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Doctors support Medicare changes
Australian – Wednesday, 9 Jun 2021 – Page 4

Doctors have welcomed changes to Medicare Benefits Schedule item numbers despite a campaign against the changes by Labor, but some surgeons say further tweaks to the system will be required in coming months.

The support of key medics comes as the federal government brokered a deal with the Australian Medical Association for postimplementation monitoring of the MBS changes. The government is also promising to expand its out-of-pocket costs website and provide more information for patients on private health insurance rebates coinciding with the Medicare overhaul.

In return the AMA has accepted the Medicare changes commencing on July 1 as clinically appropriate, including new items for plastic and reconstructive surgery.

Under the changes, there are sweeping reforms to MBS item numbers for general surgery procedures , orthopaedic surgery and cardiac surgery. The changes follow the final report of the Medicare Benefits Schedule Review Taskforce in December last year.

The changes to interventional cardiac services consolidate what used to be a large number of different MBS item numbers into one item number for each patient procedure that depends on whether the doctor is treating disease in one, two or three vascular territories of the heart, for example.

Doctors will also need to provide the reasons they are undertaking a particular procedure on a patient.

Michael Feneley, a spokesman for the Cardiac Society of Australia and New Zealand, said the new item number procedures – known as appropriate use criteria would also guarantee that taxpayer money was being spent appropriately on cardiac services.

“What it means is, instead of just describing what you do and getting paid for it, the reasons that you do it are actually part of the structure of the item number,” he said.

“It means we’re being very clear when it’s appropriate to do something and when it’s not.”

The Australian Orthopaedic Association also says it is broadly supportive of the Medicare changes.

However, the AOA is disappointed that some hip arthroscopy procedures will no longer attract Medicare funding, and it says newer procedures for the wrist, the hand and the shoulder have not been recognised . The changes to hip arthroscopy item numbers were recommended by the Medical Services Advisory Committee over concerns item numbers were being misused.

AOA president Michael Gillespie said: “We’re broadly supportive of the MBS changes because there were a lot of obsolete numbers that did need to be reviewed and there is a lot of new technology that wasn’t captured by some of the old descripts.

“But we are concerned that some of the new numberings do not reflect the techniques that are of a proven benefit that are omitted altogether.”

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