If you are unsure how to handle a matter concerning COVID-19, you can contact MIPS for clinico-legal advice and support on 1800 061 113. See how MIPS is assisting members during COVID-19.
Government, AHPRA and industry updates
- COVID-19 vaccination – Phase 1b rollout. List of general practices, Aboriginal Controlled Community Health Services, and GP-led respiratory clinics where COVID-19 vaccinations will be available to people in phase 1b of the rollout.
- Top 3 COVID-19 vaccine questions – Second vaccine dose, vaccine safety and consent forms
- Weighing up the potential benefits against the risk of harm from COVID-19 Vaccine AstraZeneca
- COVID-19 vaccination - After your AstraZeneca vaccine
- Is it true? Why do I have to wait 14 days between getting the flu and COVID-19 vaccine?
- AstraZeneca vaccine and the COVID-19 vaccination program – Patient information
- ATAGI statement on AstraZeneca vaccine in response to new vaccine safety concerns
- Joint statement on COVID-19 AstraZeneca vaccine advice from ATAGI
- On the 8th April, ATAGI recommended the COVID-19 Pfizer vaccine is preferred over the AstraZeneca vaccine for adults aged under 50 years. ATAGI recommends the AstraZeneca vaccine can be used in adults aged under 50 where:
- the benefits clearly outweigh the risk for that individual.
- the person has made an informed decision based on an understanding of the risks and benefits.
- On the 8th April, ATAGI recommended the COVID-19 Pfizer vaccine is preferred over the AstraZeneca vaccine for adults aged under 50 years. ATAGI recommends the AstraZeneca vaccine can be used in adults aged under 50 where:
- COVID-19 vaccine information for GPs
- AHPRA Statement: Registered health practitioners and students: What you need to know about the COVID-19 vaccine rollout
- COVID-19 Vaccine – Pfizer – Training Program
- Department of Health COVID-19 vaccines initiatives and programs
- TGA COVID-19 vaccines news and updates
- TGA safety information: Advertising COVID-19 vaccines
- TGA provisionally approves Pfizer COVID-19 vaccine
- Australian Government Department of Health:
- 1800 020 080 National Coronavirus Helpline (24/7)
- State Government health department updates ACT, NSW, NT, QLD, SA, TAS, VIC and WA
- AHPRA and National Boards updates
- Refer to your college for craft specific guidance (eg RACGP, ACRRM, RACS, ADA)
On 28 July 2020, the Department of Health launched a Telehealth Items Guide to provide answers for questions commonly asked by healthcare practitioners about recent changes to MBS telehealth items in response to the outbreak of COVID-19 in Australia.
MIPS encourages members who provide telehealth services to review the guideline closely to ensure they comply with AHPRA’s advice.
The recent expansion of Telehealth in Australia due to the outbreak of COVID-19 does not obviate the need for a face to face in person consult when a physical/direct examination is pivotal to support clinical decision making. See our telehealth FAQs for further information.
Cover is subject to the terms, conditions and exclusions of the Indemnity Insurance Policy and those of MIPS membership within the Member Handbook Combined PDS and FSG.
Providing COVID-19 vaccines
Am I covered to provide the COVID-19 vaccine?
Yes, as a registered practitioner you are covered through your MIPS membership under the Indemnity Insurance Policy for treatment provided by you. Administering a vaccine is within this scope provided you have appropriate training, qualifications and experience.
Do I need to advise MIPS if I administer the vaccine?
No, provided you have the required training, qualifications, experience and AHPRA registration then you can administer the vaccine.
Am I liable if a patient has an adverse reaction?
If the reaction is a result of an error or omission on your part administering the vaccine, then your MIPS policy would respond. If the adverse reaction (eg thrombosis with thrombocytopenia syndrome) is a result of the vaccine, it is a product liability issue. Should you be included in a product liability issue, your MIPS membership includes assistance to facilitate that involvement, response and any applicable recourse. Practitioners need to follow ATAGI guidelines including the need to report any unexpected or adverse vaccine reactions to the TGA and then report to MIPS.
Does MIPS' cover still apply if I provide AstraZeneca to a patient under 50 years old?
Yes, MIPS' cover applies for any TGA approved vaccines including Pfizer and AstraZeneca. MIPS' policy responds in the event of an adverse reaction that is a result of an error or omission on your part administering the vaccine to any patient 18 years and older. See also “Am I liable if a patient has an adverse reaction”.
The AstraZeneca vaccine has been provisionally approved by the Therapeutic Goods Administration (TGA) for people 18 years and older. Practitioners should follow the latest advice from the Australian Technical Advisory Group on Immunisation (ATAGI).
On 23 April 2021, the Commonwealth Department of Health responded to the latest ATAGI advice and that the Pfizer vaccine be preferred for adults under the age of 50, however, it reaffirmed that COVID-19 Vaccine AstraZeneca can be used in adults aged under 50 years where the benefits are likely to outweigh the risks for that individual and the person has made an informed decision based on an understanding of the risks and benefits. In such cases, practitioners should carefully document such discussions.
Can I administer a Flu shot and a COVID vaccine?
