We specialise in medical practices at GrowthMD, and people often ask me why they need a specialist accountant for their medical practice. Let me share the four reasons why medical practices need a specialist accountant. A snapshot of the four reasons why you should work with us. First, we know your business inside and out because we've been working with medical practices for years. Second, we'll keep you compliant with government regulations so you don't run into any problems down the road. Third, we understand all of the financial tools and technology that medical professionals like you use because we prioritise our staff on upskilling and staying up to date. And fourth is confidence - knowing that you have an expert working on your behalf who understands your business and how to help you grow it successfully over time. If your healthcare business could benefit from working with a medical practice specialist accountant, we are taking a limited number of new clients; please contact us. We would love to help you at GrowthMD. Regards Kelly Chard Founder | GrowthMD

Payroll tax continues to be a significant concern for health practice owners across Australia, with many practices unsure of the path forward and cautious about participating in amnesties. Our latest GrowthMD blog summarises key information on payroll tax in your state, a methodology for considering amnesty participation and discusses some proactive work we are doing with GrowthMD clients. We also have a dedicated Payroll Tax Resource Page to help you navigate this area. Latest Information by state Understanding that each Australian state has its own rules and thresholds around payroll tax is essential. The action you need to take will depend on the state/s in which your health practice operates. The table below summarises current information by state and the amnesty or concessions available in your state (note that amnesties and concessions are limited to GPs currently). *Updated 19th September 2023 QLD Provides Clarity - Patient fee flow and taxable wages On 19 September 2023, QLD released further information to clarify when certain payments to practitioners are considered deemed wages and taxable for payroll tax purposes. This is a welcome update for QLD practices as it provides certainty about operational changes that are being made or considered within medical centre businesses. The following table summarises the QLD interpretation: Our team are working with practices all over Australia, as well as leading technology and banking providers, to implement practical workflows to assist patient fee flow changes. QLD and SA Amnesty - Should your business participate? A strategic approach is essential for businesses contemplating the amnesty in Queensland or South Australia. Here's a methodology to guide your decision-making process: Assessing relevant contracts: Determine if your arrangements with GPs are likely to be classified as relevant contracts and if you are considered to be "paying GPs" under PTAQ000.6.2 or PTASA003. This helps establish whether you fall within the scope of the amnesty. Exploring exemptions: Investigate any exemptions that could apply to practitioners, such as those working fewer than 90 days per year. These exemptions might significantly impact your liability and, for some, mean that they fall under the taxable wages threshold in their state. Financial exposure calculation: Calculate your potential financial exposure in the case of an audit. This generally involves assessing the period from July 1, 2018, to June 30, 2023, factoring in compounding interest and potential penalties up to 75% of the calculated liability. Professional consultation: Once you have quantified your potential worst-case liability, seek advice from specialised accountants and lawyers who understand the intricacies of payroll tax risk for health practices. If your likelihood of passing a historical audit is low, combined with high worst-case liability, participating in the amnesty will likely be a preferred option. Future planning & amnesty consideration: Consider the feasibility of making operational changes within your practice to avoid making payments that fall under the payroll tax purview in the future. This could involve redefining how you engage with GPs, ensuring GPs receive their own patient fees directly or altering your business structure. Final decision - Consider not participating: If you operate your practice in a way that does not trigger payroll tax relating to practitioners in the future, you may wish to forgo amnesty participation. This may be preferred if your historical liability is low and/or you do not want to make any disclosures to the State Revenue Offices. Remember that not participating in the amnesty means you may be subjected to historical compliance activity. OR Final decision - Consider participating: You may wish to participate in the amnesty to protect against a historical audit and large worst-case liability. You may use the amnesty period to make changes in your business, or you may consider paying payroll tax at the end of the amnesty period should your business model require or allow this. Remember that participating in the amnesty now acknowledges that you are currently "making payments" to contracted GPs. If you change your business, you will not be liable for payroll tax about GPs post-amnesty. In that case, you must opt-out and explain why payroll tax is no longer applicable. Among our GrowthMD client base, we have advised practices to participate and not participate in the QLD Amnesty. Before a final decision is made, a business case detailing the risks, financial exposure and pros and cons of the amnesty should be made by a knowledgeable accountant or legal adviser for each individual practice. Not eligible, or not taking the Amnesty? What you can be doing now. GrowthMD is working with practices all over Australia to ensure their businesses are well-equipped to manage the payroll tax challenges. Our current work includes the following. Patient fee flow & service fee arrangements: Many practices are moving away from collecting on behalf of practitioners and are transitioning patient fees directly to practitioner bank accounts. We expect more and more practices to follow this path post-release of QLD's v2 ruling released on 19 September 2023. We are assisting in coordinating the implementation of automated systems to collect service fees and implementing new financial workflows and reconciliation tools in place. Forecasting for the future: Health practices recognise the need for future planning regarding payroll tax exposure. We have been engaged to prepare forecasts and projections that account for changing business models. This includes discussions around engagement models under Voluntary Patient Registration and other grant or bundled funding and running comparison scenarios of the cost of alternate models of doing business or practitioner engagement. By assessing these scenarios, practices can make informed decisions. Business entity restructuring: The structure of your business plays a crucial role in determining your financial obligations and how you do business. We are working with practices in restructuring to ensure structures are fit for purposes and able to engage with practitioners in the intended manner. Skilled legal partners & commercial agreements: Navigating the legal intricacies of agreements between health practices and practitioners requires specialised expertise. We are collaborating with professional legal advisors to help draft agreements that accurately reflect the arrangements between the practice and the practitioners. Simultaneously, these agreements provide essential commercial protections for the practice, safeguarding against potential disputes and uncertainties. Take action With most Australian states aligned with how the payroll tax legislation will be applied to medical practices and the promise of future compliance activity, now is the time to address the risk for your practice. We encourage all practices to seek medical-specific independent professional advice. GrowthMD is working for your practice. Our team of specialist Chartered Accountants work with medical practices and payroll tax risk daily. If your current accountant is not offering proactive guidance on this important issue, now is the time to change. We are taking a limited number of new clients; please contact us to express your interest.

