Practice branches in Incentives Program (PIP) and Workforce Incentive Program (WIP) - Practice Stream 012-18060500

Practices with multiple locations can be approved for the PIP and WIP - Practice Stream as a single practice, with the branch practices listed as additional locations under the main practice ID. These branch practices are known as practice branches.

The terms branch practice, branch location and additional location are also used to refer to branch practices.

The location providing the most Medicare Benefits Services (MBS) per annum should be selected as the main practice location.

To be eligible as a practice branch, the additional location must:

• provide MBS services
• have at least 1 general practitioner working at both the main location and the branch location (providing MBS services at both locations)
• maintain at least $10 million in public liability insurance cover
• make sure all practitioners at the location have current professional indemnity cover
• be accredited or registered for accreditation if the location provides 3,000 or more MBS services per annum. Practice branches providing less than 3,000 MBS services per annum do not need to be accredited

Where a practice has multiple practice branches, the same General Practitioner (GP) does not need to work at the main and each branch location.

For example, a practice has main location 1 and additional branch locations 2 and 3.

• General Practitioner A works at location 1 and 2
• General Practitioner B works at location 1 and 3

This is acceptable as there is a GP at each additional location who also works at the main location.

Practice branches do not need to be accredited if they are providing less than 3,000 MBS services per annum,

Once a practice is providing more than 3,000 MBS services per annum, they must register for accreditation at that location to continue participating in the PIP/WIP - Practice Stream. It is up to the individual practice to monitor service levels at their additional locations to make sure they remain eligible.

The practice quarterly payment advice shows how many MBS services have been provided at each practice location.

Accreditation details for practice branches will be uploaded into PIP and WIP - Practice Stream Online systems on a monthly basis. This upload does not include locations that are registered for accreditation. See Practice accreditation for PIP and WIP - Practice Stream for more information.

An accreditation or registered for accreditation certificate can also be provided to confirm accreditation. Practice accreditation for PIP and WIP - Practice Stream has more information on assessing accreditation certificates.

A practice can apply to add a practice branch using:

• Health Professional Online Services (HPOS)
• the Practice Incentives application (IP001) form when a practice applies for the program(s)
• the Practice Incentives Additional practice branch form (IP025) after the main practice address is approved for the program(s)

Practices using the IP025 to register a practice branch must provide the following:

• completed IP025
• current accreditation or registered for accreditation certificate if the practice provides 3,000 or more MBS services per year or has indicated the branch location is accredited or registered for accreditation

The practice should complete Part C of the IP025 to register the practitioners at the branch location. Practices may use the Practice Incentives individual general practitioner or nurse practitioner (IP003) form to register their practitioners instead of completing Part C. This is acceptable.

The Resources page has a link to the forms.

Practices with practice branch/es registered under the same PIP/WIP - Practice Stream ID do not have practice payments calculated for the individual locations.

The practice Standardised Whole Patient Equivalent (SWPE) is calculated using the Medicare and Department of Veterans’ Affairs services for all practitioners registered at the main and branch locations. The SWPE is not calculated individually for each location.

Branch practices do not register for individual PIP incentives. The practice branch is considered to be meeting the same incentive eligibility as the main location.

Eligible health professional hours worked at the branch location are included in the average weekly health professional hours for the practice. The practice claims the total hours worked by their eligible health professionals across all locations for the WIP - Practice Stream.

A practice branch may be removed from a practice profile at any time. The main reasons this would occur is because:

• the practice wants to register the practice branch for PIP and/or WIP - PS as a new practice
• the practice branch was/is sold and the new owners wish to apply for the program/s as a new practice

This was previously referred to as ‘splitting’ locations.

Practice branches applying for the PIP and/or WIP - PS as a new practice

This is when a practice branch is removed from the main practice address and applies for Practice Incentives in its own right as the main practice location. Ownership of both locations remains the same.

A practice must provide:

• the Practice Incentives application (IP001) form, for the practice branch that is splitting from the main practice address
• a letter from the practice owner(s). This must include:
• consent to split the practice branch from the main practice address, and
• the signature of at least one registered owner
• a current accreditation or registered for accreditation certificate, for the practice branch that is splitting from the main practice address

The above documents must be provided for each practice branch that is splitting from the main practice address.

Practices cannot use HPOS to apply for the PIP or WIP - Practice Stream for an existing branch location. The PIP and WIP - Practice Stream Online systems will not allow 2 practices to be registered at the same address at the same time. The branch location must be closed in the system before the new application can be submitted.

Staff processing these requests close the practice branch and approve the new application on the same processing day. This will make sure the practice’s Standardised Whole Patient Equivalent (SWPE) reference period is correctly captured for both practice IDs.

The SWPE is not transferable to the new practice ID if the locations remain under the same ownership. The SWPE for the branch location will remain with the original practice ID.

See also: Payments for PIP and WIP - Practice Stream.

If a branch practice is sold to a new owner and the new owner is applying for the PIP and/or WIP - Practice Stream as a new practice, the SWPE value may be transferred to the new practice ID.

In addition to completing the Practice Incentives application (IP001) form, the new owner must provide evidence to confirm:

• the change of ownership for the branch practice
• the new owner is not affiliated with the previous ownership
• the branch location is operating as an independent practice under the new ownership
• the accreditation was included in the sale (if accreditation is recorded for the location)

The new owner does not need to complete a Practice Incentives Change of practice ownership (IP010) form.

Note: if the branch location was not accredited or the new owner has new accreditation, the SWPE value will not be transferred to the new practice.

Practices cannot use HPOS to apply for the PIP or WIP - Practice Stream for an existing branch location. The PIP and WIP - Practice Stream Online systems will not allow 2 practices to be registered at the same address at the same time. The branch location must be closed in the system before the new application can be submitted.

Staff processing these requests close the practice branch and approve the new application on the same processing day. This will make sure the practice’s Standardised Whole Patient Equivalent (SWPE) reference period is correctly captured for both practice IDs.

The Process page has the steps to transfer the SWPE value to the new practice ID.

See also Payments for PIP and WIP - Practice Stream.

Questions about branch location eligibility to retain their SWPE should be referred to Local Peer Support (LPS).

See Change of practice ownership for PIP and WIP - Practice Stream for information on acceptable change of ownership evidence.

A practice using HPOS to notify a practice relocation, may create an additional location in error. The practice must submit the forms required for a practice relocation.

Once the relocation has been assessed, the ‘additional location’ will be set as the main location, and the previous main location is closed.

This is when a practice changes which location identifies as the main practice address.

A practice must provide:

• A letter from the practice owner(s). This must include:
• confirmation of which location that is identifying as the main practice address
• the Practice ID number, and
• the signature of at least one registered owner
• An accreditation certificate, for the practice branch that is identifying as the main practice address

The new main practice address must be:

• currently registered as a practice branch. If not, the practice must submit a Practice Incentives Additional practice branch (IP025) form
• accredited at the time of the notification. The new main location must have the same accreditation status as the old main location. An accredited main location cannot become registered for accreditation main location

The practice’s accreditation must be ongoing to maintain eligibility for the PIP and WIP - Practice Stream.

For example: the accreditation for the existing main practice location expires on 31 January. The accreditation for the new main practice location must start on or before 1 February.

See also: Practice accreditation for PIP and WIP - Practice Stream.