An audit has uncovered "shortfalls" in the rapid rollout of telehealth services under the Morrison government.
In response to the COVID-19 pandemic, the former federal government between March and May 2020 introduced 281 new telehealth items on the Medicare Benefits Schedule (MBS).
This enabled Australians to access health services via videoconference and phone rather than front up to a doctor, specialist or allied health professional.
The service was extended three times and then made a permanent feature of Medicare in December 2021, totalling $4.4 billion in benefits to June 2022.
A report by the auditor-general released on Thursday found the expansion of telehealth MBS items was "informed by largely robust policy advice and planning".
"However there were shortfalls in the governance, risk management and evaluation of the expansion."
The report found there was "no implementation plan for temporary telehealth ... (and) the governance arrangements for the implementation of temporary telehealth involved inadequate assessment of the implementation and integrity risks".
"(The) health (department) did not plan for performance monitoring or evaluation of temporary or permanent telehealth," it said.
"Performance monitoring of the temporary telehealth expansion was limited and lacked measures and targets that could inform judgments about performance, and there was no evaluation that could assist with the design and implementation of potential expansions to telehealth during future emergency conditions."
The audit found in the case of the initial temporary plan, the health department presented only one option for the government, which was "partly compliant with Australian government budget policy", while there were five detailed options put forward for the permanent system.
State and territory governments were involved in high-level discussions, but were "largely not consulted on the details of changes to MBS items".
As well, a key Indigenous peak body was not involved in stakeholder meetings where the specifics of the plan were discussed, the audit found.
The health department fully agreed with three recommendations out of the audit, including better planning, risk assessment and a full evaluation of the permanent telehealth system.
"The Department of Health and Aged Care acknowledges the ANAO findings while also recognising the unique scenario of the COVID-19 emergency health response," it said.
"The department delivered on its objectives to maintain patients' access to essential health services throughout lockdowns as well as reducing risk of transmission for patients and providers."
A review of the scheme, sought by Health Minister Mark Butler after Labor was elected last year, is due to report in late 2023.