The Department of Health (Federal) has advised that "people wait at least 14 days between a dose of seasonal flu vaccine and a dose of the COVID-19 vaccine. The 14-day time frame is a precautionary measure to manage the common side effects that come with many vaccinations." See more.
Am I covered if I work at a practice that is part of the Phase 1b rollout?
Yes, MIPS’ Indemnity Insurance Policy provides cover for any individual MIPS members who are in the Phase 1b rollout. You must have the appropriate training, qualifications and experience to administer the vaccine, as per any healthcare you provide, in order to be covered by the policy.
MIPS’ indemnity policy is issued to an individual thus your practice is not covered under this policy (see below for further information on Practice staff and protecting your Practice including practice entity insurance cover)
Are my practice staff covered for the work they do storing and assisting practitioners administering the vaccine?
MIPS can assist and defend you and your ‘practice staff’ within the terms of the policy for claims that allege you failed to follow proper process for the handling and storage of the vaccine. Cover for Practice staff is provided in clause 2.9 of your MIPS Indemnity Insurance Policy . “Practice Staff means a person employed directly or indirectly by You to the extent that they assist You to provide Healthcare to Your patients, but excludes any person who is, or is required to be, registered with AHPRA.”
If your staff are nurses, doctors or other registered healthcare providers who provide healthcare, they must have their own indemnity insurance, your MIPS membership will not cover them. Any practice staff member you employ who is or required to be registered with AHPRA is also required to have their own professional indemnity policy therefore are not included in or subject to the benefits of MIPS membership. Cover is subject to the standard terms, conditions and exclusions of the Indemnity Insurance Policy included in your MIPS membership.
If you own a Practice the Practice may be liable for inappropriate storage, handling and recall of patients. You may also wish to consider practice entity insurance cover to protect your practice and staff.
What happens if the patient does not return for the second dose, do I have to follow up?
Yes, you should have a robust follow-up plan in place for the patient. You should follow the Government guidelines about administration of second doses. In the first instance, MIPS advises members to make it clear that the vaccines currently available require 2 doses at advised intervals. You should establish agreed methods of communication with the patient and consider phone, SMS or postal follow-up for patients ideally varying the contact method if the patient is not responsive. You have a duty to take into account the specific patient, for example a person with a disability who is reliant on a carer may not be able to receive or read SMS or posted letters.
MIPS can assist and defend you for claims that allege you failed to follow proper process (eg follow-up) in the provision of healthcare, however, MIPS will be better able to defend you if you can provide comprehensive healthcare records including documented follow up.
If you own a practice the practice may be liable for inappropriate storage, handling and recall of patients. You may also wish to consider practice entity insurance cover to protect your practice and staff.
Does MIPS cover me and my practice staff, eg assistants and practice managers, if the vaccine is stored incorrectly?
MIPS can assist and defend you for claims that allege you failed to follow proper process for the handling and storage of the vaccine. You must ensure that you have appropriate policy, process and equipment such as a vaccine refrigerator that can reach the required temperature, in place before storing vaccines. MIPS will be better able to defend you if you can provide comprehensive healthcare records including the handling, storage and calibration of the equipment.
If you own a practice, it may be liable for inappropriate storage, handling and recall of patients. You may also wish to consider practice entity insurance cover to protect your practice and staff.
What happens if the vaccine I administered was unknowingly expired as it was not at the correct temperature?
If this is done unknowingly, then it may be covered under the policy. Ignorance is not an excuse and if you ought to have known, or any other suitably qualified professional in your position, ought to have known, then you may not be covered. You must ensure that you have appropriate policy, process and equipment such as a vaccine refrigerator that can reach the required temperature, in place before storing vaccines. Contemporary vaccine refrigerators document the temperature profile continuously in logs you can obtain as evidence of appropriate storage.
MIPS can assist and defend you for claims that allege you failed to follow proper process for the handling and storage of the vaccine, however, MIPS will be better able to defend you if you can provide comprehensive healthcare records including the handling, storage and calibration of the equipment.
What happens if the second dose is not available within the required window?
You should ensure you do everything reasonably practicable to provide the second dose including advising the patient to seek an alternate healthcare provider who may have available stock. If the patient is unable to receive the second dose and a complaint arises, provided you have taken reasonable steps to try to provide the second dose, MIPS’ policy would be able to provide coverage.
What happens if I administer the wrong vaccine or the second dose as the first dose?
If you have administered the wrong vaccine inadvertently, you should advise the patient and MIPS immediately. This accident occurs on rare occasions and in MIPS’ experience is unlikely to lead to serious harm but it is important to disclose the error to the patient and follow them up.
If you have administered the second dose as the first dose you should check the manufacturer’s latest guidelines to see if this changes or if the doses are different for the vaccine you are administering thus if it could lead to harm. If they are different and you have administered in the wrong order, you should advise the patient and MIPS immediately.
My practice has staff administering the vaccine. What happens if someone sues my practice for incorrectly administering the vaccine?
In many cases a civil action (being sued) may name individuals as well as a business. MIPS’ Indemnity Insurance Policy protects individuals and has cover for non-AHPRA registered practice staff such as practice managers, assistants and receptionists but not AHPRA registered staff such as nurses. Those staff that are AHPRA registered, should obtain their own independent indemnity insurance through a provider, such as MIPS.
