Novel COVID-19

Update 19 June 2020

This information reflects the most recent developments in relation to COVID-19 medico-legal and insurance matters for our members and clients to consider.

 
It represents our latest advice on this issue and provides answers to some commonly answered questions.

In responding to this rapidly evolving situation, it is critical to have access to the latest, reliable information.  Given this, we encourage you to review our new and updated advice as these issues arise for you. 
 
We include important links to authoritative Government information on COVID-19, and further information prepared by key professional groups which we recommend you use.  Keeping up to date with Government health advice and information remains imperative. These are changing regularly, sometimes daily. 
 
Our information covers:

  • Frequently asked questions – including about insurance, practice, patients, telehealth, surgery and your health
  • Other information and resources.

 
Contact MIGA for advice or assistance
 
We encourage you to contact:

  • MIGA’s Claims Department if you need advice about how to manage COVID-19 related issues in your practice (1800 839 280 / claims@miga.com.au), or
  • MIGA’s Client Services Officers if you have any questions about your insurance cover (1800 777 156 / miga@miga.com.au). 

You can also use MIGA’s contact form here
 

Frequently Asked Questions


Below are answers to a range of frequently asked questions that you may have in relation to COVID-19 and how to manage it in your practice. 
 
They are generally categorised as follows:

  • Insurance cover
  • Minimising the risk of COVID-19 transmission and being ready for COVID-19 cases – guidelines for practices
  • Telehealth
  • Your health – COVID-19 risks, illness and personal support
  • My patients
  • Surgery, procedures and essential medical services including elective surgery
  • Registration and training issues
  • Returning to the workforce
  • COVID-19 Premium Relief from MIGA

Insurance cover

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.
  • Am I covered for treating COVID-19 patients? Updated 3 April 2020

    Yes. Claims and inquiries arising from services provided to patients who 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 3 April 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.

    * 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? New 3 April 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 overseas travel, 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.

Minimising the risk of COVID-19 transmission and being ready for cases - Guidelines for practices

  • What should my practice do to minimise transmission risk and be ready to deal with COVID-19 cases? Updated 19 June 2020

    The Commonwealth Health Department continues to update and provide detailed information and advice to the health profession on managing COVID-19 here, including working arrangements (keeping staff and business safe), hygiene and cleaning, personal protective equipment, and providing care both face-to-face and remotely.
     
    State and territory health departments and a range of colleges and professional associations (links below under ‘Other information and resources’) are also providing detailed information on managing suspected and diagnosed COVID-19 cases.  It is important to keep up to date with new information from these sources.  

    In a community setting, consider what you need to do around triage and alerts for possible COVID-19 symptoms.The response to patients presenting with symptoms or risk factors for COVID-19 infection (these are identified and regularly updated on government health websites - see 'Other Information and resources' below) should be planned and communicated clearly to all staff in the practice so they are clear on what should be told to patients (by email, practice website or online booking facility).
     
    Things to consider include:
    • Being clear on current health department advice on criteria for a suspected COVID-19 case- Communicable Diseases Network Australia (CDNA) provides updated definitions of suspect, probable and confirmed cases – you should also check your updated local health department criteria
    • How you can have patients alert you to possible COVID-19 symptoms – i.e. when booking for an appointment (whether by telephone or online) or presenting for appointments or walk in visits
    • Consider what presentations may be suitable for telehealth (see Q&A below on telehealth)
    • Information to provide on your practice website, online booking website and on the door outside your practice
    • Preparing all staff  to deal with a suspected COVID-19 case – necessary equipment (see Q&A 'Where can I find guidance on personal protective equipment to use?), caring for the patient, protecting other patients, contacting local public health units, local dedicated COVID-19 clinics and / or local emergency departments
    • Ensuring all staff are aware of what they should do if they are suffering symptoms of a potential COVID-19 illness, have had close contact with a COVID-19 case or have recently travelled overseas– see here for more information around when healthcare workers can and cannot work, and should be tested, and here for CDNA guidance on healthcare worker symptom monitoring
    • Supporting staff who might be more vulnerable to COVID-19 – this may involve considering how to modify their work to limit their risks of contracting COVID-19
      • The Commonwealth Health Department advice for people at risk of COVID-19 here
      • Australian Health Protection Principal Committee recommendations for managing vulnerable workers here
      • RANZCOG has released information on pregnant healthcare workers and COVID-19 here 
      • ASCIA has prepared information on COVID-19 and immunosuppression here.
  • What if our practice doesn't feel it can deal with a suspected COVID-19 case? Updated 30 March 2020

    There are situations where a healthcare provider may not be able to deal with a suspected COVID-19 case, or may feel uncomfortable in seeing those patients. 
     
    Doctors should assist where they can in emergency situations, where there is no other appropriate care readily available.  Whether you can assist depends on your own skills and safety, and the impact on other patients under your care.   Your own health and availability of appropriate protective equipment are also relevant considerations.   
     
    Outside an emergency situation, if you do not feel you are able to deal with COVID-19 patients, consider how you can help the patient get the care they need and ensure continuity of care.  You can contact your local public health unit (see contact numbers under 'Other information and resources' below), local dedicated COVID-19 clinic or hospital emergency department to find out where the patient can be treated and what you can do to facilitate this.  
     
    In a hospital setting, if you are concerned you are unable to treat suspected COVID-19 cases, you should raise this with your colleagues, head of department or director of clinical services as relevant.   The scope of your role may be relevant in deciding what you can and cannot do.

  • What if I don't have the necessary equipment to manage possible COVID-19 cases? Updated 1 May 2020

    Health care professionals should not be put in positions where their own health and safety is at risk. It is important that you, your colleagues and staff are appropriately protected, and that patients can still access the care they need, even if via another method or source. 

    For more information on PPE guidance from Australian governments and peak bodies, see Q&A 'Where can I find guidance on personal protective equipment to use?'
     
