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The profession of optometry could see a shift away from bulk-billing practice to a pricing model with potential for fairer remuneration, following an announcement in the Federal Budget that the Medicare fee cap is to be removed.

The reduction in the rebate from 85 per cent to 80 per cent, announced in the Federal Budget, could cost the profession about $150 million.

Optometrists have seven months to reconsider their billing structure. If the Budget is passed through Parliament, optometrists will be able to set their own fees from 1 January 2015 in the same manner as all other health professions under Medicare.

Optometry Australia (formerly OAA) CEO Genevieve Quilty said this was a landmark decision. She said removing the fee cap would allow flexibility for optometrists to compensate for potential losses flagged by other Budget cuts to the profession.

‘It will allow optometrists to continue to offer an extensive range of preventative eye health and vision care services without having their income from consultations further diminished by the extended frozen indexation of the Medicare Benefits Schedule, and reduced Medicare rebate, which were also announced in the Budget,’ she said.

Optometry Australia campaigned for more than two years for the fee cap to be removed, claiming it was making it increasingly challenging for optometrists to provide full-scope eye-care services while maintaining a financially viable clinical practice. Many members played an active role in the campaign through letter-writing to decision-makers and representing the profession in meetings with federal politicians of all political persuasions.

The Australian Government’s decision to remove the fee cap could have far-reaching consequences for optometrists. This historic decision allows optometrists to set their own fees from 1 January 2015.

It provides important flexibility for all optometrists who incur the costs of providing clinical care, as well as the costs of investing in world-class technology and their own continuing education to enable them to provide the best care for their patients.

The financial freedom and flexibility the change signals is a breakthrough for practising optometrists who have been hamstrung by the fee cap.

Rebate lower

The government also announced in the Budget that it will save $89.6 million over four years by reducing from 85 per cent to 80 per cent the Medicare Benefits Schedule rebate for all optometry services.

Optometry Australia does not support this decision and will be working hard to attempt to have it reversed. Optometry Australia president Andrew Harris said the profession required an immediate return to 85 per cent government rebates for patients.

‘For many optometry practices that choose to bulk-bill the majority of patients, this Budget has not only failed to address the escalating cost of providing high-quality eye and vision care Australians have come to expect, but also reduced the fees payable for quality eye care,’ Mr Harris said.

An independent consultant reviewing the financial implications of the budgetary changes has advised Optometry Australia that the reduction in rebate could cost the profession about $150 million. This is more than predicted in the Budget papers as it factors in some reduction in demand for optometry services as a result of the imposition of the co-payment.

Optometry Australia has taken its concerns directly to the government. The organisation met with the Department of Health on 16 May and plans meetings in the days ahead with key offices in the federal government.

Optometrists experiences

Optometrists Jim Kokkinakis, Daniel Chew and Kate Johnson share their experiences of moving beyond bulk-billing and talk about the benefits they enjoy.

Read the Changing Billing Practices Practice Note.

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