Kept in the dark, doctors are losing confidence in MBS Review process

Medical politics

By Tessa Hoffman

20 Nov 2018

Dr Tony Bartone

The AMA warns it is losing confidence in the MBS Review process because specialists are being excluded from consultations and kept in the dark on new fee schedules.

AMA president Dr Tony Bartone has accused the MBS Taskforce of giving specialist groups unreasonable timeframes of just a few weeks or months to provide feedback on proposed item number changes, and with some key groups excluded from consultation altogether.

The AMA is also upset about the lack of transparency and rushed implementation of new fee schedules, leaving insurers and specialists in disarray when it comes to setting fees at the no or known gap levels.

Dr Bartone says the MBS Taskforce’s Clinical Committees spend years working on MBS item revisions but then dump numerous reports simultaneously out for consultation, expecting doctors to respond at short notice.

In a letter to the MBS Taskforce Chair Professor Bruce Robinson, he asks for extensions to deadlines for feedback on MBS item reviews and also more time for doctors and insurers to work through the details of fee schedules.

“The AMA has heard of significant dissatisfaction amongst the craft groups regarding the unreasonable timeframes,” Dr Bartone said.

“The AMA therefore, urges the taskforce to be flexible on the consultation timelines, as is reasonably practical, to ensure proposed changes are based on robust clinical and profession feedback.”

He also protested that MBS Review reports were only being circulated to a select few ‘targeted’ groups and individuals.

“Glaring” omissions during consultation included the oncology review’s failure to consult with the Royal Australasian College of Surgeons and the colonoscopy review excluding the Australian Private Hospitals Association.

Dr Bartone called for all MBS Review reports to be made publicly available online as soon as they are completed.

“This will ensure transparency of the review process, that relevant craft groups are not unintentionally missed, and that multiple clinical committees with overlapping issues and specialties can be cross referenced for accuracy and consistency.”

And the rushed introduction of new MBS item numbers was leading to financial chaos, he added, because health funds and specialists were not being given enough time to amend fee schedules.

Inconsistencies in fee schedules could impact patients, who end up with “fee shock”, paying higher out of pocket costs, warned Dr Bartone.

“AMA members are upset because they don’t know what to charge under particular insurance arrangements or insurers gap schemes, and therefore can’t do an informed financial consent,” he said.

“How do I know this? Well that’s what is happening right now with the 1 November changes.”

The AMA has called on the government to increase the lead times it provides before new MBS items take effect, to allow insurers and the medical profession time to study what the changes are and how they relate to the previous items.

It has also requested a roundtable with government and health funds to discuss what else may be required to protect patients from the potential of out of pocket expenses during the interim period.

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