    If you have concerns about personal protective equipment (PPE) availability, these need to be considered and potential responses worked out before there is a shortage.  We recommend you: 
    • Engage with your hospital, local primary health network or other supplier to understand any potential impacts on equipment supply
    • Discuss with your department, colleagues and / or practice what to do if there is an equipment shortage
    • Consider how telehealth can be used appropriately to conserve PPE
    • Have in place procedures to ensure that if necessary PPE is unavailable, patients can still access necessary care in a timely way, i.e. via telehealth, contact with another local practice with sufficient PPE, a COVID-19 clinic or referral to a local hospital emergency department.

     
  • Where can I find guidance on personal protective equipment to use? Updated 22 May 2020

    Commonwealth, state and territory governments, and various colleges, associations and societies, have published guidance on appropriate personal protective equipment (PPE) for a variety of clinical settings. 

    These are being updated regularly in response to developments.

    For Commonwealth Government and agency guidance:


    Available state and territory government specific guidance:


    The RACGP has also prepared COVID-19 infection control principles, RACS has produced Guidelines for PPE and ANZCA a statement on PPE.

    Links to other college, association and society guidance is available under 'Other information and resources' below.
  • Is there guidance on what can be used in cases of equipment or ventilator shortages? New 24 April 2020

    It is hoped that with decreasing numbers of new COVID-19 cases over the past couple of weeks, and extensive efforts to secure personal protective equipment (PPE) and ventilator supplies, that all healthcare workers will have the equipment they need to protect themselves and provide the care their patients need. 
    The TGA has provided a range of guidance on issues of PPE and ventilator shortage, including:
     


    You should also familarise yourself with relevant professional college / association / society guidelines (see Other Information and Resources below for links) and local requirements (i.e. health department or local hospital) if and when these concerns eventuate. 

    A Critical Health Resource Information System (CHRIS) will operate in all public and private hospitals with ICUS, showing where ICU beds and ventilators are available. 

    For PPE shortages, please also see our Q&A - What if I don’t have the necessary equipment to manage possible COVID-19 cases? 

  • What if I am asked to work outside my usual scope of practice to help my hospital deal with COVID-19 cases? Updated 1 May 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, e.g. critical care specialists (peak bodies have prepared a consensus statement these issue), doctors in training. 
     
    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.
  • Can I undertake certain practice activities outside or in other premises? New 17 April 2020

    A number of our members and clients are exploring different options for where to provide certain medical services in order to minimise risks of COVID-19 transmission, e.g. outdoor flu clinics, using separate rented premises for some face-to-face clinical presentations. 

    MIGA supports these initiatives where:

    • They are for reasons of patient and / or staff safety
    • ​You are able to provide the same level of care as you would in your usual practice location.  This includes availability of necessary emergency and monitoring equipment, infection control, post-injection monitoring and privacy / confidentiality. 


    If you are considering running certain face-to-face practice activities from a different physical location (i.e. new rented premises):

    • Consider whether you should seek a separate Medicare provider number
    • ​Make sure the owner is aware of the nature of what is being done.


    Check your other business insurances (e.g. workers’ compensation, public liability, business interruption etc) cover these activities.

  • I have been asked to work interstate to assist with COVID-19. What should I be aware of? New 9 April 2020

    We are aware some of our members are being invited to work elsewhere in Australia to help respond to the challenges of COVID-19.  

    To ensure you follow legal requirements and have the right insurance cover in place, we recommend you consider the following before starting work elsewhere:
     
    • What border and quarantine restrictions are in place both where you propose to work, and where you live (i.e. applying when you return home).  Some places provide travel and quarantine exemptions for ‘essential travellers’ like doctors and other health professionals – see here for more information, including links to specific state and territory requirements
    • If you are being asked to work outside your usual scope of practice, consider our Q&A ‘What if am asked to work outside my usual scope of practice to help my hospital deal with COVID-19 cases?’
    • You can provide Medicare services from a new location using your existing provider number for less than 12 weeks, if you return to your usual location after this – more guidance on provider numbers changes is here
    • Check with the hospital or health service where you will be working if they will be providing any insurance cover to you
    • If you will be working in a different category of insurance and / or your estimated Gross Income will change, contact MIGA to ensure you have the right cover in place.
     
     

Telehealth

  • Can I use telehealth during the COVID-19 pandemic? Updated 22 May 2020

    Yes.  If you are confident that a reliable, secure telehealth system will allow you to provide the same level of care and advice you can in a face-to-face consultation with a patient, and you have appropriate arrangements to see the patient face-to-face if necessary, it is an appropriate alternative approach.  
     
    Ahpra and the National Boards have developed Telehealth guidance for practitioners, setting out expectations for using telehealth during the COVID-19 pandemic.

    The Commonwealth Health Department has also prepared guidance on telehealth and consultations in GP respiratory clinics, and advice on when to provide care face-to-face and remotely

    A range of commonly used video platforms and landline / mobile telephone services can be suitable for telehealth. 

    Ahpra and the National Boards have advised “No specific equipment is required to provide telehealth services. Services can be provided through telephone and widely available video calling apps and software platforms such as Skype, FaceTime, Duo, GoToMeeting and others”.  They caution that “free versions of these applications (i.e. non-commercial versions) may not meet applicable laws for security and privacy. Practitioners must ensure that their chosen telecommunications solution meets their clinical requirements and satisfies privacy laws”.

    Healthdirect Australia, on behalf of various Australian governments, is providing a video consulting platform for primary health services, including GPs, until 30 September 2020.More information is available here

    For telehealth generally:

  • How has Medicare recently expanded Telehealth? Updated 24 April 2020

    New temporary Medicare telehealth items for non-admitted patients have been introduced progressively over recent weeks, being:
    • 13 to 23 March 2020 – various telehealth items for self-isolating or vulnerable patients and practitioners
    • 30 March 2020 – a ‘whole of population’ telehealth model, allowing a range of GPs, specialists and certain other health practitioners to use telehealth for a range of appropriate clinical situations, irrespective of whether the patient or practitioner has, or is at risk of, COVID-19
    • 6 April 2020:
      • Lifting of a range of bulk-billing requirements on new telehealth items – a range of patients must continue to be bulk-billed (these have since been lifted further for certain doctors) – see Q&A below 'What patients must be bulk billed under the new telehealth items?' for details
      • Further specialist services were included in telehealth billable to Medicare.
    • 20 April 2020
      • Lifting bulk-billing restrictions on telehealth items for specialist and consultant physicians, nurse practitioners, midwives and allied health practitioners
      • Providing a range of bulk-billing incentives for patients who must still be bulk-billed
      • Adding further specialist telehealth items in neurosurgery, public health and group therapy by phychiatrists.

