This is a response to the discussion paper released 18 August 2017.

CHF agrees with the Discussion Paper that there is a balance to be struck between security protections surrounding health professionals’ access to patients’ Medicare card numbers to avoid unauthorised, inappropriate or fraudulent use, and timely access to Medicare benefits for patients who are unable to present their Medicare card at the time of service.

Particular considerations for CHF are as follows:

• The July 2017 media reports of illegal selling of Medicare card numbers on the Dark Web suggest that current controls for access to others’ Medicare card numbers need to be tightened, and possible weaknesses rectified, within the Health Professional Online Services (HPOS) system and the arrangements for the Medicare provider enquiries line.
• Individuals who are unable to present their Medicare card at the time of service typically have understandable reasons for being in this situation, while possibly also being financially unable to meet the whole cost of the service provided out of their own pocket at the time of the service. For example, these individuals may be acutely or chronically unwell, homeless, escaping family violence, or under other significant stress for whatever reason. As the Discussion Paper notes, Medicare is Australia’s universal healthcare system, providing all Australians with access to timely and affordable healthcare. It is important that individuals who are unable to present their Medicare card at the time of service are not disadvantaged by changes to the HPOS system.
• CHF supports the move to a national opt-out approach to the implementation of My Health Record, as well as measures which genuinely address consumers’ legitimate security concerns in relation to the My Health Record system. It would be unfortunate if inappropriate access to Medicare card numbers, as highlighted by the July 2017 media reports, reduced public confidence in the My Health Record system.