Changes to the Medicare scheme could trigger “chaos” for patients, doctors and insurers the Australian Medical Association (AMA) has warned ahead of a major overhaul.
More than 900 Medicare Benefits Schedule (MBS) items including general, heart and orthopaedic surgery rebate will change on 1 July following a major Medicare review.
However, health funds, doctors, hospitals and patients are not yet prepared for the changes, the AMA warned on Sunday.
“Less than one month out from the implementation of these changes, and we still do not have all the information we need to assess and change over our schedules and payment processes to reflect the changes,” AMA president Dr Omar Khorshid said.
He said “poor implementation” by the Government was to blame, and that patients could be left out of pocket.
Dr Khorshid said poor organisation and insufficient detail meant private health insurers were unable to update their schedules in time for the first set of changes in 2018.
Ahead of the 1 July changes, the AMA is concerned about “history repeating”.
“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,” Khorshid said.
“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.”
He said the 2018 “debacle” showed the sector needs six months to prepare for MBS changes.
However, he said that less than a month out from the next set of changes, the sector faces an even more complex task.
“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,” Khorshid said.
“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.”
Health Minister Greg Hunt said his department had worked “very constructively” with the sector to establish the MBS changes.
He said many of the changes were first flagged in the 2020 Budget, which was released in October.