Medicare Benefits Schedule (MBS) Review
As part of the Department of Health's Medicare Benefits Schedule (MBS) review, the AASW has advocated for significant reform, with a focus on the mental health items and greater recognition of Accredited Mental Health Social Workers (AMHSW). Since 2015, we have made several submissions and engaged in all major consultation forums with key stakeholders and decision makers.
Our main points have included:
- The need for a person-centred, holistic, evidence-based, collaborative and systemic approach to MBS-funded mental health supports;
- Greater recognition and use of clinical social work services across all Medicare initiatives;
- Action to address pay parity for AMHSWs.
As part of the Review in June 2018, the Mental Health Reference Group of the Medicare Benefits Schedule Review Taskforce was formed (which includes social work representation) to specifically review the mental health Better Access items.
The AASW convened the MBS Review Working Group to provide expert feedback and direction, whose members have included:
- Julianne Whyte OAM, AMHSW
- Suzanne Doorakkers-Sprague, AMHSW
- Russell McCashney, AMHSW
- Carolyn Cousins, Convenor of the Clinical Division of the Australian College of Social Work
- Naomi Blake AMHSW
- Dorrit Schultz, Social Worker
- Lynne Harrold, AMHSW (until Dec 2018)
- Debra Parnell, Manager Social Policy & Advocacy, AASW
- Dr Sebastian Cordoba, Senior Policy Advisor, AASW
In February 2019, the Department of Health released for consultation the MBS Review Mental Health Reference Group Report. The report details the views and recommendations from the Mental Health Reference Group and have been released for the purpose of seeking the views of stakeholders. The AASW was pleased to note that many of our concerns were reflected in the Report and its recommendations.
We have been working on our submission, which also includes the AASW's proposed model for MBS Better Access that focuses on client need, recognises complexity, supports collaboration and is inclusive of all professional groups.
In our submission to the recommendations, amongst several points we:
- Support the recommendation to extend MBS Better Access clients who do not meet the full criteria for a mental health diagnosis but are at risk of developing a mental health condition
- Support the recommendation to increase the number of sessions to up to 40 per calendar year, taking into consideration complex need, not just mental health diagnosis
- Support the greater focus on group work and improved access to supports for family members and carers
- Support the recommendation that the list of approved therapies be reviewed and expanded
- Support the recommendation for inclusion of greater recognition of individual mental health support and therapy for residents in aged care facilities
- Support the expansion of digital mental health and telehealth services.
In relation to pay parity for AMHSWs, this was beyond the scope of this initial inquiry and part of the recommendations are that a new group be established to review access and rebates. The AASW supports this measure and will continue to advocate on this point, and advocate that equitable representation is ensured.
The AASW will lodge our submission shortly and the final recommendations from the MBS Review Mental Health Reference Group Report will then be considered by the Minister for Health and government for possible implementation.
As the peak body for qualified social workers, we will continue to advocate for AMHSWs and for significant mental health reform. We will update members of any progress
- In February, the Department of Health released for consultation the MBS Review Mental Health Reference Group Report. The report details the views and recommendations from the Mental Health Reference Group and have been released for the purpose of seeking the views of stakeholders until May 17. The final recommendations from this process will then be considered by the Minister for Health and government for possible implementation.
- AASW MBS Review Working Group has met to discuss these developments and the AASW approach in making a response to the recommendations and proposed changes to the Better Access program. A model for the delivery of mental health services under Better Access and evidence to support this and the role of AMHSWs is being developed to contribute to our submission.
- As reported in the media and through AASW’s e-news and social media, the Minister for Health Greg Hunt has announced a pause to the finalisation of the recommendations from the Medicare Review Taskforce, in light of disagreement between factions in the Australian Psychological Society, impacting on the position for access to Psychologists under Better Access. To ensure the AASW is informed and proactive Cindy Smith has met with the CEO and policy team of Occupational Therapy Australia. A meeting has also been requested with the CEO of APS.
The AASW has been part of the Department of Health's Medicare Benefits Schedule review since its announcement in April 2015.
On 22 April 2015, the Minister of Health announced that a Medicare Benefits Schedule (MBS) Review Taskforce would be established. The taskforce is considering how the more than 5,700 items on the MBS can be aligned with contemporary clinical evidence and practice and improve health outcomes for patients. The review is clinician-led and there are no targets for savings attached to the review. The taskforce recommendations will be made to the Minister.
The AASW has so far been involved in all the relevant stakeholder consultation forums, meeting with Chair Professor Bruce Robinson, and making two submissions based on member consultation in relation to pay equity and better utilisation of social work supports. Learn more about the process by visiting Medicare Benefits Schedule review website.
In June 2018, the Mental Health Reference Group of the Medicare Benefits Schedule Review Taskforce was formed, which includes social work representation. Following consultation with AASW members in private practice and providing services under Medicare, the AASW formally presented our arguments to the Reference Group on the 12th July, both in writing and in person.
Our submission focussed on items relating to
- Individual and group sessions of Focussed Psychological Strategies provided by eligible psychologists, OTs and SWs
- Chronic Disease Management program – GP Management Plan and Team Care Arrangements
- Psychology service for a person with a chronic condition under a care plan
- Non-Directive Pregnancy Support Counselling Services
- Psychological Therapies provided by clinical psychologists
Amongst several points we made to the Reference Group, we are strongly advocating for:
- the Medicare rebate inequities between Psychologists and Social Workers to be addressed, and the removal of the 3-tier rebate schedule;
- greater recognition of AMHSWers within the Better Access program;
- increase in the number of sessions under Better Access;
- Social Workers to be identified under items 10956 and 10968 as per psychology and other allied health. We also recommended an increase in number of sessions under these items, across disciplines.
- all residents in residential aged care facilities be able access to appropriate EPC and MH services with a GP referral regardless of funding scheme;
- Increase the therapies approved for use.
We will continue to work with the Reference Group on these and other issues, before it finalises its recommendations to the Taskforce. We are continuing to work with the Taskforce and will provide more information as it becomes available.
AASW MBS Review Submissions
Submission 1: 2015 "Rebate equity for Accredited Mental Health Social Workers"
Submission 3: 2018 "Accredited Mental Health Social Workers: Education and Training"
This is only one avenue through which the AASW advocates for Medicare reform, with other recent examples including giving evidence in relation to the Family Court System calling for a specific family violence MBS item and a letter to the Health Minister calling for the inclusion of Better Access in residential aged care.