Summary of the fourteenth meeting of the Private Health Ministerial Advisory Committee, 19 June 2018, Department of Health offices (Scarborough House), Canberra

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Page last updated: 17 July 2018

Printable version of the Meeting Summary 19 June 2018. (PDF 1216 KB)


Members and proxiesSecretariat and Other Attendees
Dr Jeffrey Harmer AO, ChairSusan Azmi, Secretariat
Michael Roff, Australian Private Hospitals AssociationMargaret Noris, Secretariat
Philip Truskett AM, Royal Australasian College of Surgeons Debbie Hurlbut, Secretariat
Matthew Koce, Members HealthPauline Dusink, Secretariat
Jane Griffiths, Day Hospitals AustraliaPierre Nijssen, Secretariat
Dr Rachel David, Private Healthcare AustraliaJosh Shanahan, Secretariat
Garry Richardson, Expert memberTristan Gairey, Secretariat
Tony Lawson, Consumer Health ForumPeta McElgunn, Secretariat
Marcus Dripps, Allied Health Professions AustraliaNicole Keeling, Secretariat
Ian Yates AM, COTADavid Weiss, Department of Health, Observer
Anne Trimmer, Australian Medical AssociationAlex Caroly, Senior Adviser to the Minister for Health
Penny Shakespeare, ex-officioIgnatius Li, Deloitte
David Ross, Medical Technology Association of Australia, ProxyAl Merten, Deloitte
Cathy Ryan, Catholic Health Australia (St John of God Health Care), ProxyCatherine Boekel, WhereTo


Ian Burgess, Medical Technology Association of Australia
Toby Hall, St Vincents Health Australia

1. Welcome, apologies and introductions

  • The Chair noted apologies for this meeting.

2. Product Design

  • Deloitte Actuaries and Consultants presented the results of further modelling undertaken on additional product categorisation scenarios.
  • The Committee considered the results of this modelling and outlined their views on the various approaches.
  • The Committee also discussed the communications that would need to occur between insurers and their policyholders on product changes associated with the new categories.

3. Implementation of Reforms Update

a) Improved Models of Care Working Group
  • The Secretariat provided an update on the progress of the Improved Models of Care Working Group, and its sub-groups on mental health and rehabilitation.
  • Members were advised that the main issues considered to date include: types of treatment and clinically appropriate settings of care; data trends and approaches to establishing an evidence base; private health insurance legislation and current funding arrangements; and incentives for admitted hospital-based care and barriers to alternative models.
b) Mental Health Reform
  • The Committee noted that additional administrative changes may be required to the Transfer Certificate in order to ensure that consumers’ use of the Mental Health upgrade waiver is accurately recorded on their records.
  • The first quarter of data on the use of the waiver will be available by early August.
c) Ministerial Advisory Committee on Out-of-Pocket Costs
  • The Committee noted that the third meeting of the Ministerial Advisory Committee on Out-of-Pocket Costs (the OOPCC) was held on 20 June 2018 and that the OOPC has reached the following interim positions:
    1. There is a need for consumer education programs to inform consumers that high fees do not necessarily represent better quality care.
    2. There is strong support for fee transparency and, to the extent that it is possible to do so, provision of meaningful fee information prior to the first consultation.
    3. Booking fees and administrative fees (not linked to Medicare items) are unacceptable.
  • The Secretariat advised members that Professor David Hillis has been engaged to interview medical leaders and other industry representatives to inform potential best practice models to address the lack of transparency around out-of-pocket costs.
  • The Department will further develop these models prior to the next meeting for the Committee’s consideration.
d) Clinical definitions
  • The Secretariat advised that Professor Nick Talley was engaged by the Department to conduct an independent review of the clinical categories and mapping of MBS items to the clinical categories.
  • Professor Talley has provided the Department with a final report which is currently being considered.
  • The updated clinical categories will be provided for further comment through the exposure draft of the amendments to the Rules.
e) Second tier
  • The Committee was informed that consultation on the list of private hospitals grouped by second-tier hospital category has been postponed until after the Department has consulted on cost recovery arrangements for second-tier.
  • The Secretariat advised that the Department is currently working with the Department of Finance to finalise a Cost Recovery Implementation Statement for second-tier before it consults the sector about its approach to cost recovery.
  • The Committee was also informed that the cost recovery fee will be included in amendments to the Private Health Insurance Rules.
  • The Secretariat also updated the Committee on the second-tier indexation working group that was proposed to PHMAC in April. The Department is currently drafting Terms of Reference for the working group, and will formally request nominations for the group from Committee members in July.

4. WhereTo presentation – Findings from consumer testing of information provision reforms

  • Ms Catherine Boekel from Whereto Research presented consumer research undertaken on the information provision reforms announced by the Government in October 2017.

5. Legislation update

  • The Secretariat advised that there was potential for the Private Health Insurance Legislation Amendment Bill 2018 package to be referred to a Senate inquiry.
  • The Secretariat advised it would let members know whether the Bill package was referred to an inquiry and what this would mean for timing of the passage of legislation.

6. Other Business

  • The Committee noted that its next meeting is scheduled for Tuesday, 11 September 2018.

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