Australian Medical Association

"let's talk about fees..." campaign products

In November 2008 the Council of Australian Governments' agreed to introduce a nationally-consistent approach to activity-based funding for public hospital services to allow comparisons of efficiency across public hospitals.

Subsequently, the Australian Government asked the Productivity Commission to examine and report on the relative performance of the public and private hospital systems. In June 2009, the Productivity Commission released a paper seeking information and feedback on a range of issues including treatment costs, including out-of-pocket patient expenses and rates of fully-informed financial consent, rates of hospital-acquired infections and other relevant performance indicators.

Below are the two submissions the AMA made to the Productivity Commission on the Performance of public and private hospital systems. The AMA submissions also address the Commission's term of reference on informed financial consent.

Price List and Order Forms for the AMA List of Medical Services and Fees available here.

Fees Gap Chart

This resources, with links to the ATO, will help doctors understand the implications and impact of GST on their practice.

Establishment of the Healthcare Identifier Service was agreed to by the Council of Australian Governments in 2006 as part of the national approach towards accelerating work on electronic health records to improve the safety of patients and improve efficiency for healthcare providers.

In July 2009, the Department of Health and Ageing released a discussion paper on legislative proposals to support the establishment and implementation of unique identifiers for healthcare purposes and the privacy of health information.

The AMA submission on the discussion paper is supported by the AMA Position Statement on Unique Healthcare Identifiers in 2008.

The consortium of eleven graduate medical schools is seeking the ACCC’s permission to continue its policies and practices for selecting applicants to graduate medical schools. These include the preference policy where applicants submit a single application to the Graduate Australian Medical Schools Admission Centre, and the one interview policy whereby applicants receive only one offer for an interview.

In its submission the AMA has said that, on balance, the public benefits from authorising the graduate medical school consortium to continue these polices and practices outweighs any potential drawbacks;  however, the AMA has noted that where a graduate medical school uses the interview process to look for certain qualities in an applicant, there is the potential for the applicant to be disadvantaged by the interview process in some circumstances. The AMA has encouraged the ACCC to address these issues in the authorisation process.

The AMA submission to the Senate Community Affairs Committee inquiry into the Health Insurance Amendment (Extended Medicare Safety Net) Bill 2009 highlighted:

• the Bill provides a framework for the Government to systematically withdraw its funding of the Extended Medicare Safety Net (EMSN);
• the shortcomings of the Centre for Health Economics Research and Evaluation Extended Medicare safety net review report 2009 upon which the Government’s decisions to cap certain services were based;
• the absence of Government consultation with the medical profession to determine the real impact on patients.

• that the Minister be required to consult with the relevant medical groups about their fee structures and any proposal to introduce and/or change a EMSN cap before making future determinations to impose EMSN caps on particular medical services;
• that the Government be required to commission an independent evaluation of the impact of this measure and the associated determination containing the 2009-10 Budget caps by 1 January 2012, and for the evaluation to be tabled in Parliament as soon as it is completed.

Caring for the frail elderly living in residential aged care requires doctors to spend a significant amount of time managing and organising the ongoing care of their patient. This includes discussing the patient's care needs with the nursing staff, maintaining medication charts, completing various forms, discussing care and treatment with the patient's relatives, liaising with pharmacies regarding prescriptions, and taking after hours telephone calls from nursing staff. There are no Medicare rebates payable for this work.

For many doctors, having made the investment in their surgeries, it is not financially viable to visit patients living in residential aged care, particularly when they have a waiting room full of patients.

The AMA's proposal for additional funding for access to medical services for residents of aged care facilities addresses this by recommending that the Australian Government provides specific funding to approved residential aged care providers to allow them to enter into service agreements with medical practitioners to provide ongoing medical care to residents in a particular facility.

Voluntary agreements between doctors and approved providers could be negotiated on a case-by-case basis and would complement Medicare rebates for medical services provided to residents of aged care facilities.

This is the link to the AMA Fees list Online website.

Because the type of work involved in preparing medico-legal, third party or other reports, eg for employers or insurance companies, varies so much and is influenced by a range of factors, such as the State or Territory in which the work is undertaken, the AMA does not recommend a level or range of fees for these services. Individual practitioners set their fees for this type of work based on the time and extent of the work involved.

The AMA has provided a submission to the Commission, highlighting the impact of Government regulation, guidelines and rules on the operation of medical practices. The AMA submission argues that medical practices are burdened with unnecessary red tape, particularly as a result of deliberate efforts by Governments to ration the number of services that patients can access and thus contain health costs.

The AMA has long campaigned for better indexation of Medicare schedule fees so that patients get appropriate rebates for their medical care. Since 1999, we have included a fee gaps chart in the AMA Fees List to show the ever-widening gap between the indexation of Medicare schedule fees and the indices for CPI, average weekly earnings and AMA fees.

This year the chart has been produced in poster format to assist doctors to explain to their patients why they might have to pay a gap for their medical care.

AMA List of Medical Services and Fees - Price List

AMA Position Statement: Ethical Considerations for Medical Practitioners in Public Health Emergencies in Australia - 2008

AMA Position Statement: Unique Healthcare Identifiers - 2008

in-fees is the AMA's newsletter providing updates on the activities of the Medicare Benefits Consultative Committee (MBCC)

AMA comments on the Review of Australian Privacy Law, Discussion Paper 72

The attached excel file contains an indices of prices, wages and medical fees for the period 1985-2006.

This submission is in response to the ACSQHC July 2007 discussion paper on the National Quality and Safety Accreditation Standards Review which calls for an alternative model and recommends high level strategic reforms together with modest operational reforms. The AMA does not support the direction of the ACSQHC paper, but advocates a single fully resourced and minimally invasive system of safety and accreditation.

This kit assists doctors in providing information to patients about the costs of their treatment.

This page contains previous issues of In-Fees.

AMA Annual Report 2006

The AMA welcomes the opportunity to respond to the Access Card Consumer and Privacy Taskforce's second discussion paper on Voluntary Medical and Emergency Information.

A brief history of the AMA List.

The AMA outlines its concerns about the consequences of the sale of Medibank Private.

AMA Position Statement: The Role of the Medical Practitioner in Advance Care Planning - 2006

IFC Survey

Let's talk about fees

The AMA has a long history of promoting the principle of obtaining Informed Financial Consent (IFC) from patients as part of the doctor-patient relationship, and AMA's policy position on this issue is clearly stated in relevant AMA policy resolutions.