Rural Retention Program

Rural Retention Program
and the Flexible Payment System

Background
The Rural Retention Program is a Commonwealth initiative which provides GPs with financial incentives to continue working in rural and remote areas.  

Most retention payments are made through a Central Payments System (CPS) administered by Medicare Australia.  These payments are made automatically on the basis of Medicare activity.  While this system works for doctors working in fee for service practices it does not cater for those providing primary health care outside Medicare or those working in Aboriginal health services who do not generate sufficient Medicare activity either to qualify under the CPS or to generate their full entitlement. 

The Flexible Payments System (FPS) was introduced to assist doctors who meet the broad requirements for the program in terms of years of service and the locations in which they have been practicing but who are not covered under the CPS.  However doctors must apply for payment under this system, which is administered by state and territory-based Rural Workforce Agencies; in the NT it is administered by GPNNT.

How Retention Payments Work (CPS & FPS)
A doctor becomes eligible for a retention payment after a qualifying period of “continuous” service in an eligible location or locations, based on the required number of active quarters for that location, and is then eligible for subsequent payments every four active quarters. The quarters are the three month periods ending 31 March, 30 June, 30 September and 31 December. 

Certain forms of leave can be included in a period of continuous service. See “Eligible Leave” below.

Eligible locations are divided into five Retention Payment Categories ranging from A to E, with E representing the most remote locations.  Doctors qualify for their first payment after different qualifying periods depending on the Retention Payment Category as follows:

 To qualify for an initial payment the doctor must be “active” for at least four in the last six quarters (of their overall qualifying period). To be eligible for a subsequent payment the doctor must be active for at least four in the last eight quarters.

Maximum payments for each Category are as follows:
Category A:  $5,000
Category B:  $10,000
Category C:  $15,000
Category D:  $20,000
Category E:  $25,000

Where doctors provide services in different location categories, a pro-rata payment applies. Pro-rata payments also apply for part-time work.

What is my rural rention category?

GPARIA is the index used for the Rural Retention Program, not RRMA. If you would like to know your location category, click on the link

www.healthworkforce.com.au/main_GPARIA_search.asp 

Flexible Payments System
The FPS provides for doctors in several broad categories affected by the limitations to the CPS:
• those who provide primary health care services through forms of employment not accessing Medicare
• those not generating sufficient Medicare activity to qualify for a CPS payment 
• those in very isolated communities who have received a part-payment under the CPS which, as a result of low Medicare billing  rates, does not reflect their relevant workload.  These “Top-up” payments are available only to doctors in Categories D and E or  those providing services predominantly to indigenous people.
• those who would have received a CPS payment but for a period of acceptable leave that has caused them to lose accrued Medicare activity.

Doctors must apply through their Rural Workforce Agency (GPNNT for the NT) and evidence of employment must be provided by the GP’s employer or employers. 

Under the FPS, an active quarter is one where the doctor has provided, on average, at least two sessions per week of eligible services.  (A session is at least 3 hours.)  A doctor will qualify for the maximum payment if working an average of 8 sessions per week.  (Under the Rural Retention Program, 8 or more sessions a week is considered full-time; there is no advantage, as far as retention payments are concerned, to working more sessions.)
Where doctors provide services in different location categories, a pro-rata assessment must be made, using the same relative weightings as apply under the CPS.

Eligible Leave
Annual leave of 4-6 weeks can be included in a period of continuous service.  Doctors in remote communities (Categories D and E) are entitled to cluster their leave and take up to 4 months’ leave at the end of their contract without affecting their entitlement.

Other forms of eligible leave, eg illness, maternity leave, upskilling, do not count as active service but do not cancel out the time already accrued; ie eligible leave will delay eligibility for a payment but will not disqualify the doctor, the count of active quarters continuing after the doctor returns to work.  If the period of leave exceeds the maximum the doctor must re-qualify.

FPS Application Process
An application form can be downloaded from here http://www.health.gov.au/internet/main/publishing.nsf/Content/work-pr-rrp-flex-appl or obtained by contacting Dr Jim Thurley, GPNNT Medical Advisor on (08) 8950 4880 or at jim.thurley@gpnnt.org.au

Signed and completed forms, with supporting letter from employer, should be returned to Dr Jim Thurley by post to PO Box 1195 Alice Springs, NT 0871 or by fax on (08) 8952 3536.

On receipt of a completed application form, GPNNT will request the doctor’s Medicare data from Medicare Australia.  It can take from a few days to a few weeks to get the data depending on Medicare Australia’s backlog.
GPNNT will then calculate the payment due, request Medicare to make the payment and inform the doctor of the amount requested.  Medicare will require bank details for direct deposit of payment.

For more information on the Rural Retention Program, follow the link to the Australian Government's Department of Health and Ageing website http://www.health.gov.au/internet/main/publishing.nsf/Content/work-pr-rrp or contact Dr Jim Thurley on (08) 8950 4880 or at jim.thurley@gpnnt.org.au
 

GPARIA is the index used for the Rural Retention Program, not RRMA.  IF you would like to know what your location Category is click on the link below.

Central Payments System
Eligibility for CPS payments is calculated on the schedule fee value of Medicare claims processed  for the doctor’s services in eligible locations.  If the value of claims over the relevant 4 active quarters is $80,000 or more the doctor is entitled to the maximum annual payment; if less than $80,000 the doctor is entitled to a pro-rata payment.  Under the CPS an active quarter is defined as one where the schedule fee value is $4,000 or more.
Payments are made direct to the doctor by Medicare Australia.

 http://www.healthworkforce.com.au/main_GPARIA_search.asp