You can obtain practice entity insurance to protect your business.
Does MIPS insure my clinic?
The MIPS indemnity policy includes cover for practice staff (eg practice managers, receptionists and assistants) errors and omissions, that are related to the member's provision of healthcare. Members should read the Member Handbook to ensure that the coverage provided meets their requirements. For more complex practice entity structures or where multiple practice staff may be involved, then members should consider a separate Practice entity insurance policy.
Does MIPS' indemnity policy cover telehealth?
Yes, MIPS Membership benefits (including insurance cover) extend to technology based health services subject to the following guidelines:
- You and the patient are located in Australia
- Your practice is in accordance with AHPRA's and specialist colleges' requirements, guidelines and advice. See Telehealth FAQs
- You hold current AHPRA healthcare practitioner registration
- You have appropriate training, experience and qualifications for the healthcare activities undertaken by you
- You have an appropriate MIPS membership classification for the healthcare activities undertaken by you
If you do not meet the above or have a query about telehealth and the services you provide, complete a Practice Assessment Questionnaire for individual assessment.
What are the temporary MBS telehealth items for COVID-19?
To limit the outbreak of Covid-19, new temporary MBS telehealth items have been introduced to ensure continued access to essential Medicare rebated consultation services. As of 30 March 2020, these items have become more general in nature. Updated details and lists can be found at MBS Online.
The numbers have been expanded to allow bulk-billed telehealth (phone or video) consultations by practitioners for ALL Australians where it is safe and clinically appropriate to do so. Effective 6 April, the Federal Government has changed the Australian COVID-19 telehealth legislation to allow for limited mixed-billing. From 20 April, specialists non GP providers are no longer required to bulk bill these new telehealth items. See ‘Can I apply my usual billing practices’ below. Criteria apply. For up to date details see the MBS online.
What are the restrictions to MBS telehealth items from 20 July 2020?
From 20 July 2020, MBS telehealth items were restricted to cases where there is an existing therapeutic relationship between a General Practitioner and a patient. This change applies everywhere in Australia, except Melbourne and the Mitchell Shire in Victoria, currently under stage three restriction orders. Consultations with infants under 12 months of age, or with people who are homeless, will be exempt.
A therapeutic relationship is defined as seeing the same GP or another GP at the same practice, in person, within the last 12 months prior to the date of the telehealth consultation.
These restrictions will apply to all temporary GP telehealth items introduced in March 2020 under the Government’s COVID-19 response measures. Restrictions to items for other specialists and allied health providers have not been confirmed at the time of this update.
Can I apply my usual billing practices?
Effective 6 April, the Federal Government has changed the Australian COVID-19 telehealth legislation to allow for limited mixed-billing. Telehealth services must be bulk billed for Commonwealth concession card holders, children under 16 years old, and patients who are more vulnerable to COVID-19. See the MBS Online. From 20 April, specialists non GP providers are no longer required to bulk bill these new telehealth items.
Otherwise members can apply their usual billing practices to the telehealth items for patients who do not meet these criteria. The usual requirement to obtain informed consent remains and, in particular, an informed financial consent. Members would be aware that a person who is at risk of COVID-19 virus means a person who:
is required to self-isolate or self-quarantine in accordance with guidance issued by the Australian Health Protection Principal Committee in relation to COVID-19; or
- is at least 70 years old; or
- if the person identifies as being of Aboriginal or Torres Strait Islander descent—is at least 50 years old; or
- is pregnant; or
- is the parent of a child aged under 12 months; or
- is being treated for a chronic health condition; or
- is immune compromised; or
- meets the current national triage protocol criteria for suspected COVID-19 infection.
What insurance cover do I need to treat COVID-19 public patients in private hospitals?
The Federal Government has announced that in conjunction with Commonwealth, State and Territory Health Ministers, private hospitals will support the COVID-19 response by providing hospital services and staff for public patients. For the most part the State and Territory governments would normally indemnify public patient healthcare. Members should check closely and be aware of the indemnity in place for the work to be undertaken.
If members are being asked to undertake different work (or sign a contract to undertake work) the following actions should be taken.
- Confirm that your contract of employment clearly defines whether your employer is providing you indemnity or not
- Ensure that your current MIPS membership classification accurately reflects the healthcare you provide, whether your indemnity is covered by the employer or not.
If you are not indemnified by the state, the hospital or another insurer, you need to declare to MIPS your non-employer indemnified (ie private) billings and/or salary for this work.
If a member is undertaking non employer indemnified work, MIPS does not differentiate between practice undertaken in a private setting and practice undertaken in a public setting. From MIPS's perspective there is, however, an assumption that members who provide services to public patients will do so with the same level of professionalism as if those patients were regular private patients. The responsibility for the provision of health services and period of ongoing care, monitoring, treatment and need for follow up remains with the practitioner/s that treat a patient unless appropriate transfer of care is undertaken.
Can I update my membership to change my membership fee?
You may be practising less or substantially changing your practice. This may change your risk profile and the applicable membership fee.
- If the type or level of your practice has been recently impacted complete the Membership Classification (Practice) Update form.
- If your type of practice has changed and you would like confirmation of coverage on the practices you are now undertaking refer to the Membership Benefits Handbook, FAQs or complete the Practice Assessment Questionnaire.