    More than 270 temporary Medicare telehealth items have been introduced during the COVID-19 pandemic for general practice, specialist and consultant physician, nurse practitioner, midwifery and allied health attendances.

    These items are in place until 30 September 2020.  They extend to all Medicare eligible Australians, so long as the requirements for individual item numbers are met.  Both you and your patient must be in Australia to use Medicare telehealth items (as is the case for Medicare items generally). 

    An overview of the various items, by reference to individual numbers, is here.   Detailed fact sheets setting out overarching obligations and for various classes of items (GPs, specialists, participating midwives etc) are available here.  Details on new bulk billing incentive rates are available here . 

    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 location.
     
  • How can I use the new Medicare Telehealth items for my patients? Updated 8 May 2020

    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 (MIGA considers this would generally include a range of commonly used video platforms and landline / mobile telephones)
    • Only use telephone if video cannot be used.


    The Commonwealth Department of Health advises “no specific equipment is required to provide Medicare-compliant telehealth services.  Practitioners must ensure that their chosen telecommunications solution meets their clinical requirements and satisfies privacy laws". It has released a Privacy Checklist for Telehealth Services, covering issues of consent, providing information, security, conducting the consultation and communication.  
     
    The Australian Cyber Security Centre provides guidance on web conferencing security, indicating you should consider:

    • Whether the service provider is based in Australia
    • The service provider’s track record
    • Whether privacy, security and legal requirements are being met
    • What information and metadata is collected
    • Reliability and scalability of the service provider’s web conferencing solution. 


    Patient preference and comfort with the proposed platform are also relevant factors in choosing what telehealth solution to use with individual patients.
     
    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:

    • Knowing what must be bulk-billed (see below Q&A - 'What patients must be bulk billed under the new telehealth items?')
    • Obtaining informed financial consent before providing telehealth where you are not bulk-billing
    • 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
    • Multiple attendances on the same day (co-claiming is precluded) - see question below "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 .
     
  • What if I see a patient via telehealth and then need to see them face-to-face? New 24 April 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, 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, so long as the individual item requirements are met – you cannot bill both items
    • The new telehealth items are stand-alone items – they cannot be co-claimed with existing face to-face or existing telehealth items
    • 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

    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. 
     
  • What patients must be bulk-billed under the new Medicare telehealth items? Updated 1 May 2020

    The new Medicare telehealth items must be bulk-billed by GP's and other doctors in general practice for:
     
    • Commonwealth concession card holders
    • Children under 16 years of age
    • Patients who are more vulnerable to COVID-19, who are:
      • Those required to self-isolate or self-quarantine
      • At least age 70
      • Of Aboriginal or Torres Strait Islander descent and at least 50 years old
      • Pregnant
      • Parent of a child aged under 12 months
      • Being treated for a chronic health condition (a condition present or likely to be present for at least 6 months, or which is terminal – more information is here)
      • Immune compromised - this is a clinical decision made by the patient's treating doctor; or
      • Meets the current national triage protocol criteria for suspected COVID-19 infection – this is based on the CDNA National Guidelines for Public Health Unit available here.

    There are a range of bulk-billing incentives available, including for medical, diagnostic imaging and pathology services to those under 16 years of age, or who are Commonwealth concession card holders.  Further information on eligibility and claiming rules is available here (COIV-19 Bulk-billing incentives – FAQs).

    For all other patients, the Department of Health indicates “bulk billing is at the discretion of the provider, so long as informed financial consent is obtained prior to the provision of the service”. 

    Informed financial consent includes details relating to fees, including any out-of-pocket expenses.

    From 20 April 2020, the above bulk-billing restrictions that previously applied to a range of other healthcare professionals, including specialist and consultant physicians, nurse practitioners and midwives, have been lifted.  They may now choose their billing method for the new telehealth items.

    More information is available here.
     
  • How can my patients obtain medications I prescribe them in a telehealth consultation? Updated 19 June 2020

    Interim image-based prescription arrangements

    An interim image-based prescription model has been introduced, which means:
    • You can create a paper prescription, signed in writing or via valid digital signature (a digital signature cannot be used in NSW, where a handwritten signature is required)
    • A clear digital copy of the entire prescription (photo or PDF) can be sent to the patient’s pharmacy via email, text message or fax (in NSW, the copies cannot be sent via text message)
    • You retain the original prescription for two years (in Victoria and Tasmania, you must make certain records of any digital image being transferred, and you are advised to make records of how you sent the prescription and the pharmacy you sent it to in Queensland).

    Image-based prescribing cannot be used for Schedule 4D or 8 medications, except in:
    • Victoria – where it can be used for all Schedule 4 medications except for drugs of dependence
    • Queensland – restricted drugs of dependency, anabolic steroids and Schedule 8 prescriptions can be sent electronically to a pharmacy so long as the paper prescription is sent to the pharmacy within 7 days and the paper copy is not given to the patient – the paper prescription should be marked as being confirmation of the earlier electronic request
    • WA - Schedule 8 prescriptions may be sent electronically via the same process to a pharmacy, and the original prescription dispatched to the pharmacy within five working days, marked to indicate that it is confirmation of an earlier digital request
    • ACT - Schedule 4D and 8 prescriptions can be sent electronically to a pharmacy. 

    The Commonwealth Department of Health provides a guide for prescribers and an overview of state and territory rules.  Further information is also available for South Australia, NSW, Victoria, Queensland, WA, Tasmania and ACT.

