Reform of Prostheses Benefits
The Department of Health has commenced work on a research and design project as a first stage in developing in benefit setting framework for prostheses.
The Project is being managed by the Department with guidance from the Prostheses List Advisory Committee.
The Department has engaged the University of Melbourne’s Centre for Health Policy to research pricing models for medical devices and develop options for the design of frameworks for prostheses benefits within the Australian private health setting.
This project leads on from the Industry Working Group on Private Health Insurance Prostheses Reform and its final report, which set out a number of areas for improvement and potential change. One such area is to create a more competitive basis for purchase and reimbursement of prostheses, including consideration of options for new pricing mechanisms.
What they are after is information on the current arrangements on supplying, purchasing and reimbursing medical devices, including the consideration of innovative approaches that may support:
1. a more competitive and value-for-money basis for purchasing and reimbursement;
2. improved transparency in benefit setting for a device, taking into consideration appropriate costs for inclusion in the benefit (eg. clinically relevant requirements, such as: in theatre assistance, software, maintenance, monitoring, and product support, etc.); and
3. timely access to a reasonable choice of prostheses.
The MTAA as a key stakeholder has been asked to provide insights that would benefit this research work.
Affected stakeholders and interested parties are invited to contribute to the project, by providing any views, comments and where possible evidence based data to help inform the project research.
The MTAA has agreed to compile feedback from our members to pass on to the research team. But we would like to extend this opportunity to non-MTAA PL companies as well to ensure we capture as much of the industry as possible.
We have set up a designated email address to assist with this task: PLreform@mtaa.org.au
Alternatively, or if you prefer not to submit to MTAA, you are welcome to submit comments directly to the Department by emailing prosthesesreform@health.gov.au
Please note all consultation responses from either peak bodies or individuals must be received by close of business 21 December 2016.
Andrea Kunca
MTAA Co-Lead
