Budget 'Cost-Shifting' Threat
Federal Budget 2016 – limited benefit and possible cost shifting for patients with macular disease and their carers
Diabetic Retinopathy
From 1 November 2016, two new MBS items will cover the testing of the diabetic retinopathy with a non-mydriatic retinal camera. This camera offers a quick, minimally-invasive way of taking images of a patient’s eyes. Aboriginal and Torres Strait Islanders will be eligible for the test once every year and non-Indigenous patients once every two years.
Medical Benefits Schedule Indexation
Patients with macular disease could face increased out-of-pocket costs following the Federal Budget’s freeze on increases to the Medicare Benefits Schedule (MBS) until 30 June 2020.
The freeze on MBS indexation will increase pressure on the provision of bulk billing services by GPs, optometrists, ophthalmologists and allied health professionals. This could result in increases of gap fees in order to meet operational costs, with gradual cost shifting to patients.
Mobility Allowance
For those with vision impairment or blindness claiming the Mobility Allowance, the eligibility requirements will be tightened and aligned with the National Disability Insurance Scheme (NDIS). This will exclude those aged 65 year old or over. Only new or re-applying applicants from 1 January 2017 will be affected by the new eligibility requirements.
Carer Allowance
Payments for the Carer Allowance will no longer be able to be backdated from 1 January 2017. Currently this payment can, in some circumstances, be backdated up to 12 weeks before the date a claim is lodged or when first contact is made.
Health Care Homes Program
A trial of the new “Health Care Homes” program is being developed to improve funding and integration of primary care services to better support those with chronic and complex conditions. This is a promising development but further details will be required before it can be better understood how patients with macular disease will benefit from this program.
5 May 2016