- If you will be ceasing all practice (temporarily or permanently) complete the Ceasing Practice in Australia form.
What if I have difficulty paying my MIPS membership?
We appreciate that some practitioners may be concerned about upcoming financial commitments. MIPS renewal documentation will be issued in May, one option available to members is to pay your membership fee by instalments at no additional cost. In the event you require assistance with your repayments, MIPS will consider any request for temporary financial hardship in a fair and appropriate manner. Complete a Financial Hardship Request form.
Mandatory mask laws
MIPS has received many requests for advice regarding the issuing of certificates exempting patients from wearing masks especially from Victorian GPs. This is an evolving area and advice will be added or modified as more information comes to light. However, MIPS thought it would be helpful to outline our current recommendations to members.
Where do mask laws apply in Australia?
Updated 11 Jan 2021
The use of face masks is not mandatory in the ACT. However, they are recommended if you:
- experience COVID-19 like symptoms (coughing, sneezing), and need to leave your home for an essential reason
- are in quarantine or isolation and need to leave your home for medical attention
Further information can be found here.
The use of face masks is mandatory in certain premises in Greater Sydney (including Wollongong, Central Coast and Blue Mountains) effective 03 Jan 2021. Face masks are mandatory in the following indoor settings:
- shopping (retail, supermarkets, and shopping centres)
- on public/shared transport and waiting areas for public/shared transport
- indoor entertainment (including cinemas and theatres)
- places of worship
- hair and beauty premises
- visiting an aged care facility.
Face masks are also mandatory for all staff in hospitality venues, gaming areas in licensed premises (including casinos) and for patrons using gaming services. Compliance became effective 04 Jan 2021 with $200 AUD on the spot fines for non-compliant individuals. Children under the age of 12 are exempt but are encouraged to wear masks where practicable. Further information can be found here.
The use of face masks is not mandatory and is at the discretion of individuals. You are encouraged to wear a face mask if you:
- have any symptoms and are seeking medical advice
- are going to get tested
- cannot maintain a physical distancing of 1.5 metres from others
- are a vulnerable person or feel uncomfortable and wish to wear a mask when in close contact with others or visiting crowded indoor areas. Further information can be found here.
The use of face masks is mandatory in the Greater Brisbane and impacted areas became effective on 06 Jan 2021, 6 pm, and has been extended until 22 Jan 2021, 1 am. Face masks must be used when leaving home unless you have a lawful reason not to. You must wear a face mask in indoor spaces, except in your home. For example in places such as:
- shopping centres, gyms, libraries, and supermarkets
- hospitals and aged care facilities
- workplaces where people cannot socially distance and where it is safe to wear a mask
- places of worship
- public transport (taxis and rideshare vehicles)
- airport terminals and during flights
- staff in hospitality venues (cafes, restaurants, pubs and clubs) must wear a facemask but not patrons.
You are not required to wear a mask when:
- at restaurants, clubs, pubs, cafes
- in your workplace, provided you can socially distance from your colleagues
- driving in private vehicles
- when doing strenuous exercise.
Further information can be found here.
The use of face masks is not mandatory, but it is recommended when out in public if you are unable to physically distance. Futher information can be found here.
The use of face masks is not mandatory. However, they are recommended for people:
- who are suspected or known to have the virus (if they need to leave home for medical care or testing)
- in close contact of someone suspected or known to have the virus
- who spend time in places where there is known and ongoing community transmission and is not possible to physically distance from other people.
Further information can be found here.
From 11.59 pm on 17 Jan 2021, rules and mandatory mask-wearing guidelines will be eased in Victoria.
Face masks must be worn:
- On all domestic flights
- At airports
- In hospitals
- On public transport
- In commercial passenger vehicles
- At supermarkets and other large indoor retail locations, including shopping centres
- At any other settings when unable to socially distance.
Further information can be found here.
The use of face masks is not mandatory in WA. They are recommended as an extra precaution in circumstances where community transmission may occur, such as:
- when physical distance is difficult to maintain (on a bus, train or shopping centre)
- for older people and people with existing medical conditions (heart disease, diabetes or respiratory illness)
Further information can be found here.
What details should be provided to the patient?
In all cases MIPS believe that the practitioner should carefully explain the medical rationale behind mandatory mask-wearing, especially detailing that masks may prevent the patient from transmitting COVID-19 to others whilst asymptomatic. This discussion should be comprehensibly documented in the patient’s medical records.
Where can I obtain further details about the DHHS recommendations?
Practitioners may wish to refer (and possibly direct their patients) to the DHHS website. Among other information, the website details the DHHS recommendations when a face covering is not required.
A face covering is not required in the following circumstances:
- Infants and children under the age of 12 years.
- A person who is affected by a relevant medical condition – including problems with their breathing, a serious skin condition on the face, a disability or a mental health condition. This also includes persons who are communicating with a person who is hearing impaired, where the ability to see the mouth is essential for communication.
- Persons for whom wearing a face covering would create a risk to that person’s health and safety related to their work, as determined through OH&S guidelines.
- Persons whose professions require clear enunciation or visibility of their mouth. This includes teaching or live broadcasting.
