Compassionate release of super

Meeting your professional obligations

Guidance

• When assessing a patient, practitioners must put their patients’ best interests first, providing treatment options that are based on the best available information and are not influenced by financial gain or incentives.
• When assessing whether there are clinical indications that comply with the ATO rules for a patient to access CRS, practitioners must:
  • properly assess the patient. This is likely to include taking a history, performing an appropriate physical examination and ordering any necessary investigations or reviewing the results of investigations ordered by other practitioners. It is unlikely that a telehealth consultation is appropriate for the assessment required for dental and medical conditions considered by CRS. Practitioners should be prepared to be able to explain to their Board how the manner of assessment allowed for the provision of a fulsome, accurate report to the ATO
  • making clear the limits of their knowledge and not giving opinion beyond those limits when providing evidence. For example, medical practitioners proposing to provide certificates about dental treatments must have the necessary dental knowledge.
• When providing a report supporting an application for CRS, practitioners must:
  • ensure that the patient’s request to access CRS fits the eligibility criteria.
  • be honest and not misleading when writing reports and certificates, and only sign documents that accurately reflect their medical opinion.
  • ensure that they complete the report accurately and only certify treatments or expenses that are medically required for the patient’s circumstances.
• Before accepting payment for treatment practitioners should ensure patients have given informed financial consent about to the implications of using their superannuation and they understand the full costs of treatment.
• Practitioners must be careful not to encourage patients to take on debt (including personal loans, mortgages) or access superannuation for treatment. Influencing patients to access their super early without an Australian financial services licence could be considered financial advice and result in severe penalties from the Australian Securities & Investments Commission (ASIC). Doctors and dentists do not have a role in providing financial advice but should encourage patients to seek independent financial advice.

Note - The Medical Board of Australia’s Guidelines for registered medical practitioners who perform cosmetic surgery and procedures state that medical practitioners must not encourage patients to take on debt or access superannuation, to access cosmetic surgery.

Advertising

Advertising that promotes or encourages access to superannuation for treatment is one indicator that a practitioner or business may be operating their practice in a way that puts profit above patient care.

Practitioners that advertise CRS, should ensure that this content is limited to highlighting CRS as a payment option and ensure that any content aligns with the ATOs guidance. If practitioners are unsure their content is accurate, practitioners should refer patients to the ATO’s published guidance.

In relation to advertising a regulated health service:

• Practitioners must ensure their advertising is clear and honest to help patients make informed choices about their healthcare needs. Advertising shouldn’t create unrealistic expectations and use phrases like ‘stress-free’ that underplay the risks or financial impacts of treatment.
• The advertising of regulated health services must not encourage the indiscriminate or unnecessary use of a regulated health service. Encouraging the unnecessary and indiscriminate use of a regulated health service can lead the public to buy or use a regulated. health service they do not need and is not clinically indicated or provides no therapeutic benefit.
• Advertising must not provide information that is false, misleading or deceptive. Advertising may be false, misleading or deceptive when it provides partial information and/or omits important details.
• Advertising must not use patient stories, patient journeys or anecdotes that may create an unreasonable expectation of beneficial treatment. The outcomes experienced by one person do not necessarily reflect the outcomes that other people may experience.

Notes of caution

• Influencing or advising patients to access their superannuation early without an Australian financial services licence could be considered financial advice. If you are unlicensed, this can result in severe penalties from ASIC.
• The ATO can impose significant penalties against practitioners who include false or misleading information in medical reports for the purposes of CRS. This includes when inaccurate reports have been produced because a proper assessment did not take place.
• Ahpra and the Dental and Medical Boards are working with other regulators to understand the increase in requests to access superannuation and consumer concerns. We may investigate the practitioners’ practice based on information shared by other regulators or identified in advertising or online, even if we have not received a complaint.

Examples of poor practice in relation to CRS include

• The appointment for assessing the need for CRS is by telehealth when an in-person, physical examination is required to produce a fulsome, accurate report to the ATO.
• Practitioners completing CRS certification when they do not have the knowledge, skills and experience in the particular medical/dental discipline.
• Expensive treatments recommended when there are other satisfactory and cheaper treatments available, without properly discussing the availability of the other treatment options and the pros and cons of different options.
• Inappropriate or aggressive sales tactics promoting the use of CRS for treatment.
• Limited information provided to the patient about ongoing costs.
• Missing financial consent information.
• Overinflating the cost of the treatment when the funds are from CRS.
• Inaccurately completing CRS certifications to support treatment that doesn’t meet the legislated criteria (e.g. treatment with cosmetic intent).