    If the patient prefers to receive the original prescription themselves to take to the pharmacist to fill, instead of using the interim electronic prescribing arrangement, you can still post it to them for this purpose.

    Electronic prescribing initiatives to come

    The Department and Australian Digital Health Agency have foreshadowed introducing the following electronic prescribing processes:
    • From around late May 2020, a staged approach involving QR barcode tokens sent to a patient’s device
    • From the end of 2020, an Active Script List Model, involving a list of a patient’s active or current prescriptions which can be dispensed by a pharmacist when the patient presents with sufficient identification.

    More information on these plans is available here
  • Can the Medicare telehealth items be used if either I or my patient are overseas? New 19 June 2020

    No.  Both you and your patient must be in Australia to use Medicare telehealth items.  This is the case for any use of Medicare.
  • Can my practice use my Medicare provider number to bill telehealth consultations undertaken by other practitioners in the same practice? New 19 June 2020

    No. Your Medicare provider number should only be used for telehealth consultations you undertake yourself.

    Your are responsible for meeting Medicare billing requirements for an item billed using your provider number.

    If incorrectly or inappropriately billed for services provided by another, you would be responsible for meeting any repayment to Medicare, and could also face Medicare restrictions or professional disciplinary action.
  • Can I use telehealth for patients in aged care facilities? New 17 April 2020

    Yes, the Medicare telehealth items can be used for patients in aged care facilities, subject to individual item number requirements and whether it is clinically appropriate to use telehealth for the patient in question.

    Where a patient lacks capacity, their substitute decision-maker (guardian, power of attorney, close relative as relevant) can be involved, whether with the patient or linked in from another location via video or telephone.  MIGA’s resource on Substitute consent provides more information on who should be involved in these situations.  

     

  • Can I use Telehealth if it doesn't qualify for Medicare? New 30 March 2020

    Telehealth can still be used if it does not qualify for a Medicare item where clinically appropriate to do so. 
     
    This can include providing care to patients via telehealth from your home if you are self-isolating or otherwise remaining at home.  Your fees for this should be disclosed to the patient prior to consultation.  Ideally this would occur during the telehealth booking process.  
  • I am an international medical graduate with limited or provisional registration. Can I use telehealth? New 1 May 2020

    The Medical Board has temporarily varied the definitions of level 1 and 2 supervision to allow international medical graduates (IMGs) under level 1 and 2 supervision to participate in telehealth where appropriate supervision can be assured, including where:
     

    • Level 1 – your supervisor is contactable 100% of the time you are consulting and you consult your supervisor in person, via video or teleconference before each patient consultation ends
    • Level 2 – your supervisor is contactable at least 80% of the time you are consulting, and you discuss with your supervisor patients you have consulted on at least a daily basis, and more frequently if necessary
    • Levels 3 and 4 – telehealth is already permissible under these supervision requirements.

Your health - COVID-19 risks, illness and personal support

  • I'm feeling ill and think I might have been exposed to COVID-19. What should I do? Updated 22 May 2020

    You should:

    • Not go to work if you have a fever or any symptom (however minor) of respiratory illness
    • Be tested for COVID-19 if you develop fever or respiratory symptoms
    • Stay home in self isolation until you receive your test result – you should not be at workContact the National COVID-19 Helpline on 1800 020 080 
    • Seek advice from your GP, local public health unit or dedicated COVID-19 clinic
    • Familiarise yourself with the latest health department advice
    • Alert your hospital or practice
    • Ensure you follow government and professional advice and guidance on isolating yourself and when you are able to return to practice. 


    More information is available from the Commonwealth Health Department and CDNA.   You should also follow any additional requirements specific to your state or territory. 
     
    You should also familiarise yourself with health department advice on isolation requirements following COVID-19 diagnosis, close contact or recent travel.The CDNA’s guidelines cover return to work following isolation for healthcare workers.  

     

  • I'm worried about returning to work after a period of isolation. Updated 22 May 2020

    If your concerns are health-related, speak to your GP or local public health unit.
     
    For employment or contract issues, the Fair Work Ombudsman has information on COVID-19 related issues here.  Consider raising your concerns with your employer, hospital or practice as relevant. 

    Safe Work Australia also has healthcare specific advice on work health and safety during the COVID-19 pandemic. 
     
    Consider raising your concerns with your employer, hospital or practice as relevant. 

  • This is an incredibly stressful time for me. What services are there for personal support? Updated 19 June 2020

    It is important that you seek any professional and personal support you need. 

    The Commonwealth Department of Health provides a range of information about looking after yourself and links to various support services here.

    Doctors can access Doctors’ Health Services 24/7 helplines across Australia to help you find the support you need, which includes:

    • Drs4Drs Support Service - crisis support as well as non-urgent mental health support, provided by psychologists, social workers and counsellors - 1300 374 377 or www.Drs4Drs.com.au
    • State and territory doctors health services - individual contact details are here.  


    Midwives can access Nurse & Midwife Support, a 24/7 telephone and online service – contact details are here.

    Whether you are a doctor, midwife, practice manager/owner or practice staff member, your college or association may have its own professional support program you can access. 

    Doctors’ Health SA has also prepared ‘Self-care for doctors in a Covid world’, available here.

    Doctors’ Health Advisory Service WA has also provided “Managing your Mental Wellbeing” during this pandemic, available here.

    MIGA’s Doctors’ Health website also provides a range of other resources and links.

    The Pandemic Kindness Movement has been created by Australian clinicians to support healthcare workers, providing resources and links to services to support healthcare worker well-being.

    Beyond Blue has also developed a 24/7 Coronavirus Mental Wellbeing Support Service.

