific circumstances. 
      
    In MIGA’s view, such requirements could only ever be contemplated as a last resort, where there is no other reasonable option to protect yourself, staff and patients (see below for more information on this) and there are significant numbers of COVID-19 cases in the community. 

    Such situations are likely to be rare, e.g. where a certain worker is particularly vulnerable to the effects of COVID-19 infection due to a serious underlying condition.  Even then, it would be difficult to justify extending a preclusion on seeing unvaccinated patients face-to-face to other doctors and staff in the same practice who aren’t as vulnerable.    

    MIGA recommends thoroughly exploring whether the options detailed below are sufficient to protect yourself, your colleagues / staff and other patients, seeking public health / specialist advice as needed, before considering mandatory vaccination requirements for face-to-face care:

    • Strongly encouraging vaccination
    • Exploring with individual patients their reluctance to be vaccinated
    • Increased COVID Safe measures for non-vaccinated patients, such as triaging, enhanced PPE, use of different, appropriate practice areas apart from other staff and patients (particularly those at higher risk from COVID-19), outdoor consultations (where clinically appropriate) hygiene measures, physical distancing and air filtration / purification
    • Following AHPPC and ICEG guidance for minimising risk of COVID-19 transmission in primary healthcare settings
    • Pre-consultation triaging for use of telehealth where clinically appropriate
    • Pre-consultation COVID-19 rapid antigen testing
    • Limiting face-to-face consultations with unvaccinated persons to clinical issues which cannot be dealt with via telehealth
    • For staff at higher risk of COVID-19 infection, whether they can be kept separate to unvaccinated patients and those patients be seen by those at lesser risk. 

    Consider seeking public health / other specialist advice if uncertain about the extent to which these more straightforward approaches for seeing unvaccinated patients face-to-face where necessary would provide sufficient protection for yourself, your colleagues / staff and your patients. 

    In the rare situation where these steps are insufficient to protect staff and patients,  a wide range of issues need to be considered before imposing mandatory vaccination requirements for face-to-face care, including:
    • Current regulatory, ATAGI, public health and peak body advice – this includes Ahpra and the National Boards Facilitating access to care in a COVID-19 environment: Guidance for health practitioners and the AMA Position Statement on the Management of Patients Unvaccinated Against COVID-19
    • Extent of COVID-19 case numbers in the local community
    • Vulnerability of individual staff and particular patient groups
    • Why other measures such as staff vaccination, PPE, COVID-19 testing, telehealth triaging, hygiene measures and physical distancing are inadequate reduce transmission risk sufficiently
    • Why mandatory vaccination for patients is necessary if exposed workers are not required to be ‘furloughed’ or isolate if they are vaccinated and using certain PPE
    • What to do when use of telehealth would be clinically inappropriate
    • Practical limits on whether you are able to see patients outside your practice, such as in the car park – such as need for physical examination, privacy, access to devices and records, patient privacy etc
    • Access to care – including other local healthcare options and continuity of care for non-vaccinated patients when face-to-face care is needed
    • Whether the current volume of COVID-19 cases in the community would make it difficult to provide necessary face-to-face care in  your broader community if mandatory vaccination requirments were introduced by your practice
    • Discrimination law (generally there are exemptions under discrimination law for things reasonably necessary to protect individuals or public health)
    • Appropriate exceptions (e.g. emergencies, other urgent care and medical contraindications to vaccination).
  • Can I ask my patients and staff about their COVID-19 vaccination status? Updated 3 May 2022

    It is generally appropriate to ask patients about the COVID-19 vaccination status where there are COVID-19 patients in the community, given its relevance to the safety of you, your colleagues / staff and other patients.

    If you decide to ask your patients and / or staff about COVID-19 vaccination status, MIGA recommends:
    • Explaining the reasons why you are taking such steps
    • Exploring the concerns of the patient / staff member
    • If they remain reluctant to provide the information, consider whether there are other ways to ensure protection of other patients and staff without pressing for the information. 
    • Do not retain copies of their COVID-19 digital vaccination certificate that has an Individual Health Identifier number on it – see Q&A Should I keep a copy of COVID-19 digital vaccination certificates for my staff?
  • Can I ask my patients to wear masks when attending our practice? Updated 3 May 2022

