A new era begins

Rebates have been set for nurse practitioners and midwives. By Annie May

The first day in November will be remembered as a big step for nurses – the day when Medicare starts offering rebates for services provided by nurse practitioners and midwives.

It has been a long road to get to this point with the government hoping the landmark changes relieve the pressure within the health system.

For the nurse practitioners (NP) and midwives, it is the start of being properly recognised for their skills and the work they do.

While Medicare already pays rebates for limited services provided by NP’s, they have had to be working under the GP’s direct supervision, and the rebate continues to be claimed in the doctor’s name.

The rebates will vary, according to the time of the consultation and the complexity of service provided.

For a standard 20 minute consultation with a PN, the rebate will be $20.15. For a straightforward attendance that requires a short patient history and limited examination it is $9.20.

Longer consultations between 20 to 40 minutes will attract a rebate of $38.25, rising to $56.30 for those that run after that time.

Helen Grosby, president of Australian College of Nurse Practitioners, said it was exciting times for these nurses.

However, she said, there was still a way to go.

“It is a shame that nurse practitioners still aren’t considered for the work they do. When comparing the rebates doctors receive for doing the same service, the disparity is clear,” she said.
Grosby said the ACNP was currently working on addressing this with the government.

“Now that we have a foot in the door, and are actually considered part of the health system, we can mount more pressure for equity.”

For midwives, a short antenatal consultation lasting up to 40 minutes will qualify for a rebate of $31.10. Consultations that last longer will rise to $51.35.

Consultations lasting at least 90 minutes and include an assessment and the preparation of a maternity plan attract $306.90.

If a midwife provided, or is a member of the practice which provided the patients antenatal care and is required for up to 12 hours for the delivery, the fee is $724.75.

And if the midwife has provided the patient’s antenatal care and is required for up to 12 hours at the hospital for the delivery, it will cost $724.75.

The rebates only apply to midwives working in hospital environment and do not apply to home births.

Some concern has been raised over the introduction of the changes, with the Pharmacy Guild of Australia saying inconsistent legislation between states and territories will cause confusion.

Pharmacy Guild president Kos Sclavos told Pharmacy eNews that the changes had been rushed through unnecessarily.

“Another month or so, so that we could get definite information from all the state and territory governments, wouldn’t have done any harm,” Sclavos said.
While clear information about the new prescribing powers has been issued by the federal government, the eight state and territory governments have not had time to create legislation for it.”

Meanwhile, the RCNA have called for an MBS review to improve access to mental health services
Access to mental health care would not improve until the public are provided with Medicare rebates for the full range of health care services they need, said Debra Cerasa, RCNA CEO.

The items listed under the MBS need to be urgently reviewed and expanded to ensure they adequately cover the mental health care services provided by health professionals other than doctors, she said.

“Currently, there are not enough items under the MBS that cover the range of services required by people with serious and complex mental health conditions. The public is being prevented from accessing the services they need from nurses because of this lack of flexibility in the system,” she said.

“We need to ensure that the community is able to access the mental health care they need from the full range of health care professionals who can provide it.”

“Mental health nurses play a critical role in improving mental health because they are able to connect vulnerable groups, such as homeless people and the asylum seeker community, into other health services they may otherwise be unable to access.”