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MBS Review Advisory Group pictured in May 2018 (L-R): Michelle Waugh, Garry Fitzpatrick, Jason Holland, Mario Basso, William Trinh, Peter Murphy, Christine Nguyen, Stuart Aitchison, Simon Hanna, Isabelle Jalbert and Paula Katalinic. Not pictured: Paul Graveson.

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By Rhiannon Riches
Communications Manager

 

Optometry Australia is recommending the federal government amend the Optometric MBS to enable patients aged 45 to 64 years to access a comprehensive assessment every second year.

The recommendation is one of several put forward to the federal government’s MBS Review Taskforce.

Optometry Australia’s specially convened MBS Review Advisory Group, comprising a wide cross section of optometrists from private practice, academia, and corporate groups, has reviewed the current schedule and investigated how it can be contemporised to meet the eye health needs of the population.

Skye Cappuccio, General Manager, Policy, said that on the advice of the group, Optometry Australia has put forward a comprehensive list of recommendations to contemporise the Optometric MBS.

Specifically, Optometry Australia wants the federal government to amend item 10910 to enable patients aged 45 to 64 years to access a comprehensive assessment every second year.

‘We recommend that item 10910 be replaced with two items, one that continues to support patients under 45 years to access a comprehensive assessment every three years, and one which supports patients aged 45 to 64 years to access a comprehensive assessment every second year,’ Ms Cappuccio said.

Optometry Australia also recommends amalgamating items 10912 and 10913 for administrative simplicity, and removing the requirement that the patient be from ‘within the same practice’.

Both item 10912 and 10913 support a comprehensive consultation of over 15 minutes, have the same scheduled fee, the same associations to other items and the same eligibility criteria with the exception that one is for a patient with a ‘significant change in visual function’ and the other is for a patient with ‘new signs or symptoms’.

‘In contemporary practice, practitioners frequently have access to patient records across practices, and this is expected to become the norm in coming years if a broad uptake of the My Health Record system is established,’ Ms Cappuccio said.

‘We recommend that the requirement that the patient is from ‘within the same practice’ be removed such that the onus rests with the practitioner to be able to justify that an understanding of the patient’s prior condition is sufficient to determine if a ‘new sign or symptom’ has been established,’ she said.

Optometry Australia also recommends amending item 10905, which supports a comprehensive consultation where the patient has been referred by another optometrist, to also support a consultation if the patient has been referred by a medical practitioner.

‘Optometrists frequently receive referrals from medical practitioners, often due to concerns requiring extensive investigation, but which do not meet the criteria for comprehensive items that attract a full rebate. In these cases, the patient is only eligible for a lower rebate, not commensurate with the time commitments required to provide a thorough assessment,’ Ms Cappuccio said.

Additionally, Optometry Australia recommends that the MBS Review clarify descriptors of items 10940 and 10941 similar to the wording used for equivalent items in the ophthalmology schedule, to support best use of the health workforce.

‘Currently these two items, which support computerised perimetry, stipulate that the service is ‘performed by an optometrist’. Given the nature of computerised perimetry where quality results can be obtained when aspects of the testing are undertaken by trained non-optometric staff, we believe this is unnecessary,’ Ms Cappuccio said.

Optometry Australia has also recommended that the frequency with which these items can be billed be amended to enable more frequent billing for perimetry where clinically indicated by the presence of relevant ocular disease or suspected pathology of the visual pathways or brain.

Optometry Australia has made further recommendations to support clarity, consistency and alignment with contemporary practice.

View Optometry Australia’s submission to the MBS Review Committee in full here.

The MBS Review Taskforce is expected to convene a committee to review optometry items in October or November 2018.

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Filed in category: Medicare & private billing, Patient care & management
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