I questioned the Minister regarding Schedule 1 of the Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025, specifically the automation of Medicare Provider Numbers (MPNs).
My primary concern, as always, is ensuring that “automation” isn’t just a fancy word for another government digital disaster. We’ve seen the Robodebt fiasco, the Bureau of Meteorology website fiasco, Australia Post software fiasco and the Border Force Cargo management automation fiasco; my job is to make sure Australians aren’t the next victims of a “government stuff-up.”
I asked the Minister why legislation is needed for a process that is already using computers. She replied that this bill provides legislative support for existing practices and introduces safeguards, adding that computers will not be used to revoke or suspend provider numbers without a human request.
I asked if this automation of MPNs was a “Trojan horse” for Artificial Intelligence (AI). Despite the Explanatory Memorandum mentioning “computer programs” for non-discretionary decisions, the Minister stated on the record that there is no intention or requirement to use AI for allocating MPNs.
Finally, I sought clarification on changes to Commonwealth supported places. Under the new rules, medical students who withdraw from their degree, even late in their studies, will no longer be forced to repay the scholarship cost (though they remain liable for HECS). The Minister said that this is about “fairness” rather than recouping funds from students facing hardship.
I remain sceptical of any move toward “automated” government software, and I will be monitoring these automated systems very closely.
Transcript
Senator ROBERTS: Minister, schedule 1 of the bill automates the issuance of Medicare providers numbers, MPNs. ‘Automation’, I assume, means computer software. Computers are used now for the process. What is different about the process being proposed that it requires legislation to enact it?
Senator McALLISTER (Minister for the National Disability Insurance Scheme): Thank you for your patience, Senator Roberts. I was just obtaining advice so I can advise you correctly. This new part of the act will ensure that the system can approve the use of a computer program for certain decisions relating to the allocation and management of Medicare provider numbers. It will not—and this, I think, will be important to you—enable the approval of the use of a computer program to make decisions about revoking a Medicare provider number or suspending a Medicare provider number where the suspension is not at the request of a health professional.
It will also include safeguards around the use of computer programs to make decisions relating to Medicare provider numbers. Those safeguards include a requirement to notify a person where a computer program was used to make a decision about their Medicare provider number; a requirement to make it public when the use of a computer program to make decisions about Medicare provider numbers has been approved; a power to make substitute decisions where they are satisfied that a decision made by the operation of a computer program is incorrect; and a requirement to include information in the Services Australia annual report about the number and types of substituted decisions.
Importantly, these things introduce safeguards, and they also, as is indicated in the explanatory memorandum, provide legislative support for an existing practice where some Medicare provider numbers have been allocated by use of a computer program, rather than by a human delegate.
Senator ROBERTS: I think you anticipated one of my future questions, but, in the meantime, who decides if a person is qualified for a Medicare provider number, including the decision to give a Medicare provider number to a new arrival in the country? I’m asking this to see how this automation will impinge on the process of determining qualifications.
Senator McALLISTER: May I clarify. I think what you’re asking is, ‘How would a new migrant to Australia have their qualifications recognised for the purpose of practising in an Australian context?’ Is that correct?
Senator ROBERTS: That’s part of the question. The other part concerns any Australian who’s here right now; how would they be qualified?
Senator McALLISTER: I’m terribly sorry. I might ask you to clarify further. You said that you’re asking about how a person who is here now would obtain a Medicare provider number. Do you mean an Australian citizen or another person? What are you trying to elicit from me?
Senator ROBERTS: Anybody who’s qualified to get a Medicare provider number—how would you make sure they are qualified, and how would you make sure that we’re not excluding people?
Senator McALLISTER: The advice I have is that the bill that’s before us doesn’t change any of the existing arrangements. Those arrangements, of course, include a series of processes to ensure that a person seeking to practise within the Medicare system is qualified.
Senator ROBERTS: How extensive are the checks, and is there any hint of automation being more than just computer software? Is the bill intending to allow for the use of AI for automatic MPNs?
Senator McALLISTER: No.