- Professional sportspeople when training or competing.
- When the individual is doing any exercise or physical activity where they are out of breath or puffing, examples include jogging or running but not walking. You must have a face covering on you and wear it when you finish exercising.
- When directed by police to remove the face covering to ascertain identity.
- The person is travelling in a vehicle by themselves or with other members of their household.
- When consuming food, drink, medication or when smoking or vaping.
- When asked to remove a face covering to ascertain identity, for example at a bank branch or bottle shop.
- When undergoing dental treatment or other medical care to the extent that the procedure requires that no face covering may be worn.
- During emergencies.
What is ‘a relevant medical condition’?
The severity of a relevant medical condition that is enough to provide a clinically appropriate exemption is open to interpretation. For instance, a MIPS clinician may not consider it appropriate to provide an exemption for an asthmatic patient who has not used a preventer for two years. Interestingly, recent media reports suggest that Lung Foundation Australia’s COVID-19 Expert Group has advised people with asthma or Chronic Obstructive Pulmonary Disease (COPD) to wear a face covering if at all possible. They suggest patients try wearing a mask at home, for increasing periods of time, to get used to the effects.
The medical literature acknowledges that for some patients with respiratory conditions, wearing a face mask may cause further difficulty in breathing and recommends choosing a mask type that is easy to breathe, depending on the respiratory condition (Kim, 2020). The DHHS acknowledges that whilst a mask with three layers is the ideal option, any face mask or covering is better than none. This includes a scarf, bandana or face shield.
Will MIPS support members who either decline or agree to provide a certificate of exemption?
MIPS advice is that members should encourage patients to comply with the mandatory mask laws wherever possible. Ultimately the decision whether to issue an exemption certificate is a clinical decision and MIPS would support our members in their considered judgement. Practitioners should be aware that any clinical decisions may ultimately be peer reviewed and should be justifiable. To this end it may be preferable to discuss any possible exemptions with the patient’s other providers or a colleague.
Is there a certificate template?
The RACGP has developed a letter template for GPs to use. The College encourages practitioners to use these templates sensibly, as with all medical certification. The document may be tailored to suit the needs of each individual practice and patients.
Elective surgery and dental procedures
Dental practices across all Australian states and Territories remain at Level 1 restrictions according to ADA Dental Restrictions.
Across all States and Territories, some elective surgery procedures are now available, including:
- screening programs (cancer and other diseases)
- post-cancer reconstruction (such as breast reconstruction)
- procedures for children aged under 18 years
- joint replacements, including knees, hips and shoulders
- cataracts and eye procedures
- endoscopy and colonoscopy procedures
Around 1 in 4 closed elective surgery lists are reopening as part of this first stage of a gradual restart. See Elective surgery on the Department of Health website.
Practice and employee FAQs
Does my practice need insurance in addition to my own insurance?
You may like to consider the option of acquiring a practice entity insurance policy to suit your practice's needs. Irrespective of COVID-19, this is an insurance cover that may be of benefit. Consider:
What should I do if I, or one of my staff, might have COVID-19?
You should check the most recent Government update. The Australian Health Protection Principal Committee (AHPPC) has recommendations for health and aged-care workers. You should not go to work if you have respiratory/influenza like illness or meet the criteria for self-isolation or quarantine. MIPS suggests you check current recommendations.
There are no AHPPC work restrictions on healthcare workers who are casual contacts of COVID-19 patients and are well, including those who have provided direct care for confirmed cases with adequate personal protective equipment. In this instance, healthcare workers are advised to self-monitor for symptoms and self-isolate if they become unwell until COVID-19 is excluded.
If my staff are self-isolating do I need to continue to pay them?
This a complex legal area and the answer may vary depending on any awards employees may fall under or their employment contact conditions. MIPS’ advice is the self-isolation in accordance with Department of Health advice should be considered sick-leave, however, if the employee is well then a work-from home arrangement can be put in place if viable. Compensation does not apply to contractors.
Do I have to pay my staff if I am forced to close my practice?
If you are forced to close your practice for valid reasons such as a COVID-19 infection/s, fire, flood, or breakdown of critical equipment, you can stand down employees who are unable to do useful work. You can only do this in certain circumstances. See Fairwork guidance. You do not need to pay an employee during a stand down. It may be better to consider offering employees the chance to take paid leave.
If I close my practice what do AHPRA require me to do?
In the code of conduct of the Medical Board at 3.15 and the Dental Board at 3.16 , it states when closing or relocating your practice, good medical practice involves giving advance notice where this is possible and facilitating arrangements for the continuing medical care of all your current patients, including the transfer or appropriate management of all patient records. You must follow the law governing health records in your jurisdiction. See also Retiring or ceasing your practice in Australia or the checklist in How to: Retiring from healthcare practice.
Program updates July 2020
What are the updates to the JobKeeper program announced on July 2020?
On 21 July 2020, the Australian Government announced the extension of JobKeeper payments until 28 March 2021. The initiative seeks to support businesses and not-for-profits who continue to be significantly affected by the outbreak of COVID-19.
The existing JobKeeper payment will remain in place until 27 September 2020.From 28 September 2020, payments will be targeted to businesses and not-for-profits that have been most significantly affected. In addition, the payment rates will decrease,and two tiers of payment will be introduced.
