Medicare Review Could Shut Nurse Practitioners Out of Primary Care, College Warns

Sydney — Australia’s proposed Medicare reforms could disadvantage nurse practitioners and restrict access to care, particularly in rural communities and aged-care facilities, unless funding and registration rules are changed, the Australian College of Nursing (ACN) has warned.

The concern centres on draft recommendations from the Medicare Benefits Schedule Review Advisory Committee, which propose extending bulk-billing incentives to nurse practitioner consultations for the first time but would make eligibility dependent on patients being registered with a practice through MyMedicare.

Nurse practitioner-led practices without a general practitioner are currently unable to join the scheme, potentially preventing their patients from accessing the proposed incentives.

ACN Chief Executive, Adjunct Professor Kathryn Zeitz, said the review had left this eligibility barrier unresolved and urged the government to reconsider the MyMedicare framework and accreditation requirements.

“We are calling for the final report to recommend the Government undertake a review of the MyMedicare framework and accreditation requirements that addresses the inequitable exclusion of NP {nurse practitioner}- and nurse-led practices,” Prof. Zeitz said.

The college argues that accredited nurse practitioner practices already meet stringent National Safety and Quality Primary and Community Healthcare Standards, challenging the rationale for using MyMedicare registration as a safeguard for patient safety and continuity of care.

“Nurse practitioners and nurses are independent primary healthcare providers who improve consumer access to safe, affordable and timely primary healthcare services,” Prof. Zeitz said.

“If we do not better incorporate them into the primary healthcare funding architecture, we fail to future-proof the healthcare system," she said.

The proposed rules could also affect incentives for home visits and aged-care consultations, which the draft recommendations would be subject to the same MyMedicare condition.

Zeitz said the restrictions could worsen access difficulties in residential aged care, where facilities outside major cities can struggle to secure medical visits.

“Aged care nurse practitioners can help close that gap, but these rules would make it harder for them to do so,” she said.

The dispute comes as Australia’s nurse practitioner workforce expands.

The college says the number of practitioners rose from 590 in 2012 to 3,194 in 2024–25, more than fivefold growth.

Around 30% work in regional, rural and remote areas, while one in seven was not working in a nurse practitioner role last year.

ACN says the draft recommendations also risk widening the financial gap between patients who consult general practitioners and those who see nurse practitioners.

The review proposes raising rebates for prescribed medical practitioners to at least match existing nurse practitioner rebates but does not propose a corresponding increase for nurse practitioner consultations.

The college wants rebates aligned where nurse practitioners and GPs provide the same service within their respective scopes of practice.

It is also calling for nurse practitioners to be considered across all recommendations, rather than included selectively, although it welcomed their proposed inclusion in an after-hours loading.

Prof. Zeitz said the review was an opportunity to address funding and regulatory obstacles that have prevented more nurse practitioners from establishing independent practices.

The college argues that the restrictions conflict with the government’s Nurse Practitioner Workforce Plan, which commits to expanding the workforce and removing barriers to practice.

Nurse practitioners are experienced registered nurses who complete postgraduate education and advanced clinical practice before endorsement by the Nursing and Midwifery Board of Australia.

Within their authorised scope, they can assess and diagnose patients, prescribe medicines, order and interpret tests and refer patients to other health professionals.