    MIGA considers it is reasonable for you to request patients to wear a face mask when attending your practice, subject to any medical or other valid reasons, where:
    • Face masks are required by public health direction or advised / encouraged by authorities / peak bodies:
      • See current state / territory requirements / advice for NSW, Victoria, Queensland, SA,  WA, Tasmania, ACT and NT
      • AHPPC advises that "voluntary wearing of face masks offers protection to individuals agains transmission even when not mandated... when there is community transmission, individuals may choose to furtehr protect themselves and others by wearing well-fitted mace masks in certain circumstances in community settings.  Wearing a mask is not dependent on whether an individual is vaccinated or mandated by public health orders.... These circumstances include... visiting hospitals and healthcare settings..."
      • ICEG recommends use of masks to reduce transmission of the Omicron variant
      • AHPPC and ICEG recommend mandating mask use in primary healthcare care settings unless there is a valid reason (including those aged under 12 years)
      • RACGP consider face masks necessary in primary healthcare settings
    • There are high risks / significant levels of community transmission
    • Patients are unvaccinated
    • You, your colleagues or your staff are vulnerable to COVID-19.

    If you are asking patients to wear masks in your practice, it would be appropriate to have stocks available for those patients who do not have one. 
     
    Where a patient is reluctant to wear a face mask, you should consider:
    • Whether there is an appropriate alternative way to provide care to your patient, eg via telehealth where clinically appropriate – see Q&A below on telehealth
    • Whether staff COVID-19 vaccination and appropriate PPE would sufficiently reduce the risk
    • How to ensure necessary continuity of care for your patient.

    The Australian Human Rights Commission provides information on whether requiring people to wear masks would constitute discrimination.  Adapted for the healthcare context, it indicates:
    • A strict rule preventing patients without face masks from accessing healthcare at your practice, even patients who are lawfully exempt from public health requirements and cannot wear masks for medical reasons, could constitute unlawful discrimination
    • The onus would be on you to show a strict rule is reasonable in the circumstances, which may include:
      • Scope of public health directions and exemptions
      • Urgency of healthcare being sought
      • Risks of transmission in your practice, e.g. scope for physical distancing
      • How long the patient would remain in the practice
      • Whether there are other patients / staff who are most vulnerable to severe COVID-19
      • Government, regulator and peak body advice on medical and work health and safety risks
      • Whether you can provide healthcare in another way (e.g. via telehealth)
      • Local incidence, severity and distribution of COVID-19
      • Alternative methods for reducing risk without strict mask wearing requirements, such as testing regimes, physical distancing or PPE.
    • You are also required to make “reasonable adjustments” for people with disability, which are those which do not impose an “unjustifiable hardship” on your business – this might include providing healthcare without need for a mask at certain times / with certain providers or telehealth
    • You may be able to use the ‘infectious disease’ exemption to justify strict mask wearing requirements if “reasonably necessary”, but it is unlikely to be enough that a mask requirement is “merely helpful, desirable or convenient in protecting public health”.
  • My patient seeks an exemption to a requirement to wear a mask - What can I do? Updated 3 May 2022

    You may be approached by your patients to provide a certificate or written support for them not wearing a mask.

    Context of the request
    Usually requests for exemptions come in the context of public health directions requiring the wearing of masks. Those directions detail circumstances where people are exempted from wearing a mask.  Generally this includes a physical or mental health condition or disability that makes wearing a mask unsuitable.

    If an employer has asked your patient to wear a mask, it is important to explore the reasons for the employer’s request with the patient.

    Assessing requests for mask exemptions
    You can only provide an opinion within the limits of your expertise, and which you feel comfortable and confident in expressing from a clinical perspective. 

    In assessing requests for mask exemptions, consider:
    • Whether the patient’s individual circumstances (risks to them / others from not wearing a mask) and broader public health imperatives outweigh any clinical issues for them in wearing a mask.  
    • Exploring with the patient alternative options to a mask exemption, such as working from home, minimising time they are required to be wearing a mask, or whether certain masks / face coverings are more acceptable to the patient than others  
    • Seeking specialist advice and / or liaising with your local public health unit as appropriate.

    For patients seeking a mask exemption due to facial skin conditions, the Australasian College of Dermatology provides guidelines for exemption.  

    Unless the patient clearly warrants an exemption consider advising them about the public health benefits of using masks, particularly if they work in higher risk settings (such as health or aged care).

