Changes to Medicare have meant that optometry practices have been either considering changes or making changes to their billing procedures.

Changes to Medicare

In the not so distant past, approximately 97% of optometric consultations in Australia that attracted Medicare benefits were bulk-billed. However, with the budget announcement in May 2014, it became clear that this would become a less viable option for practices, with the government reducing the MBS rebate for optometry services from 85% to 80% from 1st January 2015.

The time frame after which a comprehensive examination could be claimed was also changed on 1^st January 2015. After being 2 years for everyone for many years, it became every year for patients over 65 years, and every 3 years for patients aged under 65 years.

In December 2014 the Department of Health also “announced” (via one line in a media release) that Medicare fees for all services provided by GPs, medical specialists, allied health practitioners, optometrists and others would remain at their current levels until July 2018.

How are practitioners changing their billing procedures?

While it is just over two months since the new rules for comprehensive examinations came into effect, I have heard of a number of different reactions:

• A practice I know whose patient base is mainly elderly patients thought the yearly comprehensive examination for these patients would be beneficial for their practice
• One New South Wales optometrist I spoke to has decided to continue bulk-billing every new patient and every comprehensive examination but will be charging $50 for every secondary consultation
• A Queensland practice I know of is charging $75 for every new patient if they are not eligible for a comprehensive examination to be bulk-billed
• Another practice has decided to put up its fees for contact lens consultations

Optometry Australia’s stance

Optometry Australia has said that the Medicare changes are putting the sustainability of Australia’s eye care system under threat, and that the eye health of millions of Australians has been put at risk by these budget measures. Although Optometry Australia are advocating for equitable care for poor and vulnerable people, its publication Australian Optometry and recent news items on its website are advocating the benefits of optometrists charging private fees for consultations.

In late February Optometry Australia launched the Eye Care for All campaign to lobby for the 2014 Medicare rebate levels to be reinstated for concession card holders, pensioners, aged care residents and children under 16 years. However, this campaign perhaps has been incorrectly named as it does not include “all.” Optometry Australia has again sent out to members its recommended schedule of fees for consultations, which, among other things lists a comprehensive examination to be charged at $110 and $73 for a subsequent consultation.

Is it just me, or is it not really “eye care for all” that is being proposed? It’s eye care for pensioners, concession card holders, aged care residents, children aged under 16 years and those who are willing to pay for it.

So while it remains to be seen what percentage of Australian optometrists will be routinely bulk-billing for consultations in 5 years’ time, I doubt that it will be anywhere as near as high as 97%.

Amanda Griffiths.

Optometrist and Founder My Health Career

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Image: David Castillo Dominici – freedigitalphotos.net