Further information about the operation of the JobKeeper Payment Program is available on the ATO website.
How do these updates affect my practice?
If your practice currently receives JobKeeper payments, it remains unchanged and payments are available until 27 September 2020.
From 28 September 2020, your business or not-for-profit will be required to reassess its eligibility for the JobKeeper extension with reference to their actual turnover, in order to continue receiving payments.
This JobKeeper extension will be available to qualifying businesses and not-for-profits from 28 September 2020 until 28 March 2021.
What are the conditions to receive the JobKeeper extension payments after 28 September 2020?
In order to receive the JobKeeper payments after 28 September 2020, your business or organisation must demonstrate:
- Decline in turnover – still 30% or greater (compared to 2019 equivalents).
- Decline needs to be re-assessed – actual decline in June 2020 and September 2020 quarters to get JobKeeper between 28 September 2020 –03 January 2021.
- Decline needs to be re-assessed again – actual decline in June 2020, September 2020 and December 2020 quarters to get JobKeeper between 04 January 2021 – 28 March 2021.
How much will I get with the JobKeeper extension payments after 28 September 2020?
28 September 2020 – 03 January 2021:
- $1,200 per “eligible employee” who worked at least 20 hours in February 2020.
- $750 per other “eligible employee”.
- Payments to be made per fortnight.
04 January 2021 – 28 March 2021:
- $1,000 per “eligible employee” who worked at least 20 hours in February 2020.
- $650 per other “eligible employee”.
- Payments to be made per fortnight.
What is Cash Flow Boost support?
The Temporary cash flow boost seeks to support small and medium businesses and not-for-profit organizations during the economic crisis due to the outbreak of COVID-19. The support is available for businesses and not-for-profit organisations who employ staff and will receive between $20,000 to $100,000 in cash flow boost amounts by lodging their activity statements up to the month or quarter of September 2020.
What are the conditions to be eligible for the Cash Flow Boost support?
Your practice must demonstrate:
- Turnover up to $50 million.
- Carrying-on a business.
- ABN on 12 March 2020.
- Payments to employees subject to withholding tax (even if nil).
What will my business receive with the Cash Flow Boost support?
- Minimum $10,000 (twice) = $20,000
- Maximum $50,000 (twice) = $100,000
- Tax-free payment.
- Credits/Refunds applied automatically via BAS process.
What additional national wide options of financial support are available?
Instant Asset Write Off
The Instant Asset Write Off was expanded in March to support businesses through the outbreak of COVID-19. From 12 March 2020 until 31 December 2020, this initiative provides immediate deduction per depreciating asset used for business under the following conditions:
- Threshold for each asset increased to $150,000 (up from $30,000).
- Eligibility has been expanded to cover businesses with an aggregated turnover of less than $500 million (up from $50 million).
Early Release Superannuation
Eligible citizens and permanent residents of Australia or New Zealand can apply to access up to $10,000 of their super in the 2020-21 financial year. To qualify, individuals must be unemployed, receiving certain Government income support payments and on or after 01 January 2020they must:
- have been made redundant.
- have their hours reduced by 20%.
- have experienced a business turnover reduced by 20% (sole trader).
Eligible individuals can access tax-free payments from superannuation of:
- $10,000 before 30 June 2020 (closed).
- $10,000 between 01 July 2020 and 24 September 2020.
You need to check the eligibility criteria before you apply for COVID-19 early release of superannuation and keep records that demonstrate your eligibility. Apply to the ATO via the myGov website.
What State specific support initiatives are available?
The following initiatives are administered by each States. Refer to your relevant State website for details.
Payroll Tax Relief
Businesses with annual Victorian taxable wages up to $3 million are eligible to receive the Payroll tax relief for the 2019-20 financial year waived.Eligible businesses can claim an emergency tax relief refund of payroll tax already paid in the 2019-20 financial year via PTX Express.
Land Tax Relief
- Must be impacted by COVID-19 and may receive:
- Payment deferral
- Rebate / Refund
- Must pass on relief to tenant (via rent reduction).
- Refer relevant State website for details.
- Must be impacted by COVID-19 and may receive:
State Grants in NSW
- Small Business Grant to safely reopen and upscale (e.g., fit-outs, staff training, etc.).
- $500 - $3,000 in payments.
- Highly impacted industries.
- Open until 16 August 2020.
State Grants in QLD
- Small Businesses COVID-19 Adaption Grant.
- $2,000 -$10,000 in payments.
- Fully subscribed (capped).
What additional support initiatives are available through the Banking industry?
Relief available to Businesses and Households may help you to defer loan payments under the following conditions:
- Originally for six months (automatic).
- Extended by four months (not automatic).
- Interest will continue to accrue.
- Government backed lending.
MIPS encourages you to speak to your current banking contact to implement available measures for your individual circumstances.
What is the JobKeeper Payment?
JobKeeper is a wage subsidy payment provided by the government to help employers retain employees during COVID-19.
The JobKeeper Payment is $1,500 per fortnight (before tax) for each eligible employee to subsidise the eligible employee’s wages.
The JobKeeper Payment is only available from 30 March 2020 to 27 September 2020 to eligible employers who have elected to participate in the scheme.
