MTAA pushing for delay in product categorisations

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The Medical Technology Association of Australia is pushing for a one-year delay in the implementation of the reform that involves the categorisation of all private health insurance policies.

The parliament is scheduled to consider the enabling legislation next week. The reform, which has the support of most stakeholders, is currently scheduled for implementation in time for next year's 1 April premium increase.

The move to categorise all existing 70,000 private health insurance policies was announced as part of a raft of reforms in October last year.

The reform will set minimum requirements for categories of cover. It is designed to simplify private health insurance and provide consumers with greater certainty about the services covered by each type of product.

In a recent letter to Dr Jeff Harmer, chair of the Private Health Ministerial Advisory Committee (PHMAC), MTAA CEO Ian Burgess argued the current timeline for implementation will leave insufficient time for the relevant rules to be developed and adopted in time for insurers to submit their premium round applications in November.

"In addition, MTAA understands the mapping of MBS items to the standardised clinical definitions is not yet complete," he said.

"We firmly believe that recent events and the increasing likelihood that a general election will be held, proroguing Parliament, means all stakeholders in this process cannot proceed with any certainty," said Mr Burgess.

He has proposed a discussion at next week's PHMAC meeting.

"The PHMAC should formally recommend to Government postponing the reforms to provide stability and certainty to the sector and to ensure sufficient time to complete the necessary legislative and administrative steps...There is no need to continue to drive towards a 1 April 2019 start date," said Mr Burgess.

"The additional time would allow the Government to make available to stakeholders the modelling used to establish the new categorisations and the impact on current policies. It would also allow sufficient time to establish a public information campaign to help consumers be better informed about the product tiers and their inclusions as recommended by the Senate Community Affairs Legislation Committee."

The MTAA has proposed a one-year delay in implementation, to 1 April 2020, or a phased implementation with consumers provided a Private Health Insurance Statement on 1 April 2019.

The statement would include a one-page policy summary. 

"This will provide, for the first time, full transparency to consumers on their coverage including any restrictions, exclusions and waiting periods," it said.

The MTAA has previously expressed concern over the categorisation policy. In its submission to the Senate inquiry into the enabling legislation, the association said while it fully supports the intent of the reform it "is concerned the complexity of product offerings will continue due to the differences in insurance coverage across a large number of hospital treatment categories.

"The longer and more specific the list of services for inclusion/exclusion in the insurance product tiers, the more complicated the insurance product will be and lead to continued consumer confusion about what they are purchasing."