Better access to aftercare arrangements for patients (PDF 72 KB)
What are the changes?
Removing administrative burdens to improve patient access to aftercare
Aftercare is the care provided to patients in the recovery period after an operation. This aftercare is usually provided by the specialist who performed the procedure, but for some patients this care is provided by their GP, typically because of the patient’s location from their specialist.
Currently MBS benefits for routine aftercare are included in the MBS benefits for the procedure, which is limited to the specialist who performed the service. This means doctors cannot bill for aftercare even when it is provided by a patient’s GP instead of a specialist.
Currently there is an administrative block that automatically rejects the payments of services that appear to be aftercare. This block will now be removed so GPs can be paid for providing this care. Additional funding of $37.7 million over five years has been provided by the Government for this change.
These changes commence on 1 November 2017.
Why are these changes being made?
The MBS Review Taskforce recommended changes to the aftercare arrangements following an extensive period of consultation.
The Taskforce is conducting a clinician-led review, which makes recommendations to the Government on how the MBS can be modernised to improve patient safety, support equity of access and reduce waste. The Government is considering the other recommendations of the Taskforce on aftercare.
What does this mean for patients?
This change will improve access to post-operative care for patients who are not able to return to the original practitioner to receive post-operative care.
All doctors who perform an operation will still be required to provide routine aftercare without billing their patients an additional fee.
Aftercare provided by general practitioners will no longer be blocked.
What does this mean for providers?
Any GP consultation within the aftercare period will now attract MBS rebates (unless the GP performed the procedure). If a GP provides a service to a patient that is within an administratively determined aftercare period, the patient’s claim will be paid.
This will reduce administration costs for GP practices by reducing the number of claims they are required to follow up on in order for benefits to be paid. The aftercare rule will still apply when the follow-up care is provided by the practitioner (specialists and GPs) who performed the procedure (as is normal practice).
Further details on all the changes can be found on MBS Online website