Medicopolitical

GPs furious over government delay tactics on ECG items


GPs have expressed anger at the government’s continued refusal to reinstate MBS items for ECG interpretation, following the release of an official report that backs their case.

The RAGCP has accused the government of ‘kicking the can down the road’ after it ignored recommendations made by Medicare’s ECG Review Committee to reverse the 2020 changes to MBS plain ECG items that saw GPs reimbursed only for an ECG trace item.

Instead, the government said it would conduct yet another review via the MBS Reviews Advisory Committee once a further 12 months of Medicare data become available.

The report showed there had been a 16% reduction of ECG MBS claims (out of hospital) following the 1 August 2020 changes and an average increase in out-of-pocket expenses for ECG of almost $5.

“On the basis of this decline in services and increase in out of pocket costs, the Committee concluded that the changes to MBS ECG items may have contributed to a reduction in ECG services with costs representing a barrier to patient care,” the report authors said.

“The Committee was concerned that this may translate in the long term to poorer health outcomes,” they added.

However the Committee said that it had been difficult to assess the impact of the changes because of other variables such as the COVID-19 pandemic and a reduction in face to face consultations with the advent of telehealth services.

Nevertheless, the RACGP said the report findings confirmed its concerns that the item changes had created barrier to patients accessing ECG investigations by restricting them to cardiologists.

“Since August 2020, patients are only eligible for a Medicare item for ECG tracing in general practice and are not able to claim for tracing and reporting. This is despite the fact that GPs perform interpretation, report results in our patient records and determine what needs to happen next without needing to refer to another specialist for interpretation and reporting,” said RACGP president Professor Karen Price.

“What this means in practice is that patients have to access ECGs via more expensive non-GP specialists and therefore face higher out-of-pocket costs – something that is often completely unnecessary.”

The final reports recommendations were to provide access for all medical practitioners (thereby allowing access for GPs) to the trace and clinical note item (11714) with an increase to the daily number of services claimable. It also recommended introducing a new item or amending existing ECG trace and report item 11704 for specialist/consultant physicians to access a trace and report item which can be claimed with a consultation item.

Professor Price said the federal government’s refusal to act on the repot recommendations and instead conduct another review was deeply disappointing.

“The independent inquiry commissioned by Health Minister Greg Hunt tells us everything we need to know,” she said.

“Conducting another review is just kicking the can down the road …they have got this one wrong; we should be investing in general practice so that GPs can take on services like this that save lives and keep patients out of the hospital system.”

In its response to the report, the Department of Health claimed that the Committee’s comments about variables showed the decline in ECG services could not be attributed to the MBS changes alone.

“The Government has therefore instructed us to carry out another review of the plain ECG items once another 12 months of data becomes available,” it said

The review would be undertaken by the newly established MBS Reviews Advisory Committee (MRAC), with the Department saying the deferral would allowing claiming patterns to settle from the impacts of COVID-19,  provide a clearer separation from the 1 August 2020 changes and provide greater opportunity to review health outcomes data, which was not available to inform the first review.

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