(1) (a)   How often does the Medicare Benefits Consultative Committee (MBCC) meet each year, and (b) are there regularly scheduled meeting dates and times.

(2)   For the past 10 years: (a) how many submissions has the MBCC received each year; and (b) how many related to changes to the level of the fee set for Medicare items.

(3)   Can a copy of submissions and MBCC review results be provided for the last 10 years; if not, why not.

(4)   What is the timeframe for the review of a Medicare Benefits Schedule (MBS) item.

(5) (a)   How does the Government’s policy, which reviews MBS items conducted under the auspices of the MBCC on a cost neutral basis, operate; and (b) does this mean that the rebate level for a procedure would never be able to be increased unless a rebate for another procedure were decreased.

(6)   What role does the Minister play in determining changes to the MBS.

(7)   For the past 10 years, how many of the submissions to the MBCC resulted in recommendations to the Minister for increases in the level of the Medicare rebate for a particular procedure.

(8)   What percentage of these recommendations has been accepted by the Minister.

(9)   How does this compare with the percentage of recommendations for increases in the level of the Medicare rebate for a particular procedure that were accepted prior to 1996.

(1)  

(a)   On average the Medicare Benefits Consultative Committee (MBCC) has met around 12 times each year for the past decade.

(b)   No. MBCC is an informal advisory committee convened on an ad hoc basis as required to review particular services or groups of services within the Medicare Benefits Schedule, including consideration of appropriate fee levels. Representation is drawn from the Department of Health and Ageing, Medicare Australia, the Australian Medical Association (AMA) and the relevant medical craft group.

(b)   The majority of submissions involve changes, restructures and sometimes disaggregation or aggregation of items which often involve amendments to fee levels.

(2)  

(a)   The Department of Health and Ageing and the AMA has estimated that the number of submissions received from the profession in the period 1996 - 2006 would be in the order of 110. Submissions vary in size and complexity. Not all submissions result in an MBCC meeting and sometimes more than one MBCC meeting is held in order to finalise a review of items of service.

(b)   The majority of submissions involve changes, restructures and sometimes disaggregation or aggregation of items which often involve amendments to fee levels.

(3)   The submissions are not readily available and to compile the requested information would involve a significant diversion of resources within the Department. Where MBCC reviews result in changes to the Medicare Benefits Schedule (MBS), these are published in the Schedule in November each year, both in a summary at the front of the Schedule and in new and amended items reflecting specific changes.

(4)   The timeframe for the review of submissions is variable depending on the nature of the submission, analysis of clinical issues and availability of appropriate clinicians, and the time involved in analysis and costing of proposals contained in submissions. As changes are made to the MBS in November and May each year, submissions are generally assessed and changes introduced on the basis of this timetable. As such the average timeframe can range from around one week to several months.

(5)  

(a)   Individual practitioners seeking changes to the General Medical Services Table (GMST) of the Schedule are advised to seek the support of their relevant craft group or association which can pursue the matter on their behalf either through the AMA or directly with the Medicare Benefits Branch of the Department of Health and Ageing. While the complexity of information provided will reflect the extent of the review being requested, submissions for amendment to items of services already listed in the GMST are generally required to include details on the rationale for the change. The deviation of the fee should be explained based on costing data or fee relativity to existing items and any offsets identified, such as other items that would not be claimed if the new/revised item was introduced.

(b)   As a general rule, changes to the Schedule are to be implemented without an increase in Medicare outlays for a particular service or group of services, unless a genuinely new evidence-based service is being introduced. From time to time, the government may decide to increase Schedule fees in order to reflect the changing complexities of modern clinical practice. Most MBS items are indexed annually based on parameters provided by the Department of Treasury.

(6)   The Minister for Health and Ageing approves all changes to the MBS items and fees after consideration of advice put forward by the Department following an MBCC meeting or other consultation process.

(7)   This information is not currently available. The majority of submissions address fee levels to some extent due to restructures, aggregation and disaggregation of services. To compile the requested information would involve a significant resource effort that the Department is not currently able to undertake.

(8)   and (9) The information on which to calculate percentages is not currently available. To collate the requested information would involve a significant resource effort that the Department is not currently able to undertake.