    The Black Dog Institute (in partnership with a range of other organisations) is soon to release TEN – The Essential Network.  This is an app for healthcare workers providing a one stop resource and help centre for a range of mental health issues.  It will include an online clinic screening tool and facilitate streamlined online referral processes for telehealth consultations.   Further Black Dog Institute COVID-19 resources are available here

    The Australian Government’s Head to Health provides a range of resources on COVID-19 and mental health here

     

My Patients

  • My patient doesn't fit the criteria for COVID-19 testing, but they are demanding a test. Updated 5 June 2020

    Except in WA, outside health department criteria for COVID-19 testing, any testing is at the discretion of the clinician.

    You are not compelled to provide care you believe to be unwarranted or inappropriate.

    In WA there are restrictions on what COVID-19 testing primary health care providers can order.  Certain exemptions have been granted, including:
    If in doubt about whether a test is warranted or appropriate contact your local public health unit. 


  • Are there special requirements/restrictions on COVID-19 tests? Updated 5 June 2020

    Outside notifiable disease obligations for COVID-19, there are various other obligations / restrictions around testing in certain states.

    Pathology laboratory obligations

    In South Australia, by public health order there are requirements for responsible person for a pathology service to ensure:
    • Notification of COVID-19 testing results to patients within a timely manner, which must be within 72 hours of swabbing
    • SA Health Communicable Disease Control Branch notification of various details of tests, both undertaken to date and on an ongoing basis 
    • Appropriate laboratory accreditation, quality assurance (including clinical microbiologist oversight) and following the national COVID-19 surveillance plan.


    Point of care testing

    South Australia, Queensland and Western Australia, certain point of care COVID-19 tests are precluded by public health order.  Financial penalties apply for their use.  However in Western Australia there are exceptions for certain remote communities and islands.

    Victoria advises against the use of various rapid point of care COVID-19 tests outside a research framework. 

    The TGA has confirmed that supply of self-tests for COVID-19 is prohibited. 

    Each of the Australian Health Protection Principal Committee, the TGA, the Public Health Laboratory Network and the RCPA have issued guidance on these issues.  NSW-specific information is available from NSW Health Pathology. 

  • My patient refuses to follow advice for COVID-19 testing or self-isolation. What should I do? New 25 March 2020

    These situations may pose a risk to public health and safety.  Contact your local public health unit for advice.
  • A patient wants a medical clearance certificate for COVID-19. Can I give this? Updated 24 April 2020

    Patients are approaching their doctors for a range of certificates or clearances associated with the COVID-19 pandemic, particularly following quarantine / isolation, they are vulnerable to COVID-19 or have chronic health conditions.

    NSW Health has indicated there is no testing to predict whether a patient will become infected with COVID-19 and it is not possible to give a medical clearance certificate. 

    Both the WA Department of Health and ACT Health provide specific advice on COVID-19 clearances.  

    For patients seeking medical certificates around vulnerability to COVID-19, the Commonwealth Health Department has provided information on who is at greater risk of serious illness from COVID-19 here.  

    For medical certificates in a COVID-19 context (which also applies more generally to medical certificates), MIGA advises:
    • Be clear on the limits of your knowledge and expertise, both with the patient and in the certificate
    • When writing the certificate, clearly demarcate between patient history on the one hand, and your examination findings, assessment, opinion and recommendations on the other
    • Don’t let the patient ‘drive’ what is in the medical certificate – only ever include opinions you feel comfortable and confident in expressing
    • Generally speaking, the clearer the basis for your opinions and recommendations the more likely those relying on the certificate will be willing to accept them
    • It is generally better to avoid certificates lacking detail about your findings and the basis for your recommendations – if the patient doesn’t want this in the certificate explain to them this could make the certificate less useful, and consider whether you are comfortable providing a certificate lacking detail
    • Be careful about the questions you are answering – if asked to give an opinion on whether the patient fits certain criteria (e.g. ‘vulnerability’), answer based on the definition given, not your own interpretation of what the criteria should be
    • It may be the best certificate you can give is to explain the history given and clinical diagnoses if you can’t address certain questions the patient / employer want answered
    • Be prepared to say to a patient you cannot give the opinion they seek – it may be they need to see someone else with particular expertise on the issue, i.e. specialist physician or surgeon
    • Given the misconceptions around ‘certificates’, it may be better in some situations to provide a short ‘letter’ or ‘report’ instead, not using the terms ‘certificate’ or ‘clearance’.

    For medical certificates generally, the Medical Council of NSW and AMA have each prepared medical certificate guidelines.   

    The RACGP has prepared a template letter to employers, schools and child care centres around issues with requesting medical certificates or clearances.
  • I've had patients not be honest about their symptoms in order to see me. This puts me and our practice staff at risk. What can I do? New 3 April 2020

    Health care professionals should not be put in positions where their own health and safety is at risk. 

    It is important that:

    • You, your colleagues and staff are appropriately protected
    • ​Patients can still access the care they need, even if via another method or source.

    We encourage you to consider what you can do to minimise the chance of this happening as part of your practice’s COVID-19 response (see our Q&A ‘What should my practice do to be ready for possible COVID-19 cases?’

    You may wish to consider emphasising on your website / via telephone booking / triage / practice signage:

    • The responsibility you and your practice have to ensure the health and safety of staff
    • ​The need for accurate reporting of symptoms, as otherwise your practice may not be able to treat the patient and need to refer them elsewhere.

    If a patient has deliberately misreported symptoms to you, outside an emergency situation MIGA considers that this can provide appropriate grounds to terminate care.  It is important to ensure that you take steps to ensure the patient can still access the care they need, eg providing other care options or any necessary referral.

  • Can I encourage my patients or staff to use COVIDsafe, the new contact tracing app? Updated 22 May 2020

    You can encourage your patients to use COVIDSafe, but you cannot do anything that could be considered coercion or compulsion to do so.

    For example, you cannot make use of COVIDSafe a condition of attending your practice or remaining your patient.

    Similarly, you cannot compel your staff to use COVIDSafe as a workplace requirement.

    Breaches of these restrictions may lead to financial and/or criminal penalties. 

    More information about COVIDSafe is available here.
  • What requirements exist around doctors entering aged care facilities to treat their patients? Updated 24 April 2020

    Across Australia there are various restrictions in place around entry to aged care facilities.
     
