The Medicare Benefits Schedule Review Taskforce Report from the Nurse Practitioner Reference Group (NPRG) has been released, with 14 detailed recommendations. This report will now be considered by the MBS Taskforce, and released to Stakeholder consultation, which includes the ACNP. Following that, the taskforce can make recommendations to the Minister.
What we hope to achieve from the current MBS review is significant increase in access to Nurse Practitioners services for the Australian public. This will assist the development of more roles in the Private sector, and more Nurse Practitioners will be able to work towards addressing the gaps in health services, and the health of our community.
The ACNP is pleased that the changes outlines within the 14 recommendations will also lead to significant growth in Nurse Practitioner numbers in Australia, especially in areas of need, and a more sustainable workforce. The ACNP has been heartened by the large number of responses to our sharing of the "MBS Report from the NP Reference Group".
You can access the full report from the MBS Review - NP Reference Group by clicking on the link below.
You can read about the Scope of Practice of a Nurse Practitioner by clicking on the link below.
ACNP RESPONSE - MBS REVIEW TASKFORCE - REPORT FROM THE NPRG
The Australian College of Nurse Practitioners (ACNP) fully supports each of the recommendations proposed by the Nurse Practitioner Reference Group (NPRG) 2018 as part of the Medicare Benefits Schedule (MBS) Review.
The fourteen recommendations serve to improve the accessibility and availability of quality health care for Australian people, especially those in underserved and marginalised communities. The recommendations also create greater flexibility and choice for people, enabling them to access safe and high-quality healthcare delivered in the right place, at the right time.
The current constraints of the MBS items and existing legislation contribute to fragmentation of care and unnecessary duplication of services, which negatively impacts on people, as well as healthcare expenditure. Implementation of these recommendations will allow nurse practitioners to navigate and provide quality care to people to the full extent of their scope of practice, improving access to care and affordability of services, without unnecessary constraints. Adoption by the Government of the fourteen recommendations proposed by the NRPG (2018) will provide nurse practitioner services greater flexibility to provide services to Australian communities, particularly marginalised and traditionally underserved populations. These recommendations will also significantly reduce the unnecessary duplication that the current arrangements create within the MBS.
Cost Benefit Analysis of Nurse Practitioner Models of Care Report from KPMG
KPMG was engaged to conduct a cost benefit analysis (CBA) of Nurse Practitioner (NP) models of care in the aged care and primary health care sectors in Australia in order to identify key success factors and challenges as well as areas for potential expansion.
The NP role has emerged as a way to expand the scope of practice for nurses in order to improve access to healthcare, particularly for remote, marginalised and vulnerable populations. The ability for NPs to work both independently and collaboratively within a multidisciplinary health team, and their ability to undertake advanced clinical care, positions the role to provide flexible and affordable health services to Australian communities.
MBS REVIEW NEWSLETTER MARCH 2022 UPDATE
From: MBS Review - Department of Health: email@example.com
MBS Review Advisory Committee (MRAC)
The MBS Continuous Review involves the ongoing review of Medicare items and builds on the work of the MBS Review Taskforce and its MBS Review. The MBS Continuous Review is guided by the Medicare Benefits Schedule (MBS) Review Advisory Committee (MRAC), an independent clinician and consumer led non-statutory committee chaired by Conjoint Professor Anne Duggan.
The Medical Services Advisory Committee (MSAC) continues to be the standard pathway for adding new items to the MBS. Where a health technology assessment is not appropriate, the MBS Continuous Review may be the appropriate mechanism to consider the addition of new items, expanding access to existing items, amending existing items or removal of outdated or unnecessary items. The Department of Health will undertake a preliminary assessment of such matters and if appropriate, refer requests for reviews to MRAC for advice on whether a change to the MBS is warranted.
The MRAC has now met on two occasions, November 2021 and February 2022.
At the last meeting in February 2022, the MRAC commenced consideration of its first two review topics:
- Introduction of MBS items for genetic counselling services and genetic test requesting rights for Human Genetics Society of Australasia (HGSA) registered genetic counsellors and
- Surgical assistant billing arrangements and the eligibility of non-medical surgical assistants for remuneration via the Medicare Benefits Schedule.
MRAC has agreed to establish working groups to consider these reviews, which will report on their progress at the next MRAC meeting scheduled for May 2022.
