Practice amalgamation for Practice Incentives Program (PIP) and Workforce Incentive Program (WIP) – Practice Stream 012-10010020

The definition of amalgamation for the PIP and WIP – Practice Stream:

'Two or more practices coming together into one common location and sharing access to all patient records, belonging to each of the previously individual practices. The remaining original locations will close'.

• The practice must submit completed forms and provide the necessary supporting documents
• If a practitioner is moving from the amalgamated (closed) location to the current location, the practitioner must have a provider number associated with the current location

Definitions

Current location – the practice location that is remaining open. This is indicated as the current practice address in the practice details section of the Practice Incentives Change of practice details (IP005) form.

Amalgamated location – the practice location that is closing and merging their patient records with the current location. This is indicated in the amalgamation section on the IP005 form.

For a practice to request a practice amalgamation, the correct forms must be completed and submitted.

The practice must submit:

• The Practice Incentives Change of practice details (IP005) form
• All pages of the form must be received
• the practice details, amalgamation details, eligibility requirements and declaration sections must be completed. Other sections only need to be completed if there are changes to this information
• The Practice Incentives Individual general practitioner or nurse practitioner details (IP003) form
• Needed for all practitioners who join the practice or change locations as part of the amalgamation. An IP003 is not required for any practitioners who are registered on the current practice profile
• If only one IP003 form is received for a relocating provider, Services Australia can complete the relocation process. See the Process page for more information
• An accreditation certificate showing the current location must be provided:
• if the current practice location is relocating as part of the amalgamation, or
• If the accreditation from one of the amalgamating practices is being transferred to the current location
• within 6 months of the amalgamation. As with relocations, the amalgamation can be actioned without the updated accreditation certificate. Practice payments will be placed on hold until an updated accreditation certificate is provided. For further assistance, see Effect of practice amalgamation on practice accreditation
• A letter from at least one owner from each of the amalgamated practices:
• confirming they have amalgamated with another practice
• which additional practice branch(es) are to be transferred to the current practice address (if applicable)

If a practice relocates and amalgamates with a non-PIP practice, go to the Relocation scenarios table for more information on document requirements.

If a practice changes ownership as part of the amalgamation, the Practice Incentives Change of practice ownership form (IP010) and supporting documents must also be submitted. The practice updates should be updated in order of when they occurred.

Note: if the current location has never applied for the Procedural GP payment and GPs from the amalgamating locations have indicated ‘Yes’ to the Procedural GP questions in the IP003 form, the practice must register for the payment to be eligible for payments to be made to GPs. The practice will not be entitled to any Procedural GP back payments.

Amalgamations can not be updated in PIP and/or WIP – Practice Stream online during a calculation month. The calculation months are:

• February
• May
• August
• November

Amalgamation notifications received during these months should be fully assessed. If the outcome of the assessment is that:

• the application can be processed: pended as 'FUTURE DATE' to the 1st day of month following the calculation month. Add a processing note to the PaNDA item confirming assessment of the documentation
• further information is needed: reject the form, advising the practice what additional information is required

A practice can use the IP005 form to notify of multiple changes to practice details. An amalgamation may be notified with:

• a relocation
• a change of bank account details
• a change of authorised contact persons, and/or
• ceasing a general practitioner or nurse practitioner
• updating health professional details

If the practice notifies of an amalgamation and relocation, the change with the earliest date must be assessed and processed first. For example, if the date of amalgamation (Question 19) is before the date of relocation (Question 10), assess and process the amalgamation first. Then process the relocation.

Practice relocation for PIP and WIP – Practice Stream has more information about assessing and processing a relocation.

The Process page has more information about processing an amalgamation including other changes.

Existing location

If practices are amalgamating at a location that is:

already accredited, there is no need for the current location to go through the accreditation process. The practice will maintain their current accreditation cycle

• an unaccredited practice, the current location must go through accreditation (if applicable) or the existing practice accreditation must be transferred to the new location

The amalgamation can be actioned without the updated accreditation certificate. Practice payments will be placed on hold until an updated accreditation certificate is provided. If it is not provided within 6 months after the date of amalgamation, the payments will remain withheld and the three quarter rule will apply.

Practices amalgamating to an unaccredited practice location will not be eligible for the 12 month accreditation registration period.

New location

If practices amalgamate and move to a new location, the practice must provide evidence of accreditation in the new location. Evidence must be in the form of an accreditation certificate issued by the accrediting body, which indicates the current location’s address.

Practices amalgamating and relocating to a new location must retain the accreditation of one of the existing practices. They must arrange with their accreditation agency to relocate one of the current accreditation certificates to the new location.

Practice accreditation for PIP and WIP – Practice Stream has more information about accreditation certificate requirements.

Change of practice name

The accreditation certificate must match either the registered practice name, company name or trading name. If the practice name changes as part of an amalgamation, it will need a new accreditation certificate with the new practice name.

Practice payments are placed on hold until the new certificate is provided. If it is not provided within 6 months after the change of practice name, the payments will remain withheld and the three quarter rule will apply.

Amalgamating practices will retain the Standardised Whole Patient Equivalent (SWPE) value of all practices if the practices being amalgamated are all within the same local area. The SWPE value of the amalgamating practices will be the sum of the SWPE values for each practice location.

If all practices being amalgamated are not within the same local area the SWPE value for the closing practice/s will not transfer to the amalgamated practice.

If a practice notifies an amalgamation for a previous payment quarter, there is no requirement to recover payments made to the closing practice if all other eligibility conditions were met.

The SWPE will not be recalculated for the current practice to include the amalgamated practice’s historic data. The amalgamated SWPE and incentives eligibility will apply from the first quarter after the profiles have been amalgamated.