    It is appropriate to decline the patient’s request for a mask exemption if you do not feel their condition or disability justifies an exclusion from wearing a mask on clinical grounds, when balanced against public health imperatives and risks the patient may face or pose to others from not wearing a mask.

    In some circumstances, it may be appropriate to offer to provide the patient with a certificate / letter stating that they have a certain medical condition or disability if you don’t feel comfortable in saying they should be exempted from wearing a mask.
  • Can I ask my patients to undergo a COVID-19 test prior to undergoing surgery or seeing them face-to-face? Updated 3 May 2022

    If considering whether to require patients to have a COVID-19 test before they undergo surgery or attend your practice, consider:
    • Any current state / territory public health directions for testing
    • Government and peak body advice – see for example RACS elective surgery recommendations
    • Approaches taken by local public hospitals
    • Whether you practice in an area with a significant outbreak / large numbers of cases
    • Whether they have recently suffered from COVID-19 symptoms
    • Vulnerability of other patients and staff
    • Extent to which other protection measures, such as PPE and hygiene measures are likely to reduce the risk of COVID-19 transmission.

    If a patient / staff member is reluctant to undergo testing, MIGA recommends exploring with the patient / staff member whether there are ways to ensure appropriate protection of other patients / staff without testing.  As relevant this may include whether attending the practice / surgery can be delayed until this has taken place, or whether a consultation via telehealth is clinically appropriate.

Managing COVID-19 in the community

  • My patient refuses to follow advice for COVID-19 testing or self-isolation. What should I do? Updated 15 Oct 2020

    These situations may pose a risk to public health and safety.  Contact your local public health unit for advice.

    In some places, a refusal to undergo a test may be a breach of public health orders.

    Your patients should be encouraged to check their local requirements if they are reluctant to undergo testing.  Breaches can lead to financial or criminal penalties for them.
  • How are COVID-19 patients managed in the community? Updated 8 February 2022

    Across the country, states and territories are adopting / a range of approaches to managing COVID-19 cases in hospital and the community
    .
    Generally these models involve:
    • Care of higher risk / serious ill patients in hospital
    • Care of lower risk / mildly ill patients in the community via self-care, or virtual care / telehealth if needed
    • Varying involvement of usual GPs in caring for patients with COVID-19.

    Triage of patients following COVID-19 diagnosis is generally being undertaken by state / territory health departments, public health units and / or local hospital networks prior to any GP involvement.

    Isolation / quarantine periods and role of GPs in ‘clearing’ patients from isolation varies.  For example in NSW, GPs might be asked to provide medical clearance notices.  Doctors are not generally required to provide certificates or notices releasing patients from isolation or quarantine.  

    Further information about state requirement is a available for New South Wales, Victoria, Queensland, South Australia, Western Australia, Tasmania, ACT and NT.

    HealthDirect also provides information about managing COVID-19 at home – this may be useful to provide to your patients.  

    Key issues to consider around managing COVID-19 patients in the community include:
    • Being comfortable that you have the necessary skills, experience and time to manage COVID-19 patients via telehealth / virtual care – you are not required to be involved in this model of care if you do not feel comfortable doing so or your workload precludes it
    • Ensuring appropriate arrangements and clear responsibilities are in place for
      • Provision of oxygen monitoring and other necessary monitoring equipment to patients
      • Patients knowing to contact you / your practice / ambulance / hospital if certain symptoms develop or their condition deteriorates – it would be helpful for patients to have written information setting this out
      • Access to specialist advice (if and when required)
      • Continuity of / access to care if you are unavailable / your practice is closed
      • Any necessary arrangements to see patients in person – if you see patients at your practice ensuring there are appropriate COVID Safe measures (including separating COVID positive and non-COVID positive patients and PPE) in place to protect yourself, staff and other patients – see Q&A above on protecting yourself, your colleagues and your patients for more information
      • Escalation pathways if a patient’s condition deteriorates
    • Checking whether the local care model or patient’s hospital admission status precludes Medicare billing – this should be clarified via your local hospital network or primary health network.

    There is a new MBS item (until 30 June 2022) for GPs for additional cost of treating COVID-19 patients face-to-face, which can be used:
    • When the patient has recently been diagnosed with COVID-19 through positive laboratory PCR testing
    • By the GP themselves – it cannot be delegated to another professional
    • In conjunction with other eligible face-to-face items, including general attendance items at consulting rooms, residential aged care facilities or home visits. 

