Sports and exercise physicians say a “misclassification” by Medicare has left them unable to access chronic care items available to other physicians, preventing many patients with chronic conditions who would benefit from accessing their care.
The Australian College of Sports and Exercise Physicians (ACSEP) is now mounting a push for access to the Medicare’s Chronic Disease Management (CDM) items, arguing the current situation is inequitable and is stopping them from bulk billing patients.
ACSEP says currently their patients can’t claim their consultation under CDM items which offer rebates of $224.35 for an initial consult and $112.30 for a follow-up, and instead can only access rebates of $72.75 and $36.55 respectively.
ACSEP’s research committee member Dr John Orchard said the net result is only wealthy patients can afford to see sports and exercise physicians.
“There is a lot of evidence that exercise is first line for many of the chronic conditions osteoarthritis, back pain, cancer, depression, diabetes, obesity, cardiovascular disease. Yet the specialists in exercise treatment aren’t able to access that scheme,” he told the limbic.
“Almost every physician gets the same rebate for chronic care consults,” he said. “We just want it to be equitable.”
The anomaly stems from Medicare not recognising sports and exercise medicine as a physician speciality, even though they “match every definition”, said Dr Orchard.
The relatively young speciality was recognised by Medicare in 2010, at the same time as sexual health and addiction medicine were, but while the latter two were “upgraded” to physician status in 2016, SEM was left behind.
It will now take a determination by Health Minister Greg Hunt to change the status quo, a move that is both important and the only equitable solution, argues Dr Orchard.