    Doctors and other healthcare workers are permitted entry, but a range of restrictions apply around any recent travel, close contact of a confirmed COVID-19 case, presence of respiratory symptoms and whether they have been vaccinated against seasonal influenza.

    Further details are available here

    The Australian Health Protection Principal Committee has provided advice on entry to aged care facilities.

  • Are privacy and confidentiality affected by COVID-19? New 25 March 2020

    Obligations of privacy and confidentiality continue to operate for patients with suspected or diagnosed COVID-19. 
     
    COVID-19 is a notifiable disease to state and territory health departments.  This is not a breach of privacy or confidentiality. 
     
    There may be other situations where it is necessary to disclose the occurrence of COVID-19. 
     
    For example, it would be necessary to disclose certain information within a hospital or workplace to potential close contacts of the COVID-19 case.  Disclosure would be limited to what is reasonably necessary in the circumstances.  Before doing this, advice should be sought from your local public health unit, which would be involved in and guide this process. 
     
    The OAIC has prepared a useful resource here on privacy obligations and COVID-19.

  • Are there restrictions on COVID-19 clinical management? Updated 19 June 2020

    There is a range of regulatory and peak body advice on COVID-19 clinical management, including various restrictions on hydroxychloroquine usage, which vary across Australia.  Governments have also released advice on recent dexamethasone trials.

    COVID-19 medications generally

    The Australian Health Protection Principal Committee has provided advice on off-label medicines for COVID-19 treatment and prophylaxis.  It includes the following advice:

    The AHPPC considers the evidence supporting off-label usage of medications for COVID-19 is not sufficient.
     
    The TGA advisesThere are no medicines that have been approved by the TGA for treatment of COVID-19, therefore prescribing of any medicine for the treatment of COVID-19 is considered off-label use. There is currently no clear data to inform clinical guidance on the use, dosing, or duration for COVID-19 treatment”.  

    The National COVID-19 Clinical Evidence Taskforce has living guidelines’ that provide recommendations on use of antiviral and other disease modifying treatment.

    According to a recent article in Australian Prescriber, “Principles of ethical prescribing for self
    and others: hydroxychloroquine in the COVID‑19 pandemic” (available here)

    Prescribing medicines for COVID‑19 lacks evidence, risks toxicity and may prevent others accessing essential treatments for chronic diseases. …   Drugs must be reserved for approved indications for which they are a first-line treatment.  [Hydroxychloroquine] use outside of a clinical trial should be avoided until more evidence is available.

    Each of the AMA, NSW Health and the WA Health Department have also produced guidance on COVID-19 anti-viral therapy.  The Australian Commission on Safety and Quality in Health Care also has position statements on COVID-19 medicines management. 

    Dexamethasone advice

    The Australian Health Protection Committee has provided a statement on reported results of a dexamethasone trial in COVID-19 hospitalised patients, indicating "Although this seems to be an exciting development, further examination of the scientific results, when published, will be required to confirm the efficacy of dexamethasone for severe COVID-19".

    The COVID-19 Clinical Evidence Taskforce has also issued a statement on this trial, indicating "We are hopeful that the initial reports of benefit are confirmed in a peer-reviewed publication in the very near future".

    Restrictions on hydroxychloroquine

    There are a range of restrictions precluding hydroxychloroquine prescription. 

    From 1 May 2020, the Pharmaceutical Benefits Scheme (PBS) listing for hydroxychloroquine provides that both initial and continuing PBS listings will be Authority Required (STREAMLINED).  This includes a requirement that initial prescription be authorised by an Ahpra registred specialist in dermatology, intensive care medicine, paediatrics and child health, as a physician, or in emergency medicine.  More information is available here.

    Prescription of hydroxychloroquine has been restricted by the TGA and by Victorian public health order so that:

    • Only authorised specialists can prescribe hydroxychloroquine to new patients – these include dermatology, intensive care medicine, paediatrics and child health, physician and emergency medicine
    • Other doctors, including GPs and hospital doctors in training, can only prescribe hydroxychloroquine if continuing a treatment authorised by an approved specialist. 

    In NSW these hydroxychloroquine restrictions have been further modified so that:
    • Doctors practicing in a public hospital may prescribe hydroxychloroquine for hospital patients
    • Any prescription must clearly indicate it has been issued under clause 37 of the Poisons and Therapeutic Goods Regulation 2008
    • Hydrochloroquine cannot be self-administered.

    In Queensland, hydroxychloroquine restrictions have been further modified so that:
    • A prescriber initiating treatment can be a doctor training to prepare for specialist registration (i.e. a registrar) in an authorised specialty working under the supervision of an authorised specialist
    • A prescriber can continue treatment for a chronic condition where initiated by an authorised specialist (in Queensland these also include registered dentists with a registered specialty in oral medicine) or doctors in training as above.


    NPS MedicineWise is also providing up-to-date information about hydroxychloroquine and COVID-19 here.

  • My patient died from COVID-19. How do I certify cause of death? New 9 April 2020

    The Australian Bureau of Statistics has provided Guidance for Certifying Deaths due to COVID-19.   This includes example medical certificates involving ‘chains of events’ and chronic conditions. 

Surgery, procedures and essential medical services

  • Are there limits on what the health profession can do during this time? Updated 19 June 2020

    As elective surgery and other 'business' restrictions are being eased, medical and other healthcare services are gradually returning to full capacity in a way that reduces the risk of COVID-19 transmission.

    See our Q&A 'What should my practice do to minimise COVID-19 transmission risk and deal with cases?' for ensuring your practice is taking the necessary steps to reduce the risk of COVID-19 transmission in your patients and staff.

    If undertaking surgeries or procedures, you should review our Q&A on these issues below.

  • How have elective surgery restrictions been removed? Updated 19 June 2020

    On 15 May 2020, the National Cabinet announced plans for a three stage lifting of elective surgery restrictions in an “incremental and cautious way”. 
     