    The National COVID-19 Clinical Evidence Taskforce provides a range of recommendations, guidance and flowcharts for managing COVID-19 patients in the community.

    The RACGP provides the following guidelines / resources:
  • Are there restrictions / guidance on medications for managing COVID-19? Updated 3 May 2022

    The TGA details COVID-19 treatments provisionally approved for use in Australia.

    The National COVID-19 Clinical Evidence Taskforce provides:


    Decision tool on drug treatments for at risk adults with COVID-19 who do not require oxygenCertain treatments require an authority for PBS prescription, including Molnupiravir (Lagevrio) and Nirmatrelvir and Ritonavir (Paxlovid).

    In addition:
    Certain medications have been restricted from use as COVID-19 treatments, or guidelines advise that they not be used outside randomised control trial settings or at all.  These include:

Telehealth and Medicare requirements

  • When can I use telehealth? Updated 1 April 2022

    Telehealth is appropriate to use where:
    • You have a reliable, secure telehealth system
    • You can provide the same level of care and advice you can in a face-to-face consultation
    • You have appropriate arrangements to see the patient face-to-face if necessary.  

    Telehealth can still be used if it does not qualify for a Medicare item where clinically appropriate to do so. 
    Your fees for this should be disclosed to the patient prior to consultation.
     
    For telehealth guidance see:
  • What platforms can I use for telehealth? Updated 3 September 2021

    A range of commonly used video platforms and landline / mobile telephone services can be suitable for telehealth.  
     
    Be aware free versions of telehealth platforms may not meet privacy and security requirements. 
     
    To assist in choosing suitable video conferencing platforms, the Australian Digital Health Agency provides:
    Telehealth video conference platform interpreting is available via TIS National
  • What are the changes to Medicare Telehealth from January 2022? Updated 1 April 2022

    The Commonwealth Government has announced population wide telehealth under Medicare will continue permanently for GPs and other specialists.

    Although certain longer MBS telephone items were initially removed, a range of telephone items have since been restored until 30 June 2022, including longer GP telephone items (Level C) and items for specialists to provide telehealth to hospital inpatients when their doctor cannot see them because of isolation / quarantine restrictions.  These items are available across the country.

    Changes include:
    • Unrestricted access to MBS telehealth services for patients subject to COVID-19 public health orders requiring isolation / quarantine, without need for an established clinical relationship with their general practice
    • Patients in COVID-19 hotspot areas not subject to isolation / quarantine requirements must have an established clinical relationship with their general practice to access MBS telehealth, unless an exemption applies – see Q&A Can I only use Medicare COVID-19 telehealth items for existing patients? 
    • Face-to-face item for GPs caring for COVID positive patients in the community now extends to patients that have tested positive through a rapid antigen test.

    For specialists outside general practice a range of pre-pandemic telehealth items have been removed.

    A new 30/20 rule for GP and consultant physician telephone services (ie non-video services) will commence on 1 July 2022.  Breach of this rule, precluding 30 or more telephone attendances on each of 12 or more days during a 12 month period, leads to a Professional Services Review referral.

    From 1 July 2022 the existing 80/20 rule applies to all GP consultation times, whether face-to-face or telehealth 

    More information on the changes, including continuing item numbers, is available here.
  • When can I use Medicare telehealth items? Updated 3 May 2022

    The current items extend to all Medicare eligible Australians, so long as the requirements for individual item numbers are met. 

    Requirements for Medicare telehealth items include:
    • Both you and your patient must be in Australia to use Medicare telehealth items (as is the case for Medicare items generally). 
    • You do not need to be within your regular practice to provide telehealth.  It can be provided from home. 
    • You should use your provider number for your primary practice location.
    • Your Medicare provider number should only be used for telehealth consultations you undertake yourself. It cannot be used by other practitioners you work with for their consultations. 
    • For each service / consultation, the full requirements of a telehealth item must be met.  They cannot be used solely for triaging.
    • Subject to a range of exceptions, GPs and other doctors working in general practice can only claim COVID-19 telehealth items if they have an existing and continuous relationship with a patient:
      • This involves the patient having seen the same doctor or another medical or health practitioner (including a practice nurse) at the same practice face-to-face in the last 12 months.  The requirement applies to each and every telehealth claim
      • For example if this requirement was met for past telehealth claims, but you have not now since the patient face-to-face for more than 12 months, you cannot claim MBS COVID-19 telehealth items
      • For more information see AskMBS Advisory - existing relationship clarification.
     