For further information, you can email MBSContinuousReview@health.gov.au
On 23 December 2021, a new temporary MBS item was made available to support medical practitioners providing vaccine suitability assessment services to patients who require booster vaccinations. Factsheet
On 1 January we saw the release of a number of new MBS items. These included:
- MBS Telehealth Services - patient access to telehealth services supported by ongoing MBS arrangements. Factsheet
- Cardiac magnetic resonance imaging (MRI) for myocarditis associated with mRNA COVID-19 vaccination. Factsheet
1 January also saw a number of item changes and updates across a range of areas including:
- Orthopaedic surgery - minor administrative amendments to two MBS items. Factsheet
- Endoscopic Mucosal Resection (EMR) – minor amendment to MBS Item 32230. Factsheet
- Spinal surgery - amendment to MBS item 51071. Factsheet
- Extension of SARS-CoV-2 (COVID-19) Laboratory Testing Items. Factsheet
- Medicare Safety Net Arrangement. Factsheet
- Rural Bulk Billing Incentive Changes. Factsheet
- Cardiac Services T8 Item amendments. Factsheet
- Medicare Support in Response to Omicron - GP and Other Medical Officer (OMP) Longer Telephone Consultation. Factsheet
- MBS COVID-19 Management Support Service. Factsheet
On 1 March there were new items and item updates across a range of areas including:
- Participating midwives MBS items to promote safe clinical practice and high-quality maternity care through a restructure of intrapartum items and maternity care plans. Factsheet
- Pain management services changes to align with contemporary best practice. Factsheet
- Anaesthesia services to align items with contemporary clinical practice and ensure appropriate patient access. Factsheet
- Gynaecological services including the amendment of 68 items, the introduction of 13 new items and the removal of 32 items. Factsheet
- Transcatheter Aortic Valve Implantation. Factsheet
- Expanded patient access to patients who have an absolute and permanent contraindication to oral anticoagulation. Factsheet
- Telehealth, new items for the remote programming of auditory implants and/or sound processors. Factsheet
For more information on the 1 March changes visit the MBS Online March News page.
The following future changes are scheduled for implementation.
- 1 July 2022, changes to colorectal surgery items.
- 1 November 2022, plastic and reconstructive surgery changes.
- 1 March 2023, changes to items to improve access to complex allied health services for people under 25 years of age with Autism Spectrum Disorder, Complex Neurodevelopmental Disorder (previously Pervasive Developmental Disorder) and eligible disabilities.
- 1 March 2023, streamlining access for Indigenous people to services available under General Practice Management Plans and Health Assessments.
- 1 March 2023, changes to MBS items to reduce the minimum number of participants in group therapy sessions and to enable family and carers participation in treatment.
More details will be provided as the changes and details are announced.
Updates for current ILG's
Participating Midwives Implementation Liaison Group
The Participating Midwives Implementation Liaison Group (PMILG) was established in July 2021 and has met three times (9 August, 7 September and 4 November 2021). A further meeting may be held in 2022. The ILG has provided valuable input and advice on the development of new and amended MBS items for future implementation. If you have any questions about the work of the Participating Midwives Reference Group or the ILG please contact PrimaryhealthcareILG@Health.gov.au.
Collaborative Arrangements Review
The department is in the process of commissioning an independent review of collaborative arrangements for nurse practitioners, scheduled to commence soon. The review will to provide greater clarity on the efficacy of collaborative arrangements and highlight any unintended barriers.
The first two meetings of the ILG were held 10 November 2021 and 13 December, 2021. The next meeting of the ILG is planned for this month.
A Psychiatry Implementation Liaison Group is being formed, and will hold its first meeting this month to discuss the implementation of recommended changes to the Psychiatry MBS items. If you have any questions about the work of the Psychiatry Clinical Committee or the ILG, please contact MBSReviewsILGs@health.gov.au
Stakeholder consultation continues to be an integral part of the MBS Review process and upcoming ILGs will be announced as details become available
General MBS News
You can always find information about upcoming changes to MBS Items by visiting the MBS Online. The News page provides an overview of changes and the Factsheets page provides more detail and links to factsheets for each change
MBS Home page - http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Home
Medicare Benefits Schedule (MBS) Review - https://www1.health.gov.au/internet/main/publishing.nsf/content/mbsreviewtaskforce
View all ACNP submissions relating to the MBS review on the ACNP web page Submissions (Members only).
