Important Information - Bupa Medical Gap Scheme


Within the last few days, BUPA Health Insurance has announced a range of changes to its Medical Gap Scheme, to be introduced on 1 August 2018. 
The ASA is analysing the full implications of this and a number of other changes, and will keep members updated. Click here to view the full details of the BUPA 2018 Medical Gap Scheme.
Note: Members need to sign in the ASA members portal with their credentials to view the information. 

Drug shortage reported for DANTRIUM® powder for injection 20 mg vials AUST R 14435

We have been notified by Pfizer Australia that there is a supply shortage for the registered product, DANTRIUM® powder for injection 20 mg AUST R 14435, due to continued manufacturing delays. It is expected to resume mid-March 2018. Under the Section 19A of the TGA Act, there is an alternate product, Dantrium® Intravenous 20 mg powder for solution for injection vials [Norgine], for use in the meantime. More information can be read here.

Drug shortage reported for Metoprolol tartare 1mg/mL

We have been notified by LINK Healthcare that the supply for Australian registered metoprolol tartrate IV 5mg/5mL injection is in shortage.
Under the Section 19A, LINK has arranged the supply of an alternative product - METOPROLOL CARINO (metoprolol tartrate) 1mg/mL solution for injection, 5mL ampoule, registered and marketed in Germany. More information of this drug shortage and alternate supply can be read here.

New ASA RVG Unit Value

The ASA Board has approved an increase in the Relative Value Guide (RVG) unit value. The new suggested ASA RVG unit value is effective 1 November 2017. 
To find out more, sign in to our member's portal with your username and password and click here

ASA Engagement in the MBS Review

Since the MBS Review was first announced in 2015 the ASA has been active on behalf of members. Below is a summary of the level of engagement. 

For the full commentary including relevant documents please click here.


The full commentary and documents are available for ASA members only. If you are not a member but would like to become one, please apply here.

Read a short summary below

Introduction

Since the announcement of the MBS Review in 2015, the ASA has been actively campaigning on behalf of our membership. The ASA has approached the MBS Review Taskforce, the Federal Minister for Health, and their departments in pursuit of a fairer deal for all patients in Australia. Our delegations have always encouraged a more equitable and transparent process during our many meetings and submissions. During this time, the ASA has been represented at twelve important meetings. Those have been with the MBS Review Taskforce Chair and representatives, ANZCA, AMA, two Federal Health Ministers, the Prime Minister’s Office senior health advisor, the Opposition Leader, and the Federal Shadow Minister for Health. Our ASA senior delegation and the ASA MBS Review Subcommittee partook in these meetings, submissions, and letter writing. All activities have been communicated to our membership via our regular President’s enews, ASA magazine and social media. 


2001 The Turning Point – ASA RVG Introduced

The ASA RVG was introduced into the Medicare Benefits Schedule (MBS) after a 30-year campaign by the ASA in 2001.

2015 The MBS Review Announced

The Federal Minister for Health approved the modernisation and review of the MBS with accompanying stakeholder’s forums. More than 5,700 items were considered of which 70% have not been amended since their creation. As part of this process a Taskforce Chaired by Professor Bruce Robinson was set up with the undertaking of creating over thirty different clinical committees. Committee chairs and members were appointed by the MBS Review Taskforce from their direct selection and from various nominees.

2016
The Anaesthesia Clinical Committee (ACC)

ACC is announced. No one nominated by the ASA selected for the ACC or any of the other clinical committees. The ASA intensified its advocacy with several submissions and meetings with Taskforce representatives, the College and the Prime Minister’s Office senior health advisor.

2017 Preparations for the ACC Report

ASA advocacy had resulted in twelve important meetings with all major stakeholders accompanied by written submissions and letters. A new Federal Minister for Health was installed in January and after great effort the ASA managed to achieve a face to face meeting in August. ASA MBS Review Subcommittee meets on 17 Sept 2017.

MBS Review session on Sunday October 8, 2017 ASA NSC

  • 13 Oct 2017 - ASA delegation meets with Dept of Health representatives in Canberra.
  • Rebuttal to draft ACC Report prepared/submitted
  • Draft alternate Report prepared/submitted

Nov 2017

ASA has a second meeting with ACC representatives 
29 Nov 2017 - ACC ASA Teleconference

Dec 2017

ASA meets with Minister Hunt’s senior adviser in Canberra 

Thank you

The ASA would like to sincerely thank the speakers Dr Jo Sutherland (ACC Chair), Ms Helen Maxwell-Wright (ACC Consumer Representative) and Dr Mark Sinclair (ASA Economic Advisory Committee Chair) for presenting at this session and taking questions from the at times, quite passionate audience.

Next Steps

So far, the ASA has been represented in ten forums and twelve important meetings with Taskforce representatives, ANZCA, AMA, two Federal Health Ministers, the Prime Minister’s Office senior health advisor, the Opposition Leader, and the Federal Shadow Minister for Health. At this point, there is no clear indication when the Draft Report for anaesthesia will be available for public comment.

The ASA will continue to inform its membership as to our progress.



