Last-minute reprieve for specialist telehealth items?

The Federal Government is reconsidering plans to cut Medicare funding for phone consults and create a telehealth ‘speed limit’ for specialists amid complaints from doctors’ groups.

Protests are growing over the plan, scheduled for next Friday, to remove all specialist phone consultations from the MBS, except a single item for “minor attendances” with a rebate of $38.60.

Phone items for initial and subsequent attendances, along with those for complex attendances (equivalent to MBS items 110, 116, 132 and 133) will be scrapped.

And restrictions will simultaneously be introduced on the maximum number of MBS phone consults any specialists can claim per day.

This means a doctor will be automatically referred for investigation by the Professional Services Review (PSR) if they provide more than 30 phone services daily more than 20 times in a year.

Originally planned for the beginning of the year, the changes were postponed in January by the previous government after concerns were raised about rising COVID-19 case numbers and the Omicron variant.

Now, Minister for Health Mark Butler says it is possible they could be delayed again.

“The Albanese Government has sought advice about options to extend these temporary Medicare items beyond 30 June,” he told the limbic.

“This consideration includes compliance measures related to telehealth.”

AMA vice president Dr Chris Moy said it was clearly the wrong time for cuts.

“We have brought this up with him. COVID-19 has not gone away and we need to be able to practice in a safe manner, particularly considering that it is winter and transmission will again be on the rise,” he said.

Labelling the planned restrictions on phone consults “primarily a cost saving measure”, he said it was obvious they would result in reduced access for patients.

“But essentially, the conditions which triggered the need for telehealth still remain and will continue doing so while we live with a large number of people with COVID-19 in the community,” he said.

“The minister and the department are both aware of that fact and I’m glad it is being considered.”

RACP president Dr Jacqueline Small called on the government to commit to maintaining the items.

“If the MBS phone items are not carried forward beyond June 30, it will be the elderly, those with less advanced technical knowledge, some Aboriginal and Torres Strait Islander people, some people living with disability, and people in rural and remote locations – who will suffer,” she said.

“Phone consultations are preferred by many patients or necessitated by patient-specific circumstances such as old age, fragility, intellectual disabilities, less advanced technical knowledge, low bandwidth, geographical barriers, and inability to access in-person care.”

“Telehealth is critical in ensuring they can continue to receive the care and medical support they need.”

MBS telehealth changes for consultant physician attendances (items scheduled for removal shaded in green)

Service Face-to-face item Video item Telephone item
Initial attendance 110 91824 91834
Subsequent attendance 116 91825 91835
Minor attendance 119 91826 91836
Complex initial assessment (at least 45 minutes) 132 92422  92431
Complex subsequent assessment (at least 20 minutes) 133 92423 92432

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