Senator ROBERTS: So there’s no requirement for artificial intelligence to be used in allocating MPNs?
Senator McALLISTER: The advice I have is no.
Senator ROBERTS: I’ll quote from the explanatory memorandum:
The Bill will enable the Chief Executive Medicare to approve the use of a computer program to make appropriate, non-discretionary decisions relating to the registration and claims process.
Can I confirm you intend to use AI for that process? If so, what checks are in place to make sure the AI is fit for purpose?
Senator McALLISTER: The advice I have in relation to AI is that there is no intention. We do not require AI to perform the functions that are set out in the bill. In relation to your earlier question about the process by which a person becomes eligible for obtaining a Medicare number, the Parliamentary Library’s Bills Digest in relation to this says:
To be eligible to provide a Medicare service, health professionals must meet certain criteria. Practitioners eligible to have Medicare benefits payable for their services ‘at the place of practice as well as refer patients to other health professionals for Medicare eligible services, such as pathology and diagnostic imaging from the place of practice’, may apply online or in writing to Services Australia for a MPN for the locations where these services/referrals/requests will be provided.
MPNs are used by health practitioners both ‘as a means of identifying themselves and their place of practice for the purposes of claiming Medicare benefits for eligible services, and as an identifier to support other Medicare-related programs …
Senator ROBERTS: To clarify for constituents and to get some reassurance: you didn’t hesitate when you used the word ‘intention’ with regard to AI and then said there was no requirement. After the robodebt fiasco, the Bureau of Meteorology website fiasco, the Australia Post software fiasco and the Border Force cargo management automation, constituents have every right to point out that these stuff-ups keep happening because of the way in which new technology is rolled out. That’s a big concern. Now you’re giving the software decision-making powers, and it sounds like there are no plans to do that with due care. What security steps are being taken to reassure our constituents that the automations proposed in this bill don’t become yet another government stuff-up? I acknowledge that not all of the stuff-ups have occurred on your watch.
Senator McALLISTER: This bill puts in place safeguards to ensure that, to the extent that a computer is utilised, the circumstances in which a computer is being used are made very explicit. It also puts some constraints around the kinds of decisions that may be taken by a computer in the context of this process—that is, the process of obtaining a Medicare provider number. I read to you earlier some of those safeguards, which are set out in the explanatory memorandum. As I indicated to you, the advice I have is that this process, which involves the use of a computer for certain purposes that are quite tightly defined and constrained, does not require the use of AI.
Senator ROBERTS: This final question has a lengthy preamble. Item 3124ZH1 removes the requirement for students who do not complete their degree to repay the Commonwealth supported place cost. Students can currently withdraw from the program without consequence up to the HECS census date in their second year of study. If the student withdraws after that date, they incur a debt to the Commonwealth equal to the full cost of their Commonwealth supported place up to the date of withdrawal in addition to any HECS or HELP liability. The proposed amendment, as I understand it, seeks to extend the existing grace period from the HECS census date in the second year of study to the award of the medical degree. Can you please explain that provision? It sounds like they can pull out right at the end of their degree and not have to pay back the cost. Is that right?
Senator McALLISTER: Senator, you’re correct that at the moment a person who withdraws from their degree doesn’t need to pay the cost of the scholarship back if they withdraw prior to the census date you alluded to. I believe that they do remain liable for the HECS costs incurred by them in the pursuit of their studies up to that point. You are also correct that a purpose of this bill is to extend the period during which a person may withdraw without incurring a debt associated with their receipt of Commonwealth payments.
Senator ROBERTS: Sorry, that was my second-last question; I’ve got another one now. What is the rationale behind extending the withdrawal date so they won’t have to pay it back?
Senator McALLISTER: Earlier in the debate I read out an email from a person who has incurred a debt in precisely these circumstances, and they spoke about the hardship they had experienced as a consequence of that. This person made the point that the purpose of the bonded nature of this program is to ensure that people who do qualify as medical professionals fulfil their obligation to work in an area that is underserved by medical practitioners. The purpose is not in itself to recoup funds from students, and we simply seek to make the system fairer.