    The manner and speed of lifting of these restrictions varies across states and territories.  It will also take time to clear elective surgery backlogs which have built up during the COVID-19 pandemic.

    Some states, such as South Australia and Western Australia, have now returned to full elective surgery capacity.  Other states are at 75% of normal elective surgery levels (Queensland) or moving towards this level by end of June (New South Wales and Victoria).


    You should:


    The Australian Commission on Safety and Quality in Health Care has provided guidance on COVID-19: elective surgery and infection prevention and control precautions and FAQs for clinicians on elective surgery.

  • What steps should I take to ensure I am aware if my patient's elective surgery becomes an emergency or otherwise urgent? Updated 14 May 2020

    If your patient had been booked for, or is likely to need, elective surgery which is not presently permitted where you practice, or is otherwise delayed due to surgical backlogs arising from past COVID-19 restrictions, it is important you have a process where any deterioration or other changes in your patient’s condition which may create a need for urgent surgery are brought to your attention so you can consider any necessary re-categorisation.

  • Can I undertake non-surgical cosmetic procedures? Updated 19 June 2020

    Yes, subject to any local state or territory requirements (in place only in Queensland) and peak body guidance.

    In Queensland, by public health direction cosmetic injections are permitted so lon as your practice operated in comliance with a COVID SAFE checklist, has a maximum 20 patients / customers at a time on premises, no more than 1 person per 4 sq m and social distancing observed to the extent possible.  Requirements to keep patient contact and attendance details would be met by maintaining necessary clinical records.

    In terms of peak body guidance and advice:

    • The Australasian Society of Aesthetic Plastic Surgeons and the Australasian Society of Cosmetic Dermatologists have released a cosmetic injectables guide, including the advice that they "recommend a cautious approach during the reintroduction of Cosmetic Injecting treatments using neurotoxins and tissue fillers keeping patients and practices safe whilst not wasing valuable resources
    • The Cosmetic Physicians College of Australasia has released guidelines on returning to cosmetic medicine (non-surgical) practice. 

Registration and training issues

  • Am I still required to complete the same continuing professional development? New 1 May 2020

    The Medical Board has confirmed it will not take action if you cannot meet continuing professional development (CPD) registration requirements on this year’s registration renewal.  This applies to expected 2020 CPD, and renewal declarations for this year’s CPD.
     
    A range of colleges and associations have already released information around COVID-19 impacts on CPD requirements (see links below under Other information and resources).
  • How might the COVID-19 pandemic impact my medical student training? Updated 14 May 2020

    MIGA is aware that the COVID-19 pandemic has had significant impacts on many of its medical student members. 

    Medical Deans of Austalia and New Zealand, the Medical Board and Australian Medical Council have released a joint statement on supporting future doctors during COVID-19, indicating:
     
    • It is vital that students’ progression through their medical training continues
    • Reducing clinical placement experience to the extent that it affects progression and graduation will impact the supply of work-ready and pandemic-cognate graduates for 2021 onwards
    • Everything possible needs to be done to ensure clinical placements are maintained
    • Where student participation has been paused, to allow time for new forms of placements and workforce roles to be established, schools are ensuring students are well-prepared and well-supported.

    The Australian Medical Students’ Association is also providing regular updates to medical students. 

    If you are approached about or considering a role outside a clinical placement or an elective, such as an assistant in medicine role, you should contact MIGA.
  • I am concerned about completing my internship. What information is available? New 1 May 2020

    The Medical Board has published information for interns around waiving usual rotation requirements for this year, setting out revised requirements.  These include level of full-time equivalent work, supervision and teaching.   It also covers evidence required for granting general registration following internship.
    The Medical Board has also indicated:
     
    • Reduction in minimum supervised clinical experience for 2020 (from 47 weeks to at least 40 weeks) is to allow for sick leave and isolation during the COVID-19 pandemic. If your supervised practice has been less than 47 weeks, but at least 40, you need to explain the reasons for the shortfall - sick leave or to isolation due to COVID-19 are acceptable reasons
    • Internship should continue for a year (i.e. if you started at the beginning of 2020 you continue until the beginning of 2021 before applying for general registration).  It will not approve applications for general registration earlier than the usual intern completion date
    • It will continue to review requirement for interns starting in mid-2020, being flexible if there are ongoing impacts to health services from COVID-19.
  • Where can I find out about changes to my college/association training requirements due to COVID-19? New 1 May 2020

    Although colleges and associations have been providing information about changes to specialist training due to COVID-19, the AMA Council of Doctors in Training has prepared a resource, being updated regularly, to support current and aspiring specialty trainees to keep up-to-date with examinations, career progression, fees and leave. 

  • As an international medical graduate, how might COVID-19 affect my registration? New 1 May 2020

    The Medical Board has confirmed that it will not refuse to renew the registration of an international medical graduate (IMG) for 20202 solely because of inability to set an Australian Medical Council or college exam / assessment from March 2020.

    The Board has also streamlined processes around IMG redeployment in hospitals.  More information is available here.
  • I have conditions or undertakings on my registration. Am I still required to comply with them? Updated 22 May 2020

    Yes, you must continue to comply with conditions or undertakings on your registration.

    The Medical Board has published guidance on a range of issues relating to compliance with conditions and undertakings during the COVID-19 pandemic.

    For NSW doctors, information about compliance with conditions, and impact of COVID-19 on these, is available here.

Returning to the workforce

  • I am returning to practice as part of Ahpra's pandemic sub-register. Are there limitations on what I can and cannot do? New 3 April 2020

    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. 
     
    Although the Medical Board has indicated does not define scope of practice for those with unconditional general registration, it expects doctors 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.
     
    Midwifery scope of practice is defined in the Nursing and Midwifery Board’s Midwife Standards for Practice.

     
    Outside other conditions you may have on your practice, you are not restricted by the pandemic sub-register in the location or context of your work. 
     
    Ahpra provides a range of FAQs about returning to work under the pandemic sub-register.
  • I am only going to return to work in the public sector. Do I need cover from MIGA? New 3 April 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? New 3 April 2020

    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).  

