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Health assessment items: wait for clear advice continues

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The Federal Government is yet to issue a full and clear statement confirming that the time spent by practice nurses assisting in the preparation of patient health assessments can be included in the Medicare rebate claimed by GPs.

While the Department of Health has provided assurances that there was no intention to change existing arrangements when the wording of advice from the Department of Human Services was changed, the AMA is still waiting on clear advice from the Government affirming that this is the case.

In his regular GP column in this edition of Australian Medicine, Dr Brian Morton, Chair of the AMA Council of General Practice, said that although the episode appeared headed to a satisfactory conclusion, it emphasised just how easily poor decisions and misconceived ideas could arise when Governments neglected to consult with the medical profession.

“It is hard to understand what the Department was thinking when it decided to change established arrangements without consultation with the profession,” Dr Morton said. “Apparently, they didn’t think revising the 2010 Health Assessment Factsheet, which made it clear that nurse time counted, was that significant.”

Instead, it was left scrambling to try to rectify the error, botching the first attempt at providing a clarification.

“In a classic case of Yes Minister, the Department of Health was quick to respond with a clarification that suggested DHS had got it wrong,” Dr Morton said.

“However, its advice that a practice nurse may assist a GP with performing the health assessment offered little comfort to GPs around the country. A plain English statement along the lines of ‘Yes, nurse time counts’, would have provided more comfort.”

In a sign that the Health Department had heeded doctor concerns, it issued a statement that “both GP and practice nurse time can be used to decide which Medicare item would be the most appropriate to bill Medicare for a particular health assessment”.

Dr Morton said this had provided a welcome assurance that the Department was working to end the uncertainty, and was working hard to “get the wording just right”.

“The AMA remains committed to working with these departments regarding the interpretation of MBS items, and this episode should be a clear lesson to them both about the importance of consulting with the profession about how the MBS works before publishing material that overturns accepted practice and interpretation,” he said.

Adrian Rollins