As an employer am I eligible to receive the JobKeeper Payment?
Australian healthcare practices, including companies, partnerships, trusts and sole traders, not-for-profit entities and charities, are eligible if they meet the following criteria:
- have business turnover of less than $1 billion (for income tax purposes) which has been reduced, or is likely to be reduced by more than 30% (of at least a month) compared to a period a year; or
- have business turnover of $1 billion or more (for income tax purposes) which has been reduced or is likely to be reduced by more than 50% (of at least one month) compared to a period a year.
If you are an eligible healthcare practice and you have stood down employees after 1 March 2020, you can claim the JobKeeper Payment for those employees, if they are eligible employees. To be eligible to receive the payment for these employees, you will need to pay them a minimum of $1,500 per fortnight (before tax) for the JobKeeper Payment periods.
Eligible healthcare practices must register online with the ATO for the JobKeeper Payment on behalf of their eligible and nominated employees (including themselves) and provide monthly updates to the ATO.
As an employee am I eligible to receive the JobKeeper Payment?
If you are employed by an eligible healthcare practice, you will be considered as an eligible employee if you:
- were employed by your employer at 1 March 2020
- are currently employed by the employer (including if you are stood down or re-hired)
- are full-time or part-time (including fixed term), long-term casual (a casual employed on a regular and systemic basis for longer than 12 months as at 1 March 2020 and not a permanent employee of any other employer) or a sole trader
- are at least 18 years of age on 1 March 2020
- are 16 or 17 years of age on 1 March 2020 and are independent or not undertaking full time study;
- are an Australian citizen, the holder of a permanent visa, a protected special category visa, a non-protected special category visa who has been residing continually in Australia for 10 years or more, or a special category (subclass 444) visa holder
- were an Australian resident for tax purposes on 1 March 2020
- are not receiving government paid parental leave, ‘dad and partner pay’, or payment under workers’ compensation law for total incapacity to work, and
- are not receiving the JobKeeper Payment from another employer.
For more information see the JobKeeper Payment advice for employees
I am an employer who receives JobKeeper Payments for my employees. When do I have to pay my employees?
You must pay the minimum $1,500 per fortnight (before tax) to each eligible employee to claim the JobKeeper payment for that fortnight.
You should pay your employees for each JobKeeper fortnight for which you plan to claim the payment. The first fortnight was from 30 March 2020 to 12 April 2020 and each JobKeeper fortnight follows after that.
I am an employer who is receiving the JobKeeper Payment for my employees. I want my employees to perform other duties and/or work from a different location. Can I do this?
On 9 April 2020, temporary changes were made to the Fair Work Act 2009 (Cth) (Act) which apply to employers receiving the JobKeeper Payment for their eligible employees. The temporary changes remain in place until 28 September 2020.
The temporary changes to the Act provide increased flexibility for employers to give directions to employees who are receiving the JobKeeper Payment, including for stand down, changes to duties and location of work, changes to days or times that work is performed and/or the taking of annual leave by the employee, including at half pay.
Yes, you are able to direct your employees who are receiving the JobKeeper Payment to perform other duties and/or to work at a different location– provided that you consult with your employee prior to giving the direction, and provided that you give them at least three days written notice of your intention to give the direction. A shorter notice period may apply if your employee genuinely agrees to a shorter notice period.
If you direct your employee to perform other duties, the duties must be reasonable and within the scope of healthcare practice operations, and within the employee’s scope of practice, skill and competency.The employee must also have any relevant licence or qualification required to perform the duties.
If you ask your employee to work from a different location, including the employee’s home, you need to ensure that alternate location is suitable for the employee’s duties. The direction must not require the employee to travel an unreasonable distance.
I am an employee who is receiving the JobKeeper Payment and my employer has notified me that my hours will be reduced. Are they allowed to reduce my hours?
The temporary changes to the Act noted above allow your employer to direct you:
- not to work on a day you would usually work,
- to work for a lesser period on a day, or
- to work a reduced number of hours overall (which can be nil).
Your employer can only give you the direction if you cannot be usefully employed for your normal days or hours because of changes to the healthcare practice that are linked to COVID-19 or linked to government initiatives introduced to deal with COVID-19 pandemic.
Your employer must consult with you prior to the direction taking effect and provide you with at least three days written notice of their intention to give the direction. A short notice period may apply if you genuinely agree to a shorter notice period.
I am an employer who is receiving the JobKeeper Payment for my employees. I have reduced my employees’ hours. How much do I have to pay them?
This question will differ for each individual employee and it is recommended that you seek independent advice in relation to individual circumstances.
However, as a general rule:
- You must comply with the JobKeeper Payment rules and pay the minimum $1,500 per fortnight (before tax) to each eligible employee, even if your employee currently earns less than $1,500 per fortnight (before tax).
- If your employee is currently earning above $1,500 per fortnight (before tax) even with the reduced hours, you must top up the difference so that your employee receives their full entitled amount for all hours worked.
- You must not vary your employee’s hourly rate of pay in accordance with any relevant contract of employment, Modern Award or Enterprise agreement.
I am an employer who is receiving the JobKeeper Payment for my employees. Do I have to pay superannuation on the whole JobKeeper Payment amount?