We want to provide our clients with important updates as we approach the end of the financial year (EOFY). HECS Indexation and Planning Each year, on June 1st 2023, HECS-HELP debts are indexed to the Consumer Price Index (CPI). In recent years, the indexation of these balances has not been widely discussed due to the CPI remaining under 2%. 2023, the CPI debt increase is expected to be around 7%. The balance will significantly increase, although interest is not applied to HECS-HELP debts. This presents an opportunity for voluntary repayments of HECS-HELP debts. While there is no discount for early repayment, paying off the debt before the June 1st indexation will help avoid the 7% CPI increase. This option may be particularly appealing for individuals close to finalising their debt and anticipate making a compulsory repayment upon lodging their tax return. Our GrowthMD accountants can assist you with the information to facilitate a voluntary repayment. Asset Write-Offs Reducing Over the past couple of financial years, small business has benefited from temporary full expensing (with no deduction limit) and an increased instant asset write-off of up to $150,000. Starting from July 1st, 2023, these accelerated deductions will conclude. Depreciating assets valued above $20,000 must be written off for tax purposes over their useful lives. If you are considering purchasing a substantial piece of equipment or any other asset valued above $20,000 in the near future, taking action before June 30, 2023, will enable you to bring forward an immediate tax deduction associated with the asset. It is important to note that the assets must be received and in use (or ready for use) before June 30, 2023. Merely placing an order for the asset without receiving it will not qualify you for the increased earlier deduction. GrowthMD Bookkeeping Services We are delighted to announce an exciting development for the upcoming financial year. Jollys Chin has joined our team to oversee our GrowthMD bookkeeping service, supported by two junior bookkeepers. We have limited openings available for new medical practice bookkeeping clients starting from July 1st, 2023. Our bookkeeping services will use the most up-to-date software and systems to efficiently and accurately maintain your accounts. If you are interested, please get in touch with Kelly McCormick for further information. End-of-Year Tax Tips Webinar On June 1st, Kelly Chard will be a special guest for the June HotDoc Education Webinar. The webinar will cover "Tax Time Tips for Your Practice," including information on tax breaks for EOFY 2023, electric vehicle concessions, and end-of-year planning checklists to ensure you are well-prepared for June 30th. Please register for the webinar here. Superannuation Deductibility If applicable, superannuation contributions are deductible when received by the employee's superannuation fund or the ATO clearing house (if applicable). We recommend making superannuation contributions before June 23rd, 2023, to ensure the payments are considered a tax deduction in the 2023 financial year. Please reach out to our team for any further EOFY questions.