AMA supports ASA in MBS Discussions

Date: 7 September 2017

Many of you would be aware of the concerns surrounding the MBS Review of Anaesthesia items, which were raised with me via AMA Federal Council representatives, members and colleagues. 

Whilst the AMA maintains the policy that the Colleges, Associations and Societies (CAS) are best placed to respond to specific clinical and practice issues relating to the MBS, I have always sought to engage with the profession on broader issues of patient safety and proper process. These are issues the Government cannot ignore and where the AMA’s independent opinion has great impact.  

Thankfully, I can report that Minister Hunt has been consultative and highly engaged with the health sector. He and I speak most weeks and I believe he genuinely wants to be across the complexities of his portfolio.

A testament to his commitment is the result of recent conversations Minister Hunt and I had about the draft Anaesthesia MBS recommendations, where we discussed their potential impacts in depth. I am pleased to report that the Minister’s understanding of the profession’s views has translated into a productive outcome.

The Australian Society of Anaesthetists and the Minister are now discussing a way forward, hopefully to resolve their concerns with the MBS review.

The AMA will continue to broadly support the MBS reviews, and without hesitation intervene when recommendations introduce limitations that jeopardise patient safety or access to care, undermine overall clinical opinion or have restrictions that run counter to evidence-based best practice. We will also continue to highlight where we are aware there are concerns and even disagreement within the profession.

We will work to ensure relevant CAS organisations are aware of and engaged in the relevant MBS Review consultations and encourage their members to engage with the reviews and shape the narrative.

For example, the Obstetrics review both delivered in terms of increased funding to the sector and asking of doctors enhanced and evidence-based measures to improve patient care. The After Hours review demands accountability and a higher standard of care for patients.

Whilst there is much work ahead with the MBS reviews, I look forward to continuing a constructive relationship with the Government, representing the entirety of the profession throughout the process.


Dr Michael Gannon 
Federal President, Australian Medical Association (AMA)


MBS Review update from David M Scott
Date: 15 August 2017

As you may be aware, the ASA has held deep concerns with the MBS Review’s Anaesthesia Clinical Committee’s (ACC) report and recommendations. The MBS review was set up to modernise the schedule, to delete out of date item numbers, to improve access for private patients and to ensure value for taxpayers.

From the presentation made at the ASM in Brisbane by representatives from the ACC, we believe the ACC report does not meet these criteria. We are concerned that the ACC may have made recommendations for significant cuts. We have seen no evidence or science to support these cuts. We expect these recommended cuts will significantly disadvantage over a million patients who traditionally were billed at no out of pocket. It also concerned us that there has been no meaningful consultation with the ASA, ANZCA, or any of the Special Interest Groups.

The Medicare rebate system is there to reimburse patients who choose to access private healthcare, for their out of pocket costs (OOP). Medicare does not pay doctor’s bills, patients do. For many procedures like endoscopy and cataracts the rebates from Medicare and insurers have almost always been adequate to cover these costs, however if the cuts to Medicare recommended by the ACC are adopted then this group of patients will be facing a new OOP.

The ASA has been actively engaging with Government Ministers, Department advisors, leaders from gastroenterology, ophthalmology, obstetrics and psychiatry, and the AMA at the highest levels to advocate for our patients to ensure that their rebates are not slashed.

On August 9th, I met with the Health Minister Hon Greg Hunt, along with Dr Andrew Mulcahy and Associate Professor Alicia Dennis, to express our concerns. The Minister has recommended a further working group to address these concerns and ensure a broader key stakeholder engagement. It is his intention that the recommendations be fine-tuned to adjust the tone and recommendations of the draft report to ensure the best outcomes for our patients. The working group will include senior representation from the ASA and College and will consult with other experts in the field. Once the draft report is re-worked it will be delivered to the minister for consideration and release for public consultation. Members are advised that an MBS Review session will be staged as part of the upcoming NSC in Perth, and I would encourage everyone to attend that session.

I take this opportunity to express my gratitude to the President of the AMA Dr Michael Gannon for his support in this matter, along with the ASA senior leadership group. We are hopeful that an appropriate outcome will ensure the best results for our patients. 

Associate Professor David M. Scott
ASA President

ASA Letter to Medicare Benefits Schedule Review Taskforce Chair in reference to Medicare Benefits Schedule Review

Date: 5 June 2017

On 30 May 2017, President David M Scott submitted a letter to Professor Bruce Robinson, Medicare Benefits Schedule Review Taskforce Chair in reference to Medicare Benefits Schedule Review – Relative Value Guide for Anaesthesia.
The letter is now published on ASA website (member access required) under ASA submissions page.

CHANGES TO MBS ITEMS FOR URGENT AFTER-HOURS ATTENDANCES

From 1 March 2018, the Government abolished MBS item 598 - urgent after-hours attendance during sociable hours. Whilst MBS item 600 is retained with some modification, new items have been introduced with a focus on after-hours care for those in the rural and remote areas. Medical practitioners (other than GPs) providing after-hours services are able to use the new MBS items 591 or 588, according to the geographical location classification. Classification of your medical practice can be checked on this link. For subsequent patients seen during the same time period, these attendances can be billed with the new MBS item 594. 

More details about these new MBS items and changes to MBS item 600 can be read here.