News & Trends - MedTech & Diagnostics
Overhaul of funding for CIED technical services expected to take up to 18 months

The Department of Health (DoH) has unveiled stakeholder views regarding the current approach to cardiac implantable electronic devices (CIED) and the associated technical support services (TSS). The high-level summary described the existing funding model as “expensive, inefficient, and lacking transparency,” while noting that transitioning to a new model could take 12 to 18 months.
It is estimated that the total cost of follow-up cardiac TSS to be $73.3 million in 2022 and this increased to $87 million in the most recent cost estimates provided by the MTAA.
In the existing TSS model, private cardiology clinics benefit from free follow-ups provided by preferred providers, while others face exclusion from Prescribed List (PL) reimbursement. This restricts patient options and exacerbates funding disparities between public and private sectors, which remain poorly quantified.
According to the Department of Health high-level summary, while PL funding ensures TSS is free for private patients, it also conceals device costs and lack of transparency in TSS usage and reimbursement, according to some stakeholders. Cross-subsidisation between public and private sectors is poorly tracked, complicating efforts to assess financial impacts.
Dr Michael McGee, Consultant Cardiologist from regional New South Wales, underscored the potential ramifications of funding uncertainty in a recent interview with Health Industry Hub.
“Some of the most vulnerable patients, who don’t have the means to travel [to metro areas] to have these devices checked will be disproportionately impacted,” Dr McGee cautioned. “These devices are incredibly complex and technical. While you can train someone generically to manage them all on a basic level, you’re going to lose a lot of nuance and benefits. As we have certainly seen in the heart failure space, that lack of optimisation of these devices does increase mortality.
“So, if the government is going to pay for these devices, it makes sense to optimise them to make sure that we’ve not wasting that investment and patients are getting everything they can from it.”
Adding to the chorus, the Cardiac Society of Australia and New Zealand (CSANZ) Position Statement on CIEDs noted, “Industry holds an important role in facilitating the optimal device programming for each patient and in trouble shooting device-related issues. Industry provide and maintain the device programmers that are a prerequisite for CIED follow-up. Industry is also integrally involved in the provision of remote monitoring services.”
Importantly, stakeholders expressed significant concerns about potential disruptions during a shift to a new care model. These risks include:
- Workforce gaps caused by the withdrawal of industry support, as clinicians lack training to fill the void.
- Increased administrative and financial pressures on healthcare providers, potentially leading to clinic closures and higher patient loads at public hospitals.
- Greater out-of-pocket costs for patients, particularly in regional and remote areas, compromising patient safety and access to care.
Concerns were also raised about the continuity of care and monitoring standards, as changes to the existing funding model could affect device warranties and compliance with service standards.
Proposed Alternative Funding Models
Stakeholders proposed various solutions to address the identified issues, including:
- Introducing a unique billing system for TSS providers or splitting reimbursement into implant and follow-up fees.
- Establishing specific Medicare codes for CIED follow-ups and recognising accredited cardiac physiologists within the Medicare Benefits Schedule (MBS).
- Redirecting funds from CIED pricing to bolster public hospital staffing and increase Medicare rebates for private clinics.
- Creating a national CIED registry to improve transparency, accountability, and data collection on TSS costs and usage.
Additionally, stakeholders suggested adopting overseas models, which reportedly offer superior financial management, workforce development, and regulation. A hybrid approach was also recommended, maintaining current industry agreements while reallocating funds to enhance public hospital staffing and remote support.
“The matters presented in the summary will inform discussions with stakeholder groups for stage 2 of the consultation. We will provide more information on stage 2 in due course,” clarified the Department of Health.
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