✔ COVID-19 resources

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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

Telehealth

Commencing 13 March 2020 and extending until, 30 June 2021 temporary MBS telehealth items have been made available to help reduce the risk of community transmission of COVID-19 and provide protection for patients and health care providers.

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.

FAQs

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.

General

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.

Sole practitioner entity 2021/22 MIPS Indemnity Policy (section 22 Sole practitioner entity)

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?

Commencing 13 March 2020 and extending until 30 June 2021, temporary MBS telehealth items have been made available to help reduce the risk of community transmission of COVID-19 and provide protection for patients and health care providers. Updated details and lists can be found at MBS Online.

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.

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 22 June 2021

ACT

Further information can be found here.

NSW

The use of face masks is mandatory in certain settings. Further information can be found here.

NT

Further information can be found here.

QLD

Further information can be found here.

SA

Futher information can be found here.

TAS

Further information can be found here.

VIC

Further information can be found here.

WA

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.

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

The Victorian Government has announced easing of restrictions from 11.59pm Thursday 10 June 2021. This means that dental practices in metropolitan Melbourne will be able to return to Level 1 dental restrictions after that time, bringing them in line with dental practices in regional Victoria.

Elective surgery

All categories of elective surgery recommenced in metropolitan Melbourne from Tuesday 15 June 2021.

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:

Sole practitioner entity 2021/22 MIPS Indemnity Policy (22. Sole practitioner entity, page 27)

22.1 We will cover You and any company or business You own and operate for the purpose of providing Healthcare where You are the sole healthcare practitioner and an owner, including when You are temporarily replaced for sick or recreational leave by a locum/temporary healthcare professional or employ a nurse or Administrative Staff or Assistant to assist You, but only where the company or business is:

a.    wholly owned by You; or

b.    owned by a trust for which You are the sole beneficiary; or

c.    jointly owned with Your spouse who does not provide Healthcare through the business; or

d.    jointly owned with a business partner who does not provide Healthcare through the business nor is involved in the daily operation of the practice;

What should I do if I, or one of my staff, might have COVID-19?

Some business operations are restricted under state or territory government public health directions. If you want to know what restrictions on business operations apply to your workplace, go to your state or territory government website. Additional information can be found here.

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.

Financial wellbeing

Monthly business declarations for JobKeeper Fortnights in March needed to be completed by 14 April 2021 to receive final JobKeeper payments. The JobKeeper Payment scheme finished on 28 March 2021. For more information visit JobKeeper Payment.

Information about payments and services, including the Pandemic Leave Disaster Payment can be found here.

Patient FAQs

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.

Student

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.

Can I provide COVID-19 vaccine while I am a medical student?

Students can only administer vaccines if authorised to do so under state and territory legislation (for example the public health emergency order issued in Victoria). 

Cover applies where you are an authorised student administering the vaccine and:

  • your role is either:
    • employer indemnified (eg hospital)
    • part of your clinical placements for your course arranged through your university and appropriate indemnity cover is in place
  • you have appropriate training and experience
  • you are appropriately supervised by a medical practitioner.
  • with the terms and conditions of the Indemnity Insurance Policy

It is an AHPRA requirement that students:

  • are appropriately qualified and trained to administer COVID-19 vaccines if authorised, and
  • provide accurate information and advice about COVID-19 vaccination including in social media and advertising.

Victorian students refer to the Factsheet: Join the Victorian COVID-19 vaccination program workforce - Information for medical students - June 2021 from the Victorian Department of Health website or the Public Health Emergency Order (PHEO). 

Which students are authorised under the Victorian public health emergency order?

In Victoria, medical tertiary students registered with AHPRA are authorised to undertake vaccination activities for COVID-19, provided they have successfully completed all units of study from the third year of a Bachelor’s program or the first year of study of a post-graduate program or Master’s program leading to provisional registration with AHPRA as a medical intern. Dental and nuclear medicine students are not authorised. See the Public Health Emergency Order (PHEO). 

Dental

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.


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