    In determining whether telehealth is appropriate, Medicare requires the practitioner must:
    • Have the capacity to provide the full service through this means safely and in accordance with professional standards; and
    • Be satisfied that it is clinically appropriate to provide the service to the patient; and
    • Maintain a visual and audio link (or audio only for telephone) with the patient; and
    • Be satisfied that the software and hardware used to deliver the service meets the applicable laws for security and privacy – see Q&A What platforms can I use for telehealth? 
    • Only use telephone if video cannot be used.
     
    Online chat, messaging and email cannot be used for Medicare telehealth items.
     
    Before using the new items, you should familarise yourself with the requirements for telehealth use generally and each individual item.   This is very important.  This includes:
    • Obtaining informed financial consent before providing telehealth where you are not bulk-billing (the AMA’s Informed Consent guide is here)
    • Documentation – there are the same record-keeping requirements as for face-to-face consultations – this includes referrals where required
    • Assignment of benefit:
      • For the new telehealth items only, documentation in clinical notes of a patient’s agreement to assign their benefit as full payment for the service is sufficient
      • Other options include posting the completed assignment of benefit form to the patient for their signature and return, or email agreement between the practitioner and patient
      • The agreement can be provided by a patient’s carer or family member if the patient is unable to provide it
      • The Department of Health has indicated it does not intend to undertake compliance activities “directly focused on whether the assignment of benefit process aligned with the usual requirements”, but may investigate potentially fraudulent claims by seeking to verify that the service was provided to a patient
    • Multiple attendances on the same day (co-claiming is precluded) – see Q&A What if I see a patient via telehealth and then need to see them face-to-face?.
     
    The Department of Health provides an email service for questions around COVID-19 MBS items –AskMBS@health.gov.au.  It has also provided advisories for GPs, physicians and other specialists covering both telehealth and broader MBS claiming questions. 
     
    The Commonwealth Health Department has released the following Medicare telehealth guidance:
    COVID-19 telehealth item news – detailing changes to the items as made.
  • What if I see a patient via telehealth and then need to see them face-to-face? Updated 10 Sept 2020

    For use of Medicare telehealth items, the Commonwealth Health Department has indicated:

    • You need to have the capacity to see the patient face-to-face if required, wherever possible, or otherwise scope to arrange prompt care as required, whether through colleagues at your practice / hospital or other frameworks you have put in place before providing telehealth services
    • If a subsequent attendance on the same day does constitute a continuation of an earlier attendance, the sessions together are considered a single attendance for benefit purposes.
    • If you cannot meet the requirements of a telehealth item without a subsequent face-to-face consultation, you cannot bill Medicare until you have provided a complete MBS service - this could be through billing either a telehealth item or a face-to-face item, whichever took the longer, so long as the individual item requirements are met – you cannot bill both items
    • If two components of a single service are provided by different practitioners, each should bill the appropriate item number fo rhte individual service they provided
    • The new telehealth items are stand-alone items – they cannot be co-claimed with existing face to-face or existing telehealth items - in addition, you cannot claim a telehealth item and a chronic desease management plan item on the same day
    • Multiple Medicare items could only be claimed on the same day by the same practitioner if subsequent attendances are not a continuation of initial or earlier attendances – if you bill multiple items you should state the time of each attendance on the account, and also include in the clinical records time of each service, how each item descriptor was met and explain why they are separate services.

    More information is available here (Provider FAQs). 

    For telehealth that is not Medicare billable, you should ensure that you have the necessary arrangements in place to provide continuity of care within appropriate timeframes for patients who you initially consult with via telehealth, but subsequently need to see face-to-face, where you cannot do this yourself. 
     

Registration

  • What if I am working outside my usual scope of practice? Updated 16 Nov 2020

    We are conscious that a range of our members are undertaking a broader range of work in helping to respond to the challenges of COVID-19. 
     
