Prior to May 1, Medicare covered MIGS procedures regardless of whether they were performed in conjunction with cataracts, but now access to the highly effective glaucoma treatment has been restricted.Recent alterations to Medicare it numbers mean in order to qualify for a rebate, patients now either have to have a cataract operation at the same time or, pay for all costs associated with having a standalone MIGS operation in a private hospital. This includes surgeon’s fee, the theatre and other operating costs, an anaesthetist and the device/s itself, which may not be covered by private insurers.{{image2-a:r-w:200}}Even patients who are covered by Medicare may still have to pay more than the cost prior to May 1 as the public healthcare syst will not pay any extra to the surgeon for the MIGS part of the procedure.As a result, GA has produced two tplates disadvantaged patients can use to send letters to Minister Greg Hunt to express their dismay at the decision.“These decisions affect