17 July 2019

AMA rejects specialist fee change plan

AMA MBS Policy Remuneration

The AMA strongly opposes changes to specialist fees recommended to the MBS Review Taskforce that would stop patients being sent back to GPs for repeat referrals.

The Specialist and Consultant Physician Consultation Clinical Committee has proposed replacing the “initial” and “subsequent” attendances with time-tiered items similar to those in place for GPs. This is intended to remove the incentive for specialists to seek a new referral in order to claim an initial attendance, which is worth 30% to 50% more than a subsequent one.

The RACGP supports the recommendations, with President Harry Nespolon telling The Medical Republic that this abuse of the system was “incredibly annoying” and a waste of GPs’ and patients’ time.

The committee identified almost 230,000 incidences of repeat initial attendances within nine months, saying patient complaints were “common”.

Representing the views of 11 physician and surgeon groups (including the Council of Procedural Specialists, which represents many more), the AMA’s submission lists eight arguments against, including that “time does not equal complexity”; that time tiering “devalues efficiency and quality”; and that “cases of inappropriate claiming should not be addressed by wholesale change”.

“This ‘one-model-fits-all’ approach does not recognise the benefits of the current MBS structure for this group of medical practitioners and their patients,” it says.

The AMA says specialist consultations “differ greatly to GP consultations, in terms of complexity”, and that the changes will incentivise specialists to take on less complex cases.

Inability to predict the length of a consultation will make informed financial consent harder to obtain, it adds.

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lou lewis
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lou lewis
2 months 5 days ago
So, the AMA is opposed to the changes to specialist fees recommended to the MSB Review Taskforce, but, as expected, the RACGP is in favour of the recommendations. But no one has really addressed the elephant in the room, namely the almost 230,000 incidences of repeat initial attendances within nine months uncovered by the task force. If it were a GP who so flagrantly ‘defrauded’ Medicare, and let’s be blunt about it, this is nothing less than fraudulent, or at the very least inappropriate billing, they would be hauled before the courts charged with defrauding Medicare. Maybe it is true… Read more »
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