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Patients, hospitals to carry the cost of MBS Review


Patients and hospitals could be left carrying the tab if the Federal Government pushes ahead with plans to fast-track the removal of items from the Medicare Benefits Schedule while leaving the approval of new procedures and services languishing in the slow lane, the AMA has warned.

The AMA has told the Government its current controversial approach to the MBS Review not only puts the support of the medical profession at risk, but could result in patients losing Medicare rebates for services they need and instead winding up in public hospital.

Under Government plans, MBS Review Taskforce recommendations to scrap or modify existing Medicare items will go straight to Health Minister Sussan Ley for approval, while adding new services and procedures will be put in the hands of the much slower moving Medical Services Advisory Committee process.

AMA President Professor Brian Owler said this two-tiered approach would leave the MBS disjointed.

“The process outlined by the Taskforce will lead to a fragmented MBS because items will be removed and minor amendments will be made quickly, while any new items to reflect modern practice would languish in the slow-moving Medical Services Advisory Committee pipeline without being added,” Professor Owler said.

Instead, the AMA has recommended there be a single, comprehensive update process in which the Review’s 35 proposed clinical committees and working groups would make recommendations on both the removal and modification of existing items, and the inclusion of new items.

Related: It is not about savings, honest: Minister reassures AMA on MBS review

The peak medical group admitted this would be a lengthier process than that suggested by the Taskforce, and would involve a broader remit for the clinical committees than is currently envisaged.

But Professor Owler said it would be an efficient and transparent process that would produce “a modern MBS that reflects high quality, contemporary medical practice”.

“It is vitally important that the process is rigorous, and ensures that the initial set of findings is tested sufficiently with the relevant medical groups to rule out unintended consequences,” he said. “The AMA is proposing a process that would be more efficient and transparent, and which would be more likely to be support the clinical services that patients need.”

In its submission to the MBS Review Taskforce on its recently-released Consultation Paper, the AMA bemoaned recent attempts by Ms Ley and Taskforce Chair Professor Bruce Robinson to frame the process in terms of cost-cutting by claiming that 97 per cent of MBS items have never been assessed for their clinical effectiveness, and that 30 per cent of health spending is wasted.

“The Government does not need to justify the Review on such spurious grounds,” the AMA submission said. “A review of the MBS has the support of the medical profession because the MBS is in desperate need of updating.”

The AMA said the Review should be undertaken free from preconceptions or savings targets, reiterating that a process driven by arbitrary cost-cutting, or which diverts money from health into general revenue, would not be supported by the medical profession.

It said that for the Review to have the profession’s full confidence, it must emphasise patient care, deliver a schedule that reflects modern medical practice, and which supports the informed choices of patients.

View the AMA’s submission to the MBS Review Taskforce on its Consultation Paper.

Adrian Rollins

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