    The Medical Board indicates:

    • Individual doctors, as well as organisations who engage them, will need to make decisions about scope of practice
    • Decisions should prioritise patient safety and take into account your qualifications, training, experience and transferability of their skills to deliver safe care
    • Consider the conditions in which you will be working, including facilities and access to supervision and training
    • The Board does not prescribe what individual doctors can and cannot do – these are decisions for you and your hospital, practice or other workplace, prioritising patient safety.

     
    We recognise practitioners are often equipped to work across a number of specialties or fields of practice. 

    You should:

    • Make sure your Ahpra registration does not restrict or preclude new or broader work
      • The Medical Board has confirmed that doctors with general and specialist registration are not restricted in their scope of practice because they have specialist registration
      • If your registration does restrict you (e.g. you are limited to certain fields of practice)you would have to apply to Ahpra for changes to your registration before commencing work
    • Consider whether you have the necessary skills, training and experience to provide the level of care expected in the new context
    • Contact MIGA to ensure you have the right insurance category for your new work
    • Ensure you do not incorrectly represent your qualifications, training and experience – the Medical Board has confirmed working in a different scope of practice does not permit you to use a title for which you do not have specialist registration  See Ahpra and the National Boards guidance on Titles in health advertising – Getting it right.   


    If you have concerns about being able to work in a new area, you should raise them with senior colleagues, your hospital or health service.

  • I have returned to practice as part of Ahpra's pandemic sub-register. Are there limitations on what I can and cannot do? Updated 3 May 2022

    Ahpra's pandemic sub-register -  includes doctors, nurses, midwives and a range of other registered professions who if they wish can practice until 21 September 2022 to the full scope of their registration, subject to any restrictions, notations or conditions.

    Ahpra has provided information for practitioners and employers on the sub-registers.  

    Ahpra indicates “Only those who are properly qualified, competent and suitable should be on the sub-registers. Practitioners who are in a high-risk category for COVID-19 should only work in a safe practice environment”.  

    It is expected that those practising under the pandemic sub-register will exercise their professional judgement and work within their level of competence to ensure they have the necessary knowledge and skills to provide appropriate and safe care.  For more information, see Q&A What if am working outside my usual scope of practice?  

    Whilst on the sub-register, and similarly to your practising peers, you are required to follow your profession’s code of practice (doctors or midwifery) and work within your scope of practice.  Midwifery scope of practice is defined in the Nursing and Midwifery Board’s Midwife Standards for Practice.

  • I have only returned to work in the public sector. Do I need cover from MIGA? New 3 Apr 2020

    Doctors employed in the public hospital system will usually have cover for civil damages claims from their employer, but this does not normally include cover for legal expense or assistance with responding to other issues, such as professional disciplinary matters (i.e. a Medical Board / Ahpra notification) or workplace disputes.  Assistance available in relation to coronial investigations and inquests may also be limited.
     
    Before starting work, you should confirm the nature and extent of your insurance cover or indemnity with your hospital or health service.  We recommend you consider insurance cover from MIGA for matters for which you are not covered.

  • If I return to private practice will I lose eligibility for Commonwealth Government run-off cover scheme? Updated 1 April 2022

    A special exemption has been agreed to allow doctors and midwives to return to private practice and not lose their eligibility for the Commonwealth’s run-off cover scheme (ROCS) until 17 May 2022. At this stage, no arrangements have been made for it to be extended further.

    If you continue in private practice after that time, the special ROCS exemption will no longer apply and you will need to obtain run-off cover for past practice at your own expense. 

    Practitioners returning to public practice only do not lose ROCS eligibility.

  • I have ceased practice and am not currently working, do I still have to have insurance? Doctors and Midwives Updated 22 Apr 2020

    Yes, under your registration requirements as a doctor or a midwife, you must maintain run-off cover for matters that would otherwise be uncovered arising from your previous practice.

    If you cease practice, your Policy with MIGA can be amended to run-off cover only, to cover you for claims that may still be made against you that arise from your prior practice.

    If you change your policy to run-off, you will need to notify us prior to returning to practice to arrange ongoing insurance cover.

Insurance policies are issued by Medical Insurance Australia Pty Ltd (AFSL 255906).  MIGA has not taken into account your personal objectives or situation.  Before you make any decisions about our policies, please review the relevant Product Disclosure Statement (which can be found here) and consider your own needs.
Information on this site does not constitute legal or professional advice. If you have questions, or need advice please contact us for assistance.