    This is a temporary exemption for the COVID-19 pandemic.  It ceases one month after the pandemic ends.  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.

COVID-19 Premium Relief with MIGA

  • My Gross Income has dropped and is lower than I estimated due to COVID-19, what does this mean for my premium for the 2019/20 financial year? Updated 22 April 2020

    MIGA’s policies include an option to adjust the premium if your actual Gross Income (or Sessions) is higher or lower than what you expected.

    In this situation a different Income/Sessions Band may apply and you may be entitled to a premium adjustment.

    If your Gross Income has reduced but it’s not significantly lower than anticipated, we suggest that you contact us after the end of the financial year (when you know your actual Gross Income for 2019/20) and we will process any refund that may be due to you at that point.

    Alternatively we can process an adjustment for you now. We will require an Income Declaration for this and will then require a final declaration of actual Gross Income after the end of the financial year.

    Please see the Question below 'What is MIGA doing to support Members and Clients who are suffering financial hardship arising from COVID-19?'

    Please call our staff to discuss the above or e-mail us at COVIDrelief@miga.com.au.
    Our staff will guide you through your options.

    * The definition of Gross Income can be found in MIGA’s Categories Guide.
  • I am facing financial hardship following the impact of COVID-19 as my business has closed or my income has substantially reduced. What are my options? Updated 22 April 2020

    MIGA understands that some of our Members and Clients are experiencing financial hardship during this health crisis.

    With concerns over the financial impact of the current crisis, MIGA’s Boards have agreed a COVID-19 Premium Relief arrangement to support our Members and Clients during these extraordinary times.

    Please see see the Question below 'What is MIGA doing to support Members and Clients who are suffering financial hardship arising from COVID-19?'

    Please call our staff to discuss the above or e-mail us at COVIDrelief@miga.com.au.

    Our staff will guide you through your options.

  • What is MIGA doing to support Members and Clients who are suffering financial hardship arising from COVID-19? Updated 22 April 2020

    We understand the difficulties of the current situation and want to assure you that MIGA is committed to supporting our Members and Clients who are suffering financial hardship.

    We understand the challenges you are currently facing as we deal with the unprecedented change that COVID-19 has brought. No doubt many of you have had to make significant changes to the way in which you practise and MIGA has also considered what we can do to support you.

    With concerns over the financial impact of the current crisis, MIGA’s Boards have agreed a COVID-19 Premium Relief arrangement to support our Members and Clients during these extraordinary times.
     
    It involves a number of mechanisms to respond to your changing financial circumstances whilst maintaining our financial strength.  Eligible clients may include doctors in private practice, Healthcare clients and Midwives.

    Under our COVID-19 Premium Relief arrangement, you may have access to:
     
    • Eligibility for a premium reduction, if your practice and/or the level of activity of your practice has materially changed
      • You don’t have to wait until after 30 June 2020 or your next renewal to apply for this
    • If you are suffering significant financial hardship
      • If you meet our Eligibility Criteria you may be able to access additional financial relief from MIGA in terms of your annual premium or direct debit
      • The Eligibility Criteria are if you have ceased working, if your practice has closed and/or if your income for the 3 months from April 2020 has or will reduce by 50% or more of what it would normally be.

    Please call our staff to discuss if you are eligible and your specific situation or e-mail us at COVIDrelief@miga.com.au.  Our staff will guide you through your options.

    Rest assured, supporting you is a key priority for us as we understand how important this is particularly for those who are significantly impacted.

    As a member owned mutual helping our Members and Clients through difficult times is very important to us and always front of mind.
  • I have ceased practice and am not currently working, do I still have to have insurance? Doctors and Midwives Updated 22 April 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.
  • What will happen to my premium for the 2020/21 financial year if my estimated Gross Income (or Sessions) is less than prior years due to COVID-19 impact? Updated 22 April 2020

    If your estimated Gross Income or Sessions for the 2020/21 financial year is lower than in the past it may mean a lower annual premium.

    In the next 2 weeks you will receive our usual annual pre-renewal communication, asking you to review your current details and advise your estimated Gross Income or Sessions for the next financial year.

    When you receive this, please ensure you complete and return to us. We will use your amended details to calculate your medical indemnity insurance cost for 2020/21.

    *The definition of Gross Income can be found in MIGA’s Categories Guide.

Other information 

Updated 22 May 2020

A range of professional groups have been assisting the profession respond to the challenges of COVID-19, including AMA, RACGP, ACRRM, RACP, ACEM, ANZCA, ASA, RANZCO, ANZICS, RANZCR, RACS, RANZCOG, AOA, CSANZASID, GESA, ASPS, ACCS, ACAM, ACM and ANMF

Peak clinical groups, with the support of Australian Governments, have put together the National COVID-19 Clinical Evidence Taskforce.  The NSW Health COVID-19 Critical Intelligence Unit also provides daily updates on new evidence and reports.

Our government health departments are important sources of information and advice to the profession, updated regularly - Commonwealth (advice and resources), South Australia, NSW, Victoria, Qld, WA, Tasmania, ACT and NT.

NPS MedicineWise has resources on medication prescribing during COVID-19. 
 
The Therapeutic Goods Administration also has Covid-19 information for medicines and medical devices here.
Ahpra is also providing information around a range of registration and other regulatory issues here.

We encourage you to regularly check information from health departments and professional bodies as it is updated frequently.

Contact details for State and Territory Public Health Units are as follows:
 

ACT

02 5124 9213 or 02 9962 4155 after hours

NSW

1300 066 055

NT

08 8922 8044

QLD

13HEALTH (13 43 25 84)

SA

1300 232 272

TAS

1800 671 738

VIC

1300 651 160

WA

08 9328 0553


For workplace issues relating to COVID-19, the Fair Work Ombudsman and Safe Work Australia provide a range of information.

Insurance policies are issued by Medical Insurance Australia Pty Ltd.  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.