If your employee is paid more than $1,500 per fortnight, your superannuation obligations will not change.
If you are topping up your employee’s wages to $1,500 per fortnight by the JobKeeper Payment, it will be up to you if you want to pay superannuation on any additional wages paid by the JobKeeper Payment.
Can I refuse to see patients with respiratory conditions?
Yes, you can refuse to treat a patient, except in an emergency or within your Emergency Department practice The AHPRA code of conduct advises that a “patient should not be denied care, if reasonable steps can be taken to keep you and your staff safe.” It is MIPS advice that if a patient cannot be seen then they should at least be provided with advice as to how to seek alternative help Lack of appropriate PPE may be a reason for not treating a patient in the current climate. If you cannot adequately protect yourself or you know you are vulnerable, then MIPS recommends you refer the patient to a more appropriate environment where they can be examined safely.
Members can choose to end a doctor-patient relationship, for example where the patient is aggressive, has been forging certificates or consistently fails to follow medical advice. Appropriate measure should be put in place to ensure continuity of care.
Can I give a COVID-19 patient a medical certificate to return to work?
If the patient has returned a negative test, or is not exhibiting any symptoms and or has appropriately self-isolated in accordance with Department of Health advice if necessary then a carefully worded letter of support can be issued stating that the patient has told you this is the case.
What do I do if a patient demands testing or refuses to be tested?
Patients can’t demand that doctors undertake testing. This is a clinical decision based on the circumstances of each patient and the guidelines for testing and available resources at the time.
If you have first-hand knowledge of patients refusing to be tested, isolate or lying about travel, you should contact your state or territory Department of Health and document accordingly. Various State and Territory penalties are now in place for the offending individuals and companies.
Can I prescribe Hydroxychloroquine due to COVID-19?
This drug may be effective against COVID-19 (still unproven) and to avoid shortages the federal Department of Health have restricted the medical practitioners who are authorised to prescribe it.
Only AHPRA recognised specialists in dermatology, intensive care medicine, paediatrics, child health, emergency medicine or a physician may prescribe Hydroxychloroquine to new patients as part of an initial treatment plan. Following this, patients can then attend upon their general practitioners for ongoing prescription of Hydroxychloroquine or medicines containing the substance.
Returning to practise
If I return to practise during the COVID-19 pandemic, what indemnity insurance do I need?
AHPRA requires a professional indemnity insurance arrangement for all practitioners including those returning through the Pandemic Response Sub Register. If you are returning to the public sector, your employer will most likely cover you. Have this confirmed in writing. If you are returning to private practice, you will need to arrange your own cover which you can with MIPS. Both scenarios require a change of your MIPS membership to a practising classification. Please advise us by completing a Return to Practise form. Further details about the Sub Register from AHPRA.
Do I lose my run-off cover if I return to practise?
AHPRA clearly state “The Commonwealth Government has confirmed that if you were covered by the Commonwealth Run-off Cover Scheme (ROCS) and you return to the workforce to support healthcare initiatives for COVID-19, you will continue to be covered by ROCS for claims that may arise in relation to your prior medical practice before you retired. You will still need to ensure you are insured for medical services you provide once you return to practise.” In such circumstances, should you return to practise, your ROCS cover for past practice through MIPS remains unchanged.
The Department of Health states: "The Amending Regulations amend the Medical Indemnity Regulations 2003 by inserting a temporary exemption that applies to any practitioner who is eligible for the ROCS and who returns to private practice. This temporary exemption allows retired doctors to return to private practice in order to provide treatment during the COVID-19 pandemic without the practitioner losing their eligibility under the ROCS. The exemption operates on the basis that these practitioners have the requisite registration to practice, and only applies on a temporary basis for the duration of the declaration of the Human Biosecurity Emergency Declaration and a grace period of one further month."
I want to return to work and do more than COVID-19 related work?
Your circumstances will need to individually assessed by MIPS. Please complete the Practice Assessment Questionnaire.
I'm a medical student performing a role to assist with COVID-19, what insurance do I need?
MIPS' free student membership classification is appropriate if you are performing a role to assist with COVID-19:
- Where the role is employer indemnified (ie the hospital agrees to provide cover)
- irrespective of whether the role is volunteer or paid
As with all membership you must have appropriate training and experience for the healthcare services you provide including appropriate supervision (a registered healthcare practitioner). If you are undertaking a role that doesn't meet these guidelines, refer to placements for further information or complete a Student Placements, Healthcare Activities form for assessment.
Does my MIPS membership cover teledentistry?
Yes, teledentistry is another form of telehealth. See our telehealth FAQs.
In its 6.28 Teledentistry Position Statement, the ADA supported the further development of teledentistry and teleradiology services and recommended these should be monitored and assessed as they are put into effect in Australia. A summary of the main recommendations for its implementation is given below.
There is no explicit statement from the Dental Board or ADA that limits or prohibits any particular aspect of the teledentistry in response to the outbreak of COVID-19. Before deciding to carry out a procedure in person, eg after a teledentistry diagnostic evaluation, members should give full consideration to the current requirements of the Australian Government , regulators and your associated professional association, taking full account of the level 2 restrictions outlined in the ADA guidelines.