Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025; Second Reading

Senator Ananda-Rajah welcomed the bipartisan support for the bill, noting it addresses Medicare fraud identified in the Philip review. Ananda-Rajah argued that the government had reversed the decline in bulk-billing rates through targeted incentives, resulting in a 2.1 per cent uplift and significant gains in regional areas. Ananda-Rajah highlighted the government's investment of $8.12 billion in Medicare and the reduction of PBS script costs to $25 from January 2026. Ananda-Rajah also discussed measures to support women's health, including cheaper menopause medications and expanded endometriosis clinics, asserting that these policies would improve access and affordability.

Senator Steele-John supported the bill but raised concerns from the Senate inquiry about ensuring compliance powers do not create barriers for legitimate providers. Steele-John emphasised the need for education and support for practitioners rather than solely punitive enforcement, noting that much leakage stems from simple mistakes. Steele-John moved a second reading amendment urging the government to provide complete funding for and put into effect a Seniors Dental Benefits Scheme, citing recommendations from the Royal Commission into Aged Care Quality and Safety. Steele-John argued that older Australians face significant barriers to dental care, with 55 per cent delaying treatment due to cost, and highlighted the negative health impacts of untreated dental issues.

Senator Colbeck affirmed the Coalition's support for the bill to strengthen Medicare integrity, referencing the Philip review and Senate inquiry recommendations. Colbeck contested the government's narrative on Medicare performance, claiming bulk-billing rates rose consistently under the Coalition to a record 88 per cent before declining under Labor. Colbeck argued that the government's promises on Medicare affordability were false, citing data that a quarter of GP clinics would not bulk-bill despite election claims. Colbeck also criticised the government for cutting mental health services from 20 to 10 sessions and failing to manage the budget effectively, contrasting this with the Coalition's record of increasing Medicare funding and PBS listings.

Senator Cox congratulated the government on introducing the bill to protect Medicare integrity and strengthen compliance frameworks. Cox highlighted measures such as shortening the period for claims from two years to one year and enhancing investigative powers to combat fraud. Cox discussed the government's investment in urgent care clinics and public hospitals, noting an additional $1.8 billion for health services in the coming year. Cox shared personal anecdotes about the importance of Medicare for families and emphasised the government's commitment to making medicines more affordable through PBS cost reductions.

Senator McGrath supported the bill for its role in strengthening Medicare compliance and integrity, aligning with the Philip review's findings. McGrath argued that the government had failed to deliver on affordability promises, citing a fall in bulk-billing rates and record-high out-of-pocket costs. McGrath claimed that the Prime Minister's election campaign rhetoric was misleading, as departmental data indicated many clinics would not bulk-bill. McGrath also criticised the government for cutting mental health sessions in half and abolishing the National Mental Health Commission, contrasting this with the Coalition's record of increasing Medicare funding and PBS listings.

Senator Whiteaker emphasised the government's commitment to protecting Medicare from fraud and inefficiencies, citing the Philip review's findings on annual losses. Whiteaker highlighted the expansion of Medicare urgent care clinics and the largest GP training program in Australia's history. Whiteaker discussed the bill's measures to streamline pharmacy approvals and address medicine shortages by allowing the importation of substitutable products. Whiteaker also noted the government's investment in public hospitals and the reduction of PBS script costs to $25, arguing these steps would improve access and affordability for all Australians.

Senator Kovacic supported the bill for strengthening Medicare integrity but criticised the government's record on healthcare affordability. Kovacic argued that bulk-billing rates had dropped from 88 per cent to 77 per cent, resulting in 40 million fewer bulk-billed visits. Kovacic claimed that out-of-pocket costs had reached record highs, forcing families to prioritise which members could see a doctor. Kovacic contended that the Prime Minister's election promises were disingenuous, as departmental data suggested many clinics would not bulk-bill, and highlighted the impact of these costs on families during the cost-of-living crisis.

Polley argued that the bill protects Medicare integrity by cracking down on fraud and streamlining processes for healthcare providers. Polley highlighted the success of urgent care clinics in Tasmania, noting that over 33,000 northern Tasmanians had visited the Launceston clinic, which extended its hours due to high demand. Polley also emphasised the financial relief provided by allowing two months of medication on one prescription, saving an estimated $1.5 billion over four years, and criticised the previous coalition government for neglecting the health system.

Dowling supported the bill as a measure to ensure taxpayer funds are spent on patient care rather than lost to misuse. Dowling cited the government's investment of $812 billion in Medicare and the opening of 87 urgent care clinics, which have served more than 1.5 million patients. Dowling noted that bulk-billing rates are rising, with a target of nine out of 10 GP visits being bulk-billed by 2030, and praised the expansion of GP training programs to address workforce shortages.

O'Neill described the bill as a necessary step to close loopholes and strengthen investigative powers against fraudsters who abuse the system. O'Neill referenced the establishment of the Medicare Integrity Taskforce following the Philip review and noted the positive impact of 61 new mental health centres in regional New South Wales. O'Neill also highlighted the success of urgent care clinics in her electorate, stating that nearly 19,000 residents in the Robertson area had accessed care through the Umina clinic.

Smith argued that the bill is essential for maintaining the financial stability and integrity of Medicare by detecting and preventing fraud. Smith explained that the legislation cuts the period for Medicare claims from two years to one and aligns compliance powers across various health acts. Smith emphasised that these changes target a small minority of providers who do not abide by rules, thereby protecting the system for the vast majority of honest healthcare professionals.