Uber’s High Court loss: what it means for medical practice owners

On 4 November 2026 the High Court dismissed Uber’s appeal against the judgement ordering Uber to pay approximately $81 million in payroll tax to the NSW Revenue Office. While the case is about rideshare drivers, the Court provided some helpful insights for medical practices. Particularly those practices that may be utilising a clearing account.

Uber argued it was only a “limited payment collection agent”. It collected fares, kept a service fee and passed the rest to drivers, who were independent businesses. The High Court rejected this.

The majority said the label did not decide the matter, rather, it was the substance of the contractual rights and obligations. The Court focused on three things:

• Obligations owed to Uber: Drivers agreed with Uber to transport riders to their destination, to meet standards of conduct and vehicle condition, and to risk losing app access if they didn’t. This meant they supplied services to Uber as well as to riders.
• Control over the money: Uber could adjust or cancel fares unilaterally. That was inconsistent with it being a pass-through or ‘clearing account’.
• Payments linked to work. The fare and Uber’s fee were both calculated from the trip, so the payments were “for or in relation to” the driver’s work and were deemed wages.

Many practices utilise ‘clearing accounts’ to collect patient or Medicare payments, deduct a service fee and pays the balance to the doctor. In circumstances where a contract was deemed to be a ‘relevant contract’, payroll tax was then applied to these arrangements – this is consistent with the position in Optical Superstore in Victoria and Thomas and Naaz in NSW.

The High Court did not overrule either case. The Chief Justice relied on Thomas and Naaz as an example of payments caught even where the doctor is entitled to the money, and the Court’s treatment of Optical Superstore was the same.

Questions to ask about your arrangements

1. What does the agreement require of your doctors (if anything)? Obligations owed to the practice about standards, policies or how services are delivered will create similarities to Uber. The Court gave this weight, though it did not decide how far the principle reaches.
2. Who controls the money? If the practice collects fees and can adjust, withhold or reverse them – or otherwise has ‘control’ over the funds – this will also draw parallels with Uber.
3. Is the agreement with the doctor clear and consistent with other terms? If your agreement is not consistent with the relationship you portray publicly with the doctors, there could be an exposure. The Court said labels are relevant, but not decisive.

Have your agreements reviewed, consider your flow of funds, and review your websites, policies and forms to ensure consistency.

If you have any questions, or would like more information about how we can assist you or your practice, please call 1800 867 113, or to organise a confidential discussion at a time that suits you, please click here