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

High-Level Summary
The Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025 aims to enhance the integrity and sustainability of Australia's health benefits schemes, such as Medicare, by implementing measures to reduce fraud, streamline pharmacy approvals, and regulate therapeutic and tobacco goods.

Summary
The bill affects several pieces of legislation, including the Health Insurance Act 1973, National Health Act 1953, Human Services (Medicare) Act 1973, and others, to implement public health measures primarily focused on protecting Medicare's integrity. Key measures include reducing the timeframe for making Medicare claims for bulk-billed services from 2 years to 1 year, updating investigative powers for broader and consistent use across health benefits schemes, and simplifying pharmacy approval processes. It also amends the Therapeutic Goods Act 1989 to manage therapeutic goods shortages and improve compliance activities and the Public Health (Tobacco and Other Products) Act 2023 to align with international best practices in tobacco regulation. From the explanatory memo:
The amendments are necessary to protect the integrity of, and support the ongoing sustainability of, Australia’s health benefits schemes – the Medicare Benefits Schedule (MBS), the Pharmaceutical Benefits Scheme (PBS), and the Child Dental Benefits Schedule (CDBS).

Argument For
Normative Bases
  1. Utilitarian Ground Truth
  2. Pro-Democracy
  3. Non-Discrimination

The bill should be supported because it aims to secure the future of Australia's health benefits schemes by addressing fraud and inefficiencies, thereby ensuring that public funds are used effectively to provide healthcare to those in need. By reducing incorrect payments and improving investigative capabilities, the bill promotes the fair distribution of healthcare resources and upholds the principles of equality and social equity [Judgment]. Additionally, the alignment of therapeutic goods regulation with international standards helps protect public health from unsafe products, further maximizing societal well-being.


Argument Against
Normative Bases
  1. Value-Neutral / Epistemic Objection

While the goal of protecting Medicare's integrity is commendable, the bill may impose unnecessary administrative burdens on healthcare providers, potentially leading to decreased service availability and increased operational costs [Judgment]. The reduction in the timeframe for Medicare claims may disproportionately affect vulnerable populations who face barriers in accessing timely healthcare services. Furthermore, the expanded investigative powers could lead to privacy concerns and may not adequately safeguard against misuse, potentially eroding trust between healthcare providers and the government.


Date:

2025-07-23

Chamber:

Senate

Status:

Before House of Representatives

Sponsor:

Unspecified

Portfolio:

Health, Disability and Ageing

Categories:

Healthcare, Criminal Law Reform, Consumer Protection

Timeline:
29/07/2025
29/07/2025

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