Options for Reforms and Improvements to the Prostheses List

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In response to the Department’s Consultation Paper: Options for Reforms and Improvements to the Prostheses List MTAA has responded with a submission outlining strong recommendations to maintain the Prostheses List (PL). The context of the report includes:

  • Key issues for reform
  • Reasons for Reform
  • The DRG model as a solution
  • Retaining the PL
  • Benefit Review Mechanism
  • PL criteria
  • Other PL Reforms
  • The Nature and Status of Private Health Insurance
  • Value and Purpose of the Prostheses List
  • MTAA-Government Agreement
  • Issues and goals for further reform
  • Problems with the Diagnosis Related Group (DRG) Option
  • Introduction to the MTAA Proposal
  • Benefit Review Mechanisms on the PL
  • MTAA Proposal – Modified Public-Private Referencing
  • Implications for other aspects of PL reform
  • Defining the scope of the PL
  • Improving the Structure and Transparency of the PL
  • Optimising Utilisation
  • Improving listing processes
  • Department Resource and Cost Recovery
  • KPMG report on Cardiac Implantable Electronic Device (CIED) service valuation