Hospitals and industry await clarity from Department of Health on Prostheses List reform

MedTech & Diagnostics News: The Department of Health has left stakeholders and the healthcare industry in a state of uncertainty regarding the impending deadline for the removal of nearly 500 general use items (GUI) from the existing Prostheses List (PL). The controversial decision, initially set for July 1st, has encountered strong opposition from various organisations, notably the Australian Private Hospitals Association (APHA).

Key stakeholders including the APHA, Australian Society of Ophthalmologists (ASO), and the Medical Technology Association of Australia (MTAA) have discovered that the 1st July deadline has been shifted, although no formal announcement has been made by the Department of Health.

“The Department has advised key stakeholders that there will be no change on 1st July 2023 for the GUI category while we are considering the feedback received. The details of the postponement and next steps will be communicated as soon as possible,” a spokesperson from the Department of Health told Health Industry Hub.

APHA CEO, Michael Roff, has been vocal about the concerns surrounding the proposed changes. He expressed his relief that the Department has finally acknowledged the concerns raised by stakeholders, emphasising that meeting the original deadline would have led to severe financial disruptions and impact on patients in private hospitals.

“We are pleased the Department has finally listened to concerns stakeholders have been raising for months in relation to these proposals. While it is still unclear what the new implementation timeframes will be and how they propose these items be funded, we are committed to working with the government to achieve a workable solution,” he said.

In a candid interview with Health Industry Hub last month, Mr Roff highlighted APHA’s deep concerns, underlining that the Department’s lack of understanding about the intricacies of these changes posed a significant threat to patients and specific procedures. He emphasised that critical stakeholders, such as software vendors providing billing and claiming software, had not been adequately consulted.

“The Department has been told that once they get the final specifications of what the changes will be – and no decisions have been made on that yet – then it would take the software vendors about twelve months to develop, build, and test new software before it could be validly used in claiming,” Mr Roff explained.

Responding to mounting concerns raised by private hospitals, a spokesperson from the Department of Health and Aged Care assured Health Industry Hub last month that they were “in the process of briefing the Health Minister on options to progress the changes to general use items, which may include a delay of implementation. Private hospitals have been assured that the Department will provide support in the transition to new arrangements. The Department does not anticipate any impacts on patient care nor that patients will experience any out-of-pocket costs associated with the removal of these items from the PL.”

The healthcare industry is awaiting clarification and transparency from the Department of Health on the changes pertaining to the removal of general use items from the Prostheses List.

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