Legislation has been introduced to update the Assignment of Medicare Benefits (AOB) process, effective from 1 July 2026. AOB applies where a patient’s Medicare benefit is paid to another party, such as a private health fund or an approved billing agent.
Types of assignment
For services provided from 1 July 2026, simplified billing will recognise two types of assignment of Medicare benefits:
- Implied (“I”) assignment
- Requested (“R”) assignment
Implied assignment
An implied assignment applies by default where a medical provider or hospital has an arrangement with a fund that covers the service and fee. This includes AGC, MPPAs, and HPPA/PAs.
Where a provider meets the relevant terms and conditions, the assignment is treated as implied. As a provider declaration of assignment must be made with a medical claim under implied assignment changes have been made to the Account Summary Form (batch header) for paper claims.
AGC forms must only be used where AGC applies. These claims are designated as “I”.
AGC and agreement claims
All valid AGC/agreement claims should be flagged as “I” when submitted via ECLIPSE to Medicare by the fund.
Manual AGC/Agreement claims require a AOB declaration to be provided.
Requested assignment
A requested assignment applies where no fund arrangement covers the service.
Requested assignment must be obtained in writing by the provider. There is no prescribed form. The request may be incorporated into existing documents such as a patient election, admission form or patient claim form. Copies of the requested assignment do not need to be provided to the fund or billing agent.
A requested assignment can apply to all medical services within the same episode of care. Where no fund arrangement exists (Non-AGC/Agreement), these claims should be flagged as “R” claims when submitted via ECLIPSE to Medicare by the fund.
Provider responsibilities
The responsibility for obtaining the appropriate assignment of benefit rests with the provider (doctor, hospital, or medical organisation).
When a claim is lodged, the fund or billing agent may assume the provider has properly obtained the assignment. No responsibility rests with the fund or billing agent if the provider has failed to do so.
A provider declaration of assignment must be provided with the medical claim.
AOB for AHSA agreements
Where AOB applies and where a doctors provider number:
• is registered to use Access Gap Cover (AGC), Implied (“I”) assignment would apply. This includes salaried doctors at public hospitals.
• is registered under an AHSA MPPA and/or a HPPA/PA, Implied (“I”) assignment would apply.
• is not registered under any of the above-mentioned agreement types with AHSA, Requested (“R”) assignment would apply.
The AGC Billing Guide and the Account Summary Form on page 25 have been updated to accommodate Implied (“I”) assignment.
Doctors, practice staff and billing agents can email access@ahsa.com.au if they are unsure about the registration status of the provider numbers they manage.
Additional information
Implied or Requested assignment may occur in public, private, or day hospital settings.
AOB applies only to the medical service component that attracts a Medicare benefit. Hospital accommodation and facility charges are out of scope.
The legislation applies to medical claims with a date of service from 1 July 2026.
References
Legislation
- Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024
- Health Legislation Amendment (Miscellaneous Measures No. 1) Act 2025
- Health Insurance Amendment (Assignment of Medicare Benefits and Other Measures) Regulations 2025
Information from the Department
The Department have an information page on Improving the assignment of benefit process which contains updates and details regarding this change.
Further information can also be found in the slides presented by the Department on 11 February 2026 and 23 June 2026.
Frequently asked questions by the Department
Further information can also be found in Frequently asked questions document provided by the Department.
General enquiries about legislation
For general enquiries about the legislation, contact the Australian Government Department of Health, Disability and Ageing at AssignmentofBenefit@health.gov.au