May 2025 – Services Australia MyMedicare and GPACI updates

1. GPACI Q4 Service and Payment requirements:

The General Practice in Aged Care Incentive (GPACI) Quarter 4 (Q4) payment requirements are different to the requirements for Q1, Q2 and Q3.

Patients who had the GPACI added to their MyMedicare profile in the July-September 2024 quarter are now in Q4 of their 12-month care period.

Practices and providers must familiarise themselves with the below requirements, to ensure they meet Q4 eligibility.

Requirements:

• Patients who had GPACI added to their MyMedicare profile between July–September 2024 quarter are now in Q4 of their 12-month care period.
• To receive Incentive payments for GPACI patients in Q4, practices and providers must deliver the GPACI quarterly servicing requirements AND the GPACI annual servicing requirements.
• This is dependent on when the patient had GPACI added to their MyMedicare profile; not when the practice registered for GPACI or when the practice linked the provider to the patient as the Responsible Provider.
• It is the responsibility of the practice and the Responsible Provider to make sure they track which quarter each individual patient is in, and that all servicing requirements are met.
• It is recommended that practices and providers run an Eligibility Forecast in HPOS, particularly for patients in Q4. This will identify any servicing requirements that have not been met.

Quarterly servicing requirements (for all quarters, including Q4):

Each quarter:

1. Provide at least 2 regular services in different calendar months.
2. At least 1 of these must be delivered by the Responsible Provider.

Annual servicing requirements:

In each 12-month annual care period:

• 2 care planning services must be delivered by the Responsible Provider.
• 8 regular services must be delivered. For the annual assessment, these services do not have to be delivered:
  • in separate months or quarters.
  • by the Responsible Provider. They need to be delivered by an eligible provider linked to the same practice as the patient receiving the services.

Failure to meet the annual servicing requirements:

If the Responsible Provider does not deliver the 2 care planning services by the end of the 12-month care period:

• the practice and the Responsible Provider will not get the Q4 payment.
• the Responsible Provider must deliver at least 1 care planning service in Q1 of the following 12-month care period.

If the requirements are not met, the practice and provider will be ineligible for the Incentive payments for that patient for the remainder of the patient’s new 12-month care period.

HPOS sends notifications to the practice and Responsible Provider:

• if they did not meet the annual servicing requirements for a patient by the end of Q4, to notify them of the requirements to maintain eligibility.
• if they fail to meet this requirement in Q1 of the following 12-month care period, to notify them that the practice and Responsible Provider are not eligible for assessment for that patient for the remainder of the patient’s new 12-month care period.

Additional information regarding servicing requirements, including for Q4, can be found in the GPACI program guidelines here, www.health.gov.au/resources/publications/general-practice-in-aged-care-incentive-program-guidelines-2024.

2. MyMedicare Accreditation Details

• Practices must keep their Accreditation Details up to date in the MyMedicare system.

Information for practices on how to update these details is available at slide 9 of the following HPE resource: hpe.servicesaustralia.gov.au/MODULES/ORGREG/ORGREGM03/index.

• Practices may reach out to Services Australia or their PHN for additional assistance, if required.

Patient Registration – Consent and Record Keeping Requirements 

• Patients aged 14 and over must give their own consent.
• For patients under 14, consent must come from a parent or guardian.
• If a patient cannot provide consent:
  • A responsible person (e.g. parent, guardian, POA, next of kin) must sign the form.
• Practices must:
  • Use the official MyMedicare Registration Form.
  • Keep a signed copy for compliance.
  • Ensure all information is accurate and truthful.

Only the authorised MyMedicare Registration form available online at the Department’s website can be used to register a patient in MyMedicare. This form is available at www.health.gov.au/resources/publications/mymedicare-registration-form.

4. Services Australia – Feedback on Health Professional Education (HPE) Resources

• Services Australia is reviewing the suite of MyMedicare Health Professional Education (HPE) resources  and they’d like your feedback.
• HPE resources are available to help practices and providers understand Services Australia’s programs and services. Information and step-by-step guides are available on a variety of health programs and systems.
• Please provide any feedback by email (practicesupport@cesphn.com.au) by Friday, 30 May 2025.

Feedback can include:

• Is the site easy to navigate?
• Is the content accurate and complete?
• Are there missing steps or unclear areas?
• What would make the site more useful for your practice?

For support on MyMedicare or the General Practice Aged Care Incentive (GPACI), please contact CESPHNs Practice Support Team at practicesupport@cesphn.com.au