Jun 10, 2021

Government in danger of history repeating with Medicare rebate changes

Medicare

More than 900 Medicare Benefits Schedule (MBS) items for rebates for private surgery are set to change on 1 July as part of the MBS Review of all 5,700 Medicare rebates.

The latest changes will affect rebates for orthopaedic surgery, general surgery and heart surgery.

“The AMA is concerned that the private healthcare sector – including health funds, hospitals, doctors and patients – will not be ready for the 1 July changes due to poor implementation by the Government,” AMA President, Dr Omar Khorshid, said today.

“We had enough problems in November 2018 when the first tranche of MBS Review changes resulted in private health insurers, through no fault of their own, not having their schedules updated in time.

“That meant that no-gap arrangements were not possible or were significantly delayed leading to uncertainty for doctor and patient alike.

“Patients were left out of pocket, spinal surgeries were delayed, and doctors couldn’t provide patients with informed financial consent about potential gap fees.

“Those changes involved replacing 70 spinal surgery items with 60 new items.

“The 1 July changes involve expected changes to 594 orthopaedic surgery items, 150 general surgery items, and 188 cardiac surgery items.

“After the spinal surgery debacle, the AMA and the private health sector told the Department of Health that six months’ lead time is needed ahead of MBS changes.”

“This will put significant financial and operational risk on health insurers and private hospitals, and leaves doctors and patients scrambling and confused about what and how to bill against Medicare and private health insurance policies come 1 July. We simply don’t know what the rebates from funds will be, as they haven’t had the time to prepare and release them in advance – including for surgeries already booked for next month.

“The AMA and other medical groups have worked in good faith with the Government and the MBS Review Taskforce since 2015 to ensure that Medicare provides value to patients and taxpayers, and that it continues to be sustainable.”

“However, giving the sector just weeks instead of months to change over its entire system to support almost 1,000 changes leaves the health system and patients at risk.

“The Government’s reminder to doctors to consider patients’ circumstances when charging fees misses the point. At the moment there’s no way for doctors to know if they are charging a gap due to the chaos caused by the Department’s poor implementation.

“The AMA is calling on the Government to urgently commit to changing the process going forward to avoid past problems, and ensure that this massive change to MBS rebates occurs without disruption to patient care.

“We are also calling on the Government and private health insurers to safeguard patient private health insurance rebates, to ensure that they are not worse off financially, for undergoing orthopaedic, general or cardiac surgery after 1 July due to implementation issues with the MBS.”

Leave a Reply

Your email address will not be published. Required fields are marked *

Advertisement
Advertisement
Advertisement

Peak bodies unite before Christmas to warn of looming aged care crisis

  Australia’s aged care peak bodies have issued an urgent plea to the government for “urgent funding” to avoid a crisis in the aged care sector. According to a survey conducted by the peak bodies, around 15 per cent of aged care providers say they may need to close their doors within the next 12... Read More

Resident Death: Should All Family Members be Notified?

The death of a family member can be one of the most significant and difficult moments of a person’s life. Unfortunately, the finality of death assures that there will be no second chances regarding your opportunity to pay your respects, or do what you feel is necessary to honour a person’s passing. Aged care facilities... Read More

When vaccinating 26 million Australians, expect a mistake or two. But we can minimise the risk of repeating Queensland’s overdose incident

It emerged today that two aged-care residents in Brisbane were given an incorrect dose of the Pfizer vaccine — more than the amount recommended. The 88-year-old man and 94-year-old woman were receiving their vaccinations yesterday as part of the first phase of Australia’s vaccine rollout, which began this week. Both residents are being monitored, but haven’t shown any signs of adverse reactions so far. Read More
Advertisement