Kelly Chard from GrowthMD and Ben Ryan from Avant Law were recently featured on the Medicubes podcast, where they delved into the confusing world of payroll tax for medical practices. This two-part podcast covers a range of topics that can help you navigate the intricacies of payroll tax. Here's a sneak peek of what you can expect to learn: Understanding Payroll Tax: Are you curious about what payroll tax is and who's responsible for assessing it in Australia? Kelly and Ben break it down for you, providing a clear understanding of this important tax and its implications. Recent Cases and Appeal Activity: Stay up-to-date with the latest developments. Discover how recent cases and appeal activities impact medical practices regarding payroll tax. Banking and Business Structure Impact: Did you know your banking and business structure choices can influence your exposure to payroll tax? Practice Considerations for Fee Flow Changes: Changing how patient fees flow to doctors? The podcast explores practical considerations for medical practices, helping you navigate potential payroll tax implications when making such changes. Professional Advice for Your Practice: The importance of professional advice cannot be overstated. Get valuable insights on seeking and utilising professional guidance effectively for your medical practice's payroll tax matters. Listen Now

Key Learnings: ✅ Structuring tax-deductible overseas conference travel ✅ What is and what is not considered work-related travel ✅ Food, entertainment & incidentals to claim while travelling ✅ Smart systems to track employee travel expenses

Many people ask us what is different about a specialised health accountant. I really think that the answer to this lies in the conversations and the extra value a health-specific accountant can provide to your business. Watch below for five conversations I recommend all business owners have with their accountants in 2023. If you are not getting the support you need please reach out to our team.

On May 9, 2023, Treasurer Jim Chalmers presented the Australian 2023/24 Federal Budget. The budget took a cautious approach, focusing on cost of living pressures, health funding, and strengthening tax compliance. Below are four updates relevant to our GrowthMD clients: 1. Small Wins for Small Business While the wins for small businesses in this year's budget are less impactful than in previous years, there are still some positive changes: Small businesses with a turnover of less than $10 million can now instantly write off assets of up to $20,000 if the assets are used or installed for use between July 1, 2023, and June 30, 2024. Small businesses can claim an additional 20% deduction up to a cap of $20,000 for depreciable assets that support energy efficiency and electrification if the assets are used or installed for use between July 1, 2023, and June 30, 2024. Examples of these assets are energy-efficient fridges and electric heating or cooling systems. This is available to businesses with a turnover of up to $50 million. Small businesses with a turnover of less than $10 million can participate in the lodgement penalty amnesty program, which applies to unmet tax obligations due between December 1, 2019, and February 28, 2022. Lodgement of these returns between June 1, 2023, and December 31, 2023, will not trigger late lodgement penalties. 2. Increased Future ATO Compliance Activity Revenue estimates from ATO tax compliance activity are among the largest revenue-raising items in this budget. Taxpayers should ensure their affairs are up to date and correctly managed in the event of future compliance activities. The activity funded in this budget includes: Expanded anti-avoidance provisions to apply to the taxation of foreign residents paying low rates of tax in Australia. A focus on GST compliance with funding for the ATO to develop more sophisticated analytical tools to identify risk. Expanded scope of the personal income tax compliance program, particularly focused on emerging risk areas of deductions around short-term rental properties such as Airbnb. ATO funding to deal with taxpayers with large tax debts or aged debt of more than 2 years. 3. Medicare Funding Increases Given recent awareness campaigns on the state of General Practice and Health in Australia, this area received significant funding in the 2024 budget. Of particular interest to our GrowthMD client groups will be: Introduction of the MyMedicare patient registration system, including a $2,000 upfront payment for registering a patient identified as a regular hospital ED user. Increases to the Workforce Incentive Payment, making the maximum payment $130,000 per practice. Increases to Medicare Rebates from November 2023. Creation of a Level E MBS item for consults over 60 minutes ($184 rebate). Tripling of the bulk billing incentive for select patient groups on select item numbers. Increased funding of telehealth for registered MyMedicare patients. Changes to the bulk billing incentive and patient registration funding should be carefully considered before changing your current billing and appointment policies. GrowthMD can discuss the financial impacts and analysis for your practice with you once full details become available. 4. Other Need-to-Knows From July 1, 2026, employers will be required to pay superannuation on payday, rather than quarterly. While there is a 3-year timeline to ready our clients for this change, it should be kept on the radar and factored into future business and cash model planning. Pay As You Go (PAYG) instalments will be increased by only 6% for the 2023/24 year, down from the 12% originally set in reference to GDP adjustment. This delivers a cash flow reprieve for business and investment-earning individuals or entities paying quarterly PAYG instalments. The Build-To-Rent Scheme will be available for construction projects of over 50 apartments and will provide increased capital works write-off deductions and decreased withholding tax rates. This scheme will primarily benefit developers and has significant restrictions involving a 10-year ownership term and 3-year minimum lease term. Do you have further questions on how the budget will impact you and your business? Please contact your GrowthMD accountant or call us on 07 3292 1158.