View all ACNP submissions relating to the MBS review on the ACNP web page Submissions (Members only).
Letters to Minister for Health, Greg Hunt
01 July 2020 Request for copy of Taskforce review of NPRG recommendations.
08 July 2020 Request for an Update
24 March 2020 Removal of barriers preventing Nurse Practitioners assisting in this time of high demand for health services (Covid implications)
14 January 2020 Contact us urgently to discuss what you might need from the ACNP to prevent addititional delays
02 December 2019 Update request on the timelines and outcome of the MBS Review
16 October 2019 Rrequest to support as the peak body for Australian Nurse Practitioners within the MBS and the NPRG
28 August 2019 Request to meet to enable his understanding of our level of engagement
21 August 2019 MBS review
19 August 2019 Request to meet to consider ACNP as both a stake holder and a resource in future policy development
04 June 2019 Request to discuss NPRG Repoprt
13 March 2019 Thanks for supporting the NPRG
04 March 2019 MBS Funded Pathology isses - refereal rejections
25 February 2019 Confirmation that ACNP support all 14 NPRG recommendations
05 March 2020 Letter to all Senators and Federal members of Parliament to fully support the MBS review along with the KPMG report
24 October 2019 Letter to all Senators and Federal members of Parliament to fully support the MBS review for the NPRG recommendations
22 February 2019 Support request letter to 20 Health Care Professional Organisations
08 February 2019 Letter to all Senators and Federal members of Parliament that the NPRG report is now available
Requests for Support
See letters of Support following this section
We are expecting the ACNP to be formally invited to a MBS review workshop in Brisbane on 27th March, I will update membership once confirmed.
For this, we will need to be prepared to extensively support each of the recommendations, then we will follow up with a written submission.
We have 10 member working parties working on the support for the MBS review based on the analysis of the member survey. Some great work is already coming through, and I thank you all yet again for your commitment and your time.
Working Groups Timeline:
- The working parties were given the brief of preparing some preliminary materials by 24th March. This includes 3 case studies (per working group) to demonstrate support for the recommendation/s. If possible, please include cost savings or costs alongside the cases.
- Also, a draft brief of support for the recommendation/s, references would be ideal, however time frames are short, so please just do what you can.
- The information will then be collated by the ACNP on 25th and 26th March ready for Brisbane.
- Following the 27th March, we will send through feedback on the workshop, and also on the preliminary materials, so that the we can start work on our written submission.
- Please email these preliminary materials through to Domenique at firstname.lastname@example.org
LETTERS OF SUPPORT
The ACNP is pleased to acknowledge the support of the following organisations who are equally encouraged by the recommendations and their positive improvement to better health outcomes for all Australians, including the Aged Care sector and Rural and Remote areas
MBS Update 02/11/21
November MBS Review Newsletter 2021 Update.
Read the full article here: MBS Review November 2021 Update
MBS Update 01/02/21
In response to the NPRG Final Report, ACNP has provided the Minister of Health, the Hon. Mr Greg Hunt, with the following proposal.
The College is appreciative of the support received for this proposal from many nursing organisations, health care organisations, consumer groups, universities and health services.
Full proposal: ACNP’s Proposal in response to the MBS Taskforce’s Final Report from the NPRG
MBS Update - 21/12/20
ACNP Members have received many updates on the release of the MBS Taskforce recommendations over this last week.
The Minster for Health, the Hon Greg Hunt stated “This is a report to and not of Government. While not Pre emoting any response, my clear unequivocal positions that our task is to expand, not reduce, the role which nurse practitioners will have going forwards. This is a fundamental and guiding principle.”
We have already received a lot of support from our colleagues, nursing associations, and professional bodies.
Just to reiterate, these are the recommendations of the Taskforce, it is now entirely up to the Minister. The Minister for Health does know what Nurse Practitioners do, and how significantly they can contribute to health care. He is also well aware of the implications of the limitations that currently exist on patients and costs to the health system.
Please find below the link to see the letter from the Australian College of Nurse Practitioners to The Hon. Greg Hunt.
ACNP Letter to The Hon. Greg Hunt
MBS Update - 28/4/20
The ACNP has been in regular communications with the Chair of the MBS Taskforce Prof. Bruce Robinson over the course of the MBS review. Today we received an update, it is important that you are all aware that the Taskforce is still working towards an outcome by 30 June 2020.
