Conflicting views on the recently announced categorisations of private health insurance policies amongst the representative bodies of Australians living with pain.
Last week health minister Greg Hunt confirmed the rules that will see all private health insurance policies categorised as gold, silver, bronze or basic.
The new rules will mean the adoption of minimum and standard clinical categories for all product tiers.
Private health insurers welcomed the announcement, which includes a 12-month transition period, but medical device companies expressed disappointment over the government's decision not to delay the reform's full implementation.
Under the new rules, pain management involving treatment in a hospital that does not require the insertion or surgical management of a device will be covered in all policies categorised as gold, silver or bronze.
Pain management involving treatment in a hospital for the implantation, replacement or other surgical management of a device required for pain, only needs to be covered in policies categorised as gold.
Painaustralia welcomed the categorisations as a step towards "increasing transparency" for consumers.
It said the new rules address many of its concerns, and those expressed by the Australian and New Zealand College of Anaesthetists Faculty of Pain Medicine and the Australian Pain Society, through the creation of a clinical category
"The new rules ensure that pain management will be a minimum requirement for bronze, silver and gold categories. This will ensure that people will continue to have access to all of the pain management treatments available at this time," it said.
“We welcome the new rules and would like to thank Minister Greg Hunt and his office and department for working collaboratively with the pain sector in attempting to resolve our concerns,” said Painaustralia CEO Carol Bennett.
“We have been presented with a much-improved proposal that will see a range of pain management options as a minimum requirement available in every category. This is so important to the one-in-five Australians who live with pain conditions ,” said the Dean of the Faculty of Pain Medicine, Dr Meredith Craigie.
However, in a separate statement, the Neuromodulation Society of Australia and New Zealand (NSANZ) said the categorisations could lead to an increase in the use of opioids.
“We are calling for the Government to make good on their promise, and guarantee that all existing procedures for pain management, including devices, be made available in Bronze, Silver and Gold policies,” said Dr Richard Sullivan, pain medicine specialist physician and NSANZ president.
“Australian strong opioid-related deaths now exceed heroin deaths by two-and-a-half-times, and estimates suggest more than a quarter of chronic pain patients are misusing prescription strong opioids.
“These numbers will increase should patients be denied access to chronic pain procedures they currently have under their existing policies,” added Dr Sullivan.
Private Healthcare Australia said there was "no truth" in the NSANZ claim and described as "claptrap" any suggestion the use categorisations would lead to an increase in the use of opioids.
"When the cost of spinal cord stimulators comes down from $25,000 per item, so too will the cost of premiums for consumers," it said.