Privacy, access concerns if Medicare and pharmaceutical claims and payments are outsourced

Friday, August 8, 2014

The Australian Healthcare and Hospitals Association (AHHA) considers a number of important issues need to be considered with the proposed commercial provision of Medical and Pharmaceutical Benefits Claims and Payment Services currently being provided by the Department of Human Services and Department of Veterans’ Affairs. This follows the Department of Health today advertising for expressions of interest to market test the outsourcing of these services.

“The AHHA is supportive of an efficient, modern and innovative way of providing health payment services and believes that, with so much technology available today, a service model meeting these criteria can be found,” AHHA Chief Executive Ms Alison Verhoeven said today. 

“However, the commercial delivery of health claims and payments raises concerns on a number of levels.”

Ms Verhoeven emphasised that where the delivery of these crucial health services to Australians is provided commercially, there must be appropriate governance arrangements in place to ensure individual privacy.

“The issue of privacy really comes into play here, as bank tellers, post office managers or other attendants generally don’t hold the security clearances required to be dealing with sensitive and very personal information,” Ms Verhoeven said.

“I don’t know how comfortable people would feel having their home loan manager providing them with a Medicare rebate and knowing very detailed information about their healthcare.”

Ms Verhoeven also raised concerns about the about the collection, storage and access to important personal health data.

“We know that it's already quite difficult to access Medicare and pharmaceuticals data to undertake clinical and health services research: will this be further compromised?” Ms Verhoeven asked.

“There will need to be very strong quality of service guarantees in place with any private providers to ensure that all Australians are able to access these services wherever they live, and that data is managed sensitively to ensure privacy and able to be accessed for vital research and planning needs.  I’d also be interested to see more detail on what fraud control measures will be put in place with any new claims and payments arrangements.”

“With so much change occurring in access to and payment for healthcare in Australia at the moment, it is important for the Minister to make sure that these changes do not result in a disjointed system,” Ms Verhoeven said.

For more information on the AHHA, visit

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, community and primary healthcare services, and advocates for universal, high quality and affordable healthcare to benefit the whole community.

Media Enquiries:

Alison Verhoeven

Chief Executive, The Australian Healthcare and Hospitals Association

0403 282 501