Prof Robinson did previously notify us that the planned meeting of the Taskforce scheduled for earlier this month was postponed due to COVID 19. Today he let us know that despite the fact that many of the Taskforce members are clinicians, supporting front-line work in response to COVID-19, they still are committed to the June 30 timeline.
We will provide further updates should anything arise.
“With the MBS Review still underway the ACNP would like to reassure all of you that we are still actively engaged in this process, while also working on the current COVID-19 Telehealth MBS items, and the response to COVID-19.
The ACNP will continue to work with the Government towards the best outcome that improves access to care for the community, and is sustainable for Nurse Practitioners. We understand that this is taking longer than anticipated and it is enormously trying for us all, but we need to remain determined, united and strong-minded. While all 14 recommendations of the NPRG would no doubt assist during the pandemic, we must prioritise the key items needed urgently to maximise patient access to care. The safety of the Australian community remains paramount and we will continue to keep members updated of the progress in this area."
Leanne Boase, ACNP President
Letter Campaign - September 2019
We are calling on you to write to the Minister of Health and your local Member of Parliament in relation to supporting the 14 recommendations of the MBS Review – Report from the Nurse Practitioner Reference Group, and particularly, the removal of the collaborative arrangements.
We have created a letter template (available via the website) and included the steps and tips to streamline this process for you.
We are pleased to announce that the cost benefit analysis of Nurse Practitioner Models of Care report is now available on the MBS Review page of the ACNP website.
This analysis was prepared for the Department of Health by KPMG, and the findings support and align with the recommendations of the Nurse Practitioner Reference Group as part of the MBS Review.
MBS Review - May Update
As the closing date of May 17, 2019 approaches your College is reaching out to individuals and professional bodies to encourage them to provide feedback. Here is the latest ACNP Letter to Stakeholders NPRG for written submission that has been distributed.
To offer your support, you can send a submission of your own to the Medicare Benefits Schedule Review Taskforce, Professor Tim Usherwood, Chair – General Practice and Primary Care Clinical Committee. If you are not sure what to write, ACNP has a NPRG Submission Template For Members to build on.
We ask our members to consider the following main principles of the ACNP response, including the focus on:
- Benefits to patients - the patient comes first
- Improvement of access to care - not all needs are being met in our community
- Nurses, including Nurse Practitioners, can deliver better health care in more places if enabled to work to full scope of practice
- Nurse Practitioners focus on preventative care and health education, as well as managing acute or chronic illness, and are therefore economically sustainable, and excellent value for the taxpayer dollar.
The College is not responding to negative media, or statements that are not supported by evidence. We will instead focus on the added value we bring to the Australian Health care system and our community, and engaging with key stakeholders to support the 14 recommendations.
If members would like to complete an individual submission, you can choose to focus on any, or all of the recommendations, or the general principles as above.
We thank everyone who has worked on the ACNP submission, we are pleased with the response and support received from our members, and our submission is progressing well. Many other nursing organisations, and healthcare organisations have also expressed their support, and have made submissions already. Their willingness to engage with us, and support us is a real indicator for the future of our roles, and our College.
Have your say: Consultation on the definition of 'cultural safety'
ACNP is collating feedback to submit to Ahpra for the Consultation on the definition of 'cultural safety'.
ACNP needs your input to ensure we are best able to advocate for you in response to this important topic. Please take time to provide your feedback on this issue by Sunday 12th May. This will ensure the College has time to collate your feedback and draft the submission. Thank you.
You may also like to consider formulating your own response, and submitting it directly, as per the submission link below.
Here is the link to the survey for members to give us their feedback https://www.surveymonkey.com/r/6KMYZWP
If you would like more info here is the link to the submission https://www.ahpra.gov.au/News/2019-04-03-cultural-safety.aspx
Last Wednesday, the 27th March the ACNP attended the Stakeholder Consultation relating to the Medicare Benefits Schedule (MBS) Review Taskforce – Report from the Nurse Practitioner Health Reference Group.
In attendance representing ACNP and our members were Catherine Smith, Amanda Davies and myself.
Each of the recommendations were discussed with Taskforce and NPRG members, other nursing stakeholders, and consumer representatives.
We were very well supported by the other attendees at the Stakeholder consultation.
