Current and future policy
Importantly, GPs should be aware that the Ministry’s enrolment policy is regularly evolving, with input from DHBs, PHOs and providers. While it would be expected that a GP’s PHO would communicate changes in enrolment policy to them, it is nevertheless the GP’s responsibility to ensure they are aware of the current enrolment requirements and that their practice is compliant.
GPs will be aware there was a moratorium (previously set out in Appendix 4 to the Audit Protocol) that applied to all audits conducted between 12 March 2010 and 28 February 2011. The purpose of the moratorium was to give PHOs and providers the opportunity to become fully compliant with enrolment requirements before they were due to submit their Enrolment Registers for the April-June 2011 period.
From 1 May 2011 to 30 April 2013 a quality improvement process applies (Quality Improvement Period). This is set out in the enrolment requirements document. GPs must be aware that after 28 February 2011, only one of the previous moratorium exception factors remained available: this relates to ineligible patients only. Ineligibility relates to whether a person is a New Zealand resident, holds valid resident visas or work visas, etc.
While it is the person’s responsibility to provide appropriate documentation evidencing eligibility, the GP practice is responsible for assessing the person’s eligibility, and they are expected to view and confirm the existence of relevant documentation to assess eligibility, and ideally take a copy and hold it with the person’s medical records.
Under section 300 of the Immigration Act 2009 (which came into effect in November 2010), the Ministry and DHBs have access to eligibility data for overseas travellers and immigrants to determine eligibility to access publicly-funded health services. Similar disclosure is available to health providers under section 301 of the Immigration Act 2009.