Medicare Assignment of Benefit Changes from 1 July 2026. What Every Practice Needs to Know

The rules for how practices capture patient consent to bulk bill are changing on 1 July 2026. The familiar paper forms are being retired, verbal consent will no longer count, and every practice that bulk bills will need to rethink how it collects, records and stores patient agreement. Get it wrong, and the consequences range from rejected claims to Medicare clawbacks and compliance scrutiny.

Here's a guide to what the Assignment of Benefit (AoB) changes mean, why they matter, and the practical steps your practice should take before the deadline.

First, what is an “Assignment of Benefit”?

When a doctor bulk bills, the patient pays nothing at the point of care. Instead, the practice claims the Medicare rebate directly from the government.

But there's a legal step that makes that possible. The Medicare rebate technically belongs to the patient. For the practice to claim it directly, the patient has to formally hand over or “assign” that benefit to the provider. That hand-over is the Assignment of Benefit.

Think of it like signing the back of a cheque so it can be deposited into someone else's account. Without a valid assignment, the practice has no legal basis to claim the rebate from Medicare for that service.

What's changing on 1 July 2026?

The Australian Government is modernising the AoB process. The commencement date was pushed back from January 2026 to 1 July 2026, giving practices a little more breathing room but the substance of the reform is significant.

Here are the key changes.

1. The old approved forms are being retired

The long-standing approved forms including the DB4e and DB020 will no longer satisfy the requirements for a valid Assignment of Benefit. In their place, there is no mandatory template. An AoB agreement can be presented in any format, paper or electronic, provided it contains a defined set of required information (the “data set”) and the patient agrees to it in writing.

2. Verbal consent will no longer be accepted

This is one of the biggest practical shifts. A verbal “yes, that's fine” will no longer be valid including for telehealth services. Consent must be captured in writing or electronically.

3. Consent can be captured before or after the service

Practices will be able to obtain assignment before a service (pre-service) or after it (post-service) but the agreement must be in place before the Medicare claim is lodged.

4. Consent is per episode of care

Each assignment covers a single episode of care. In practice, that means patients will need to consent each time they are bulk billed. (An “enduring” or standing assignment model is expected to follow in 2027, subject to final regulations.)

5. The GP co-signature requirement is removed

The current requirement for a GP to co-sign each bulk-billed AoB form is being removed.

6. Records must be kept for two years

Practices must retain the completed, signed agreement for two years for every consent obtained. If Medicare audits a claim, the practice needs to be able to produce evidence that valid consent was captured.

7. New consent may be needed when details change

When reconciling bulk-bill batches, for example, if an MBS item number changes or a service is resubmitted, you may need to collect a fresh Assignment of Benefit reflecting the corrected details.

Why this matters, the compliance risk

These changes are not just administrative housekeeping. Consent is the legal foundation of every bulk-billed claim, and from 1 July 2026 the standard of proof is higher.

If a practice bulk bills but cannot produce a valid, properly captured agreement:

• Claims can be rejected, disrupting cash flow.

• Medicare can demand repayment (“clawback”) of amounts already paid.

• Persistent or systemic issues can attract scrutiny from the Professional Services Review (PSR) (Medicare's billing-compliance watchdog).

In short, no valid captured consent, no compliant bulk bill. The administrative burden of proving consent now sits squarely with the practice.

A particular challenge for aged care and home visits

Practices that deliver care in residential aged care facilities or in patients' homes face an added layer of complexity. Capturing written or electronic consent at the bedside is harder than at a clinic front desk, and many residents may lack the capacity to provide consent themselves.

Where a patient lacks the mental or physical capacity to make their own financial or health decisions, an assignor can act on their behalf, typically a carer, partner, parent, or a person holding Power of Attorney. Getting this “substitute assignor” pathway right is essential for practices operating in aged care, and it raises real questions about capacity, authority and privacy that are worth working through before July.

What your practice should do before 1 July 2026

1. Audit your current consent workflow. Map exactly how you capture, record and store AoB consent today.

2. Confirm your software is ready. Check that your practice management or billing software will support the new data set and digital consent options.

3. Stop relying on verbal consent, including in telehealth and build a written/electronic capture step into every bulk-billed encounter.

4. Set up two-year record retention that lets you quickly retrieve a signed agreement if audited.

5. Design a process for substitute assignors, especially if you serve aged care or housebound patients.

6. Build a “details changed” trigger so staff know when a fresh assignment is required.

7. Train your team on the new rules well ahead of the deadline.

8. Get tailored legal advice if you are unsure whether your consent process or any tool you use to capture it meets the new requirements.

Frequently asked questions

When do the new Assignment of Benefit rules start?

1 July 2026, for Medicare bulk-billed and simplified billing services. The date was deferred from January 2026.

Are the DB4e and DB020 forms still valid?

No. From 1 July 2026 these approved forms will no longer meet the requirements. There is no mandatory replacement form, any compliant format that captures the required information and records the patient's written agreement is acceptable.

Can I still take verbal consent over the phone or telehealth?

No. Verbal consent will no longer be accepted, including for telehealth. Consent must be written or electronic.

How long do I need to keep consent records?

Two years for every signed agreement.

Do patients need to consent every time?

Yes. Under the changes commencing 1 July 2026, each assignment covers a single episode of care, so consent must be captured for each bulk-billed service. An enduring assignment model is expected in 2027.

What happens if I can't prove consent?

The claim may be rejected, Medicare may seek repayment, and repeated issues can attract Professional Services Review scrutiny.

How Northbridge Legal can help

The AoB reform sits at the intersection of Medicare compliance, privacy and clinical governance and the practices that prepare early will avoid the scramble (and the risk) later.

Northbridge Legal advises medical practices, healthcare providers and digital-health businesses on Medicare and bulk-billing compliance, privacy and consent obligations, and clinical governance. We can review your consent workflows against the new requirements, advise on the substitute-assignor and capacity issues that affect aged care providers, and help you put a defensible, audit-ready process in place before 1 July 2026.