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Current reviews of existing MBS items

PUBLIC CONSULTATION

On 28 March 2013 the Department published the scope, or terms of reference, for the review of ear, nose and throat services, seeking feedback on key stakeholders, the scope itself, and the proposed review methods and techniques.

• Draft Scope for Ear, Nose and Throat Services (Word 95 KB)
• Draft Scope for Ear, Nose and Throat Services (PDF 640 KB)

Public consultation closes on 28 April 2013. Feedback should be sent to the MBS Reviews Section.

Public consultation has now closed for several MBS reviews.
From 5 February to 5 March 2013 the Department sought comments on draft protocols for reviews of botulinum toxin injection, lipectomy, perfusion, rhinoplasty, vulvoplasty, knee arthroscopy, wrist ganglia surgery, and inguinal hernia repairs as well as the draft scope for the review of paediatric surgery.

Additionally, from 25 February to 25 March 2013 the Department sought comments on draft protocols for reviews of Vitamin D and Vitamin B12/folate testing.

The documents have been removed from the website while working groups for each review consider them and comments received. The Department will publish them again once they are made final.

MBS REVIEWS

In the 2011-12 Budget, the Australian Government committed, through the Comprehensive Management Framework for the MBS (CMFM), to continue the systematic review of Medicare Benefits Schedule (MBS) items to ensure that they reflect contemporary evidence, improve health outcomes for patients and represent value for money.

PRINCIPLES TO GUIDE MBS REVIEWS

Reviews will:

• have a primary focus on improving health outcomes and the financial sustainability of the MBS, through consideration of areas potentially representing:
• patient safety risk;
• limited health benefit; and/or
• inappropriate use (under or over use);
• be evidence-based and fit-for-purpose;
• be conducted in consultation with key stakeholders including, but not limited to, the medical profession and consumers;
• include opportunities for public submission;
• be published; and
• use Government resources efficiently.

OBJECTIVES OF THE REVIEWS

To ensure the clinical and financial sustainability of the MBS, reviews will assess specific services or MBS item(s) and associated policy issues in a focused, fit-for-purpose, evidence based process. Findings will recognise that MBS funding should align with contemporary evidence, reflecting appropriate patient groups and best clinical practice.

MBS REVIEWS PROCESSES

The first stage of a review is the identification of its scope, including whether parts of the review should be considered via the MBS-specific pathway or the policy-orientated pathway, which will consider policy issues not suitable for the formal MBS processes, or other issues (such as pharmaceuticals or prostheses) falling under separate processes.

The identification of a review scope and the allotment of pathways is the task of the Consultation Review Committee (CRC), a time limited committee of nominated experts, determined and chaired by the Department, and given the charter to advise the Department on policy issues.

The MBS pathway will follow the Medical Services Advisory Committee (MSAC) process. (MSAC and its subcommittees were established expressly to advise on MBS matters.) The MBS pathway includes the:

• development of a protocol;
• collection and evaluation of evidence on the basis of the protocol, ending in a review report; and
• advice and recommendations to the Minister through the Department.

Throughout the review process, there will be pollination of issues across the MBS and policy pathways, ensuring alignment of processes and consistency in deliberations, but at the same time providing flexibility and the ability to react to circumstance as they arise.

At a review’s culmination, the advice and recommendations of the CRC and MSAC inform the Department’s advice for the Minister.

STAKEHOLDER AND PUBLIC CONSULTATION

Stakeholder engagement is a vital part of MBS Reviews, particularly as feedback will help inform the final review report and recommendations to the Minister. In that vein, the Department will publish for public comment the draft review documents, that is the draft protocol and draft report. Direct stakeholder and the general public (patients, consumer groups, individual service providers, health professionals and manufacturers) will be invited to provide comment on the draft review documents as they are made available on this website.

As part of its commitment to stakeholder engagement, the Department will open MBS Reviews documents such as review scopes, protocols and reports to periods of public consultation, seeking feedback on their design and content. The Department is particularly interested in feedback on the clinical research questions, clinical pathways, and target stakeholders set out in the MBS Reviews protocols and reports.

Any feedback should be sent to MBSReviews@health.gov.au during the designated window of public consultation. All feedback will be treated as confidential; it will not be published

The table below sets out past and current reviews, and whether review documents—scopes, protocols and reports—are open for public comment.

General inquiries or comment on MBS Reviews documents can also be sent to MBSReviews@health.gov.au

CURRENT MBS REVIEWS

These review topics were selected against current evidence, quality and safety concerns identified in national and international literature, MBS claiming data, and on advice from medical craft groups.

	Services	Status
		Scope	Protocol	Report
MBS Review 1	Ophthalmology (Stage I)	MBS Reviews 1–4 were demonstration reviews, and are completed. Demonstration reviews of existing MBS items
MBS Review 2	Colonoscopy
MBS Review 3	Obesity surgery
MBS Review 4	Pulmonary artery catheterisation
MBS Review 5	Ophthalmology (Stage II)	Complete	Complete	Complete
MBS Review 6	Cardioverter defibrillator services	Complete	In development
MBS Review 7	Carotid surgery	Complete	In development
MBS Review 8	Vulvoplasty/labioplasty	Complete	Public Consultation closed on 5 March 2013
MBS Review 9	Inguinal hernia surgery	Complete	Public Consultation closed on 5 March 2013
MBS Review 10	Botulinum toxin injections	Complete	Public Consultation closed on 5 March 2013
MBS Review 11	Lipectomy	Complete	Public Consultation closed on 5 March 2013
MBS Review 12	Cardiac perfusion	Complete	Public Consultation closed on 5 March 2013
MBS Review 13	Rhinoplasty	Complete	Public Consultation closed on 5 March 2013
MBS Review 14	Diagnostic knee arthroscopy	Complete	Public Consultation closed on 5 March 2013
MBS Review 15	Varicose vein surgery	Complete	On hold
MBS Review 16	Wrist ganglia surgery	Complete	Public Consultation closed on 5 March 2013
MBS Review 17	Skin services	Complete	In development
MBS Review 18	Paediatric surgery	Public Consultation closed on 5 March 2013
MBS Review 19	Ear, nose and throat surgery	Out for public comment until 28 April 2013
MBS Review 20	Radiation oncology	In development
MBS Review 21	Vitamin D testing	Complete	Public Consultation closed on 25 March 2013
MBS Review 22	Vitamin B 12 testing	Complete	Public Consultation closed on 25 March 2013

Page currency, Latest update: 12 March, 2013