Bottom Line: Before 30 June 2026, register your practice SMS sender ID, switch on a digital (SMS or email) AoB consent workflow in your practice software, and brief reception staff that a GP no longer co-signs each bulk-billed form. Keep every completed AoB agreement for two years.
Background
Assignment of benefit is the mechanism by which a patient agrees to assign their Medicare benefit directly to the practitioner, which is the legal basis for bulk billing. Historically this required a signed paper form, generally completed during the attendance, with the practitioner also signing to certify the service.
The Department of Health, Disability and Ageing has been modernising this process to reduce administrative burden and strengthen Medicare integrity. The reform was originally scheduled to commence on 9 January 2026 but was deferred to 1 July 2026 to give software vendors and practices more time to prepare.
The timing is significant because the AoB changes coincide with a separate but related reform: the Australian Communications and Media Authority (ACMA) SMS Sender ID Register, which also becomes mandatory from 1 July 2026. Because the new AoB workflow relies heavily on SMS, the two reforms need to be implemented together.
The Change in Detail
Digital consent replaces the paper-only model
From 1 July 2026, patients can assign their Medicare benefit through more flexible channels:
- Digital consent by SMS or email that opens a PIN-protected web form on the patient’s own device
- An updated paper form remains available as a fallback for patients who cannot or prefer not to use digital methods
- Consent can be collected before the consultation (pre-assignment, for example at the time of booking) or after it (post-assignment) — it no longer has to occur during the attendance itself
The practitioner co-signature requirement is removed
One of the most practically significant changes: the requirement for a GP to co-sign each bulk-billed AoB form is removed. Practitioner signatures are no longer required on AoB agreements. Practices, billing agents and private health insurers are also no longer obliged to use a prescribed or approved AoB form, provided the agreement captures all the required information.
New two-year retention rule
For every consent request, the practice must retain a copy of the completed AoB agreement for two years. This applies regardless of whether consent was collected digitally or on paper, and should be reflected in your records-management and data-retention policies.
The ACMA SMS Sender ID Register
Running in parallel, the ACMA SMS Sender ID Register becomes mandatory from 1 July 2026:
- Businesses must register their alphanumeric SMS sender IDs
- From 1 July 2026, messages sent from an unregistered sender ID will be labelled “Unverified” on patients’ phones and may appear as a separate message thread rather than in the practice’s usual conversation
- Practices should register their sender ID with their telecommunications or SMS provider by 30 June 2026 so that AoB consent messages arrive as trusted, branded communications
This matters because patients are being conditioned to ignore unverified messages as potential scams. An AoB consent request that lands as “Unverified” is far less likely to be actioned.
Clinical and Practical Implications
For day-to-day practice, the headline effect is a smoother, less paper-dependent billing workflow — but only if the set-up is done before the deadline. Pre-assignment at the time of booking means many patients can arrive with consent already captured, reducing front-desk friction on the day.
Removing the practitioner co-signature is a meaningful efficiency gain for high-volume bulk-billing clinics, where GPs previously signed large batches of forms. The trade-off is that the integrity burden shifts toward the practice’s systems: the agreement must still contain all required information, and the two-year retention obligation must be reliably met.
The SMS sender ID issue is the one most likely to catch practices out. A practice can have a perfectly configured digital AoB workflow that fails in the real world simply because its messages are flagged “Unverified” and patients do not respond. Registering the sender ID is a small administrative step with an outsized impact on whether the new system works.
What You Need to Do
- Register your SMS sender ID with your telecommunications or SMS provider before 30 June 2026 so AoB messages are not labelled “Unverified.”
- Confirm your practice software is updated to support digital SMS/email AoB consent with a PIN-protected web form. Check the release timeline with your clinical software vendor.
- Decide your default workflow — pre-assignment at booking, post-assignment, or a mix — and configure templates accordingly.
- Update your records-retention policy to capture the two-year retention rule for completed AoB agreements, and confirm where these are stored.
- Brief reception and billing staff that a GP co-signature is no longer required on each bulk-billed AoB, and that paper remains available as a fallback.
- Retain a paper option for patients who cannot use digital consent, so no patient is excluded from bulk billing by the change.
- Test the end-to-end flow with a small number of patients before 1 July to confirm messages arrive as verified and the web form completes correctly.
Summary
- Effective date: 1 July 2026 (deferred from 9 January 2026)
- Core change: Digital SMS/email AoB consent via PIN-protected web form; paper form retained as fallback
- Co-signature: Practitioner signature on each bulk-billed AoB agreement is no longer required
- Timing flexibility: Consent can be collected before or after the consultation, not only during it
- Record-keeping: Completed AoB agreements must be retained for two years
- Parallel reform: ACMA SMS Sender ID Register is mandatory from 1 July 2026 — register your sender ID by 30 June or messages may show as “Unverified”
- GP/practice action: Register sender ID, update software and templates, brief staff, retain a paper fallback, and test before go-live
- Source: Department of Health, Disability and Ageing (Improving the assignment of benefit process); ACMA SMS Sender ID Register guidance
This article is intended as educational information for Australian general practitioners and practice managers and is not a substitute for the official Department of Health, Disability and Ageing guidance or advice from your clinical software vendor. Always confirm implementation details against the current departmental materials and your own software’s release notes.