The Australian Tax Office has made a change regarding tax deductions for working from home. There are now two methods available for claiming a tax deduction for expenses incurred while working from home. Method 1 The first method is called the "actual method." This involves keeping all invoices and receipts related to running your home and calculating your deduction as a portion of your expenses. To use this method, you must have a part of your house set aside exclusively for work (staff working from your home, seeing clients at your home etc). This method will not be applicable to the majority of GrowthMD health clients. Method 2 The second method is the new "67 cents per hour method." This method allows you to claim a tax deduction by multiplying the number of hours worked at home by 67 cents. You can use this method to claim expenses such as energy, internet, phone, stationery, and computer consumables. Unlike the actual method, you don't need to have a specific part of your house set aside for work to use this method, and more than one person in your house can use it. Record-Keeping Requirements – Method 2 To use the new 67 cents per hour method, you must keep actual records of the hours you work at home from 1 March 2023. Looking ahead to the 2023 income tax return claim, this means keeping a daily record of the hours worked from 1 March 2023 to 30 June 2023. We suggest keeping a diary note (or a worksheet record) of the number of hours you worked each day. Additionally, you must keep at least one monthly or quarterly bill to show that you incur expenses (such as internet and electricity bills). If you have any questions about claiming a tax deduction for working from home, please reach out to your GrowthMD accountant. We are here to help you keep the required documents for this change and ensure that you receive the maximum tax deduction available.

QLD Payroll Tax Amnesty In early February, the QLD Government announced an intended “payroll tax amnesty” for medical centres making payments to General Practitioners. While the amnesty was initially seen as a welcome relief in the aftermath of PTAQ000.6.1 (Relevant contracts – medical centres), the subsequently released detail around eligibility for the amnesty may not be as pleasing. We recommend practices obtain individual legal and accounting advice before registering an expression of interest for the amnesty. Eligibility The Queensland Revenue Office website (updated 10 February 2023) and its expression of interest form state that medical practices that successfully apply for the amnesty will not be required to pay payroll tax on payments made to contracted GPs up to 30 June 2025, and for the previous 5 years. Other eligibility requirements include: The amnesty is limited to contractor payments made to GPs. For the purposes of the amnesty, a GP is registered as a general practitioner with the Medical Board of Australia. The amnesty may be available to medical practices that have: - Not been paying payroll tax on payments to contracted GPs - been, or currently are, subject to compliance activity in relation to payments to contracted GPs. The amnesty is not available to: - other medical doctors or allied health professionals - medical practices that are already complying with their payroll tax obligations - new medical practices Evolving Terms We reached out to the Queensland Revenue Office for clarification on some of the amnesty eligibility wording and received communication on 16th February 2023 noting that Government is still deciding the final terms of the amnesty. We advise our clients not to complete an expression of interest or registration application until the terms of the amnesty are finalised and understood. Proceed With Caution We are concerned about the current wording of the amnesty and whether agreeing to the amnesty terms is akin to nominating that the medical centre is indeed making taxable payments to contractor GPs, which will in the future be liable for payroll tax. We note that many medical centre entities are structured and operated in a manner where no payments are made from the medical centre to GPs for services. These entities seemingly do not fit the amnesty eligibility criteria and should be cautious in agreeing to criteria that do not reflect their actual conduct and operations. While it is understandable that many medical centres want relief from the threat of a large payroll tax liability, registering for the amnesty (based on the current detail) may run the risk of the practice unknowingly self-nominating themselves for future payroll tax liabilities once the amnesty period ends. We certainly hope this is not the case and the final terms resolve this concern, however, we suggest a cautious approach to registration in the interim. Further Advice We will continue to keep you updated on the evolving terms of the amnesty. For specific concerns please contact kelly@growth-md.com. We also encourage you to obtain further legal and individual accounting advice in relation to your practice arrangements, structure and payroll tax liability risk.

