Department of Health to host post-Budget Prostheses List webinar

MedTech News: The Medical Technology Association of Australia (MTAA) recently welcomed the Government’s decision to retain the Prostheses List as part of its 2021-22 Federal Budget announcements on reforms to private health insurance.

The Government announced an investment of $22 million over four years to improve the Prostheses List and its arrangements. These reforms build on the reform activities which key stakeholders, including clinicians, private hospitals, medical technology companies and patients, have contributed to over the past three years.

In line with MTAA, Australian Medical Association (AMA) and Australian Private Hospitals Association (APHA) submissions, the Prostheses List will continue to be the way in which hospitals, insurers and device companies know what benefits are payable for listed prostheses.

Changes will be introduced by the Department of Health, supported by the Independent Hospital Pricing Authority (IHPA), to better align Prostheses List benefits with the medical devices costs in the public hospital system.

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The Hon Greg Hunt MP said during the post-Budget Q&A “What we’ve seen is that there’s a mismatch between the public price and the private price of medical devices. We’ve already been able to bring down prices within the sector on a fair and reasonable basis.

“Our principles are there. Firstly, value for money for the sector, for patients and for those who are engaging with private health. Secondly, we want to make sure that patient and doctor choice is unaffected – the clinical choice determines the choice of prosthesis.

“If we have a four year agreement with MTAA, and we bring in the hospitals and private health insurers to have a comprehensive partnership, then we can progressively bring down the price of prostheses in the private sector towards the public sector.”

Other key features of the reforms to the Prostheses List include:

1. Clarifying the scope of the Prostheses List by defining which prostheses are eligible for inclusion on the Prostheses List, and removing ineligible products.
2. Regrouping the items on the Prostheses List to better align devices with similar intended use or health outcomes.
3. Streamlining the listing of new devices by reviewing the functions of the Prostheses List Advisory Committee.
4. Improving the post-listing activities, including reviews and compliance activities.
5. Updating the existing cost recovery arrangements.

These reforms will be implemented by the Department over a number of years, commencing 1 February 2022. The reforms are expected to be implemented by 2025. A review of these reforms will be conducted in 2024.

To provide greater detail on the reforms, the Department will host a webinar on 25 May 2021. Register here.