The meeting progressed well, with a number of key themes emerging to inform our upcoming written consultation.
We clearly expressed strong support for each of the 14 recommendations in the Report, highlighting case examples and the evidence to support them. We will continue with our working groups to ensure we are well prepared for our written response.
Thank-you to all of our members that helped us to prepare for last Wednesday! We will be in touch shortly for the next stage of our response.
We are really moving ahead with the MBS Review now, and I would like to sincerely thank every one of you who have responded to our extensive survey. We have received over 130 detailed responses, and have extended the closing date to Monday 4th March 5.00pm should anyone need a bit more time.
There is a Stakeholder Workshop with the MBS Review team in relation to the NPRG report coming up soon, and I will provide an update following this.
I thank each of you who have already volunteered to help with the review of the NPRG recommendations, we will be in touch with you next week.
In the interim, we will continue to work on our written submission to the NPRG report (due in May), and also contribute to the other MBS reviews open for consultation.
On the 8th March, submissions are closing for the following MBS reviews:
- Diagnostic Medicine
- Plastic and Reconstructive Surgery
- Colorectal Surgery
If you feel able to contribute to any of these, please consider a written submission, or send your thoughts to us by Tuesday 5th March 5pm at the latest.
The ACNP has responded to the call for submissions on the report from the General Practice and Primary Care Clinical Committee which closed today. This will be available on our website next week.
Please check the ACNP website regularly for updates on the MBS Review and the letters of support we are continuing to receive.
MBS BENEFITS SCHEDULE REVIEW TASKFORCE –
REPORT FROM THE NURSE PRACTITIONER REFERENCE GROUP (NPRG)
We have all been waiting to hear the findings of the MBS review in relation to the Nurse Practitioner role, and I’ve been reflecting on what MBS access really means.
The Medicare Benefits Schedule reimburses the patient, in part, for health services that they have paid for, and in the case of bulk billing, the patient assigns that rebate to the provider as the full payment for services.
What we hope to achieve from the current MBS review is a significant increase in access to Nurse Practitioner services for the Australian public. This will assist the development of more roles in the Private sector, and more Nurse Practitioners will be able to work towards addressing the gaps in health services, and the health of our community.
I am pleased to announce that the Medicare Benefits Schedule Review Taskforce Report from the Nurse Practitioner Reference Group (NPRG) has been released, with 14 detailed recommendations. This report will now be considered by the MBS Taskforce, and released to Stakeholder consultation, which includes the ACNP. Following that, the taskforce can make recommendations to the Minister.
This report represents the opportunity to significantly improve the health of our community, and increase access to quality healthcare for countless Australians.
Each of the 14 recommendations by the NPRG are unquestionably positive for our community and the growth of our profession. These are well considered, extensively researched, and well supported by the evidence that reflects the high standard of Nurse Practitioner care in Australia. The recommendations focus on the following key areas:
Enabling much greater access for our patients to subsidised diagnostics – removing current restrictions
Enabling access for our patients to preventative care and early intervention through MBS care plans and longer consultations
Removal of artificial barriers to practice, which limit access to Nurse Practitioners services including the collaborative arrangements and improving NP role sustainability
Enabling our patients to access rebates for procedures provided by Nurse Practitioners
Improving access to services for vulnerable patients
Improving the ability of Nurse Practitioners to work to their full scope of practice, especially in areas of Australia where communities have poor, or reduced access to health services, including significant improvements to Telehealth arrangements.
The 14 recommendations, if implemented, would also lead to significant growth in Nurse Practitioner numbers. As Advanced Practice Nurses around Australia see how these recommendations can maximise their ability to provide comprehensive care for their patients they will complete their qualifications and meet the criteria for endorsement as a Nurse Practitioner.
I would like to acknowledge the extensive work that has gone into this report, and call on our membership to support our patients and community, as always, by working with the ACNP to ensure these recommendations are fulfilled. It is up to the ACNP and our membership to work hard to support them on behalf of the Australian community.
The ACNP will shortly call for your feedback on these recommendations, we encourage you to read the report available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/MBSR-pcrg-consult
With 2019 already shaping up to be very busy, now is a time of positive change for the health of our community, and the Nurse Practitioner role. A strong membership of NPs and APNs will help to support our stand to achieve the positive effect we all know is possible.