The QLD Office of State Revenue released PTAQ000.6.1 – Relevant Contracts – Medical Centres on 22nd December 2022. In a Nutshell (Our Interpretation) If applied, the OSR's position in this ruling will see more QLD medical centre entities assessed for payroll tax in relation to independent practitioners providing services from their centres The ruling does not contain new or altered application of the payroll tax legislation The ruling is the QLD OSR's interpretation of legislation and recent case law However, it does delve deeper and provides specific guidance on service entity and tenancy-type arrangements. The examples provide a narrower and stricter interpretation than previously published Office of State Revenue guidance The ruling implies a “typical” service arrangement, and many tenancy arrangements are viewed as relevant contracts by the OSR and therefore payments will be considered taxable wages and subject to payroll tax Examples are provided that are reflective of many current medical centre arrangements Trust account arrangements are likely to be ineffective in isolation Changing banking arrangements so that the medical centre does not collect fees is not in itself a solution to avoiding payroll tax liability Medical centres should re-consider if their arrangements with independent practitioners are likely to be classed as relevant contracts Relevant Contract - Medical Centre Setting Payroll tax liability is not restricted to situations where an employee-employer relationship exists. When amounts are paid to contractors under a “relevant contract” they are considered to be taxable wages unless a specific exemption applies. This ruling defines a relevant contract between an entity that conducts a medical centre and a practitioner when: the practitioner carries on a business or practice of providing medical-related services to patients in the course of conducting its business, the medical centre provides members of the public with access to medical-related services engages a practitioner to supply services to the medical centre by serving patients on its behalf an exemption does not apply. The relevant contract provisions were introduced in 2008 to capture payroll tax revenues lost when an entity engaged contractors rather than traditional employees. The relevant contract provisions in NSW, Victoria and QLD are substantially aligned. Ruling Key Points OSR Interpretation The detail in the ruling, in addition to the numerous examples shared, puts all medical centre operators on notice. Previous ambiguous or varied interpretations are effectively squashed by this ruling meaning that there is less confusion over where the line in the sand sits when it comes to audit activity and the OSR's position. It should be noted that this ruling is the OSR interpretation of legislation and recent case decisions only. However, in the absence of a test case that examines the legal basis for this interpretation, it appears that a medical centre providing services to independent practitioners under an agreement will likely be assessed for payroll tax in relation to the practitioner's services or payments. The onus will be on the medical centre to object to this payroll tax assessment. QLD Audit Activity As a result of consultation between the QLD OSR and various interest groups including AMA Queensland, written confirmation has been provided confirming audit activity in General Practice will be limited to the 2022 financial year and onwards. While this is welcome and provides some comfort around the size of potential audit liabilities, it still leaves a large portion of the health practice community exposed and vulnerable to audit liability and penalties moving forward. Exemption Eligibility There are limited exemptions, which are available on application to the commissioner. In our experience, the majority of medical centres and independent practitioner arrangements do not meet the exemption criteria. The exemptions are: 1. The practitioner provides services to the public generally 2. The practitioner performs work for no more than 90 days in the financial year 3. Services are performed by two or more persons Recommended Action All health practices should re-engage with legal and accounting experts knowledgeable in payroll tax application to health and medical centres. GrowthMD is working with other leading medical accounting and legal advisers in QLD to provide clear communication to health practice owners over the coming weeks and months. While we have always operated a payroll tax risk minimisation strategy for our clients, looking ahead we intend to work through various business model changes and reporting options available. Further communications will be circulated to our clients shortly. This information is general in nature. We encourage all readers to obtain specific legal and accounting advice. This information is based on our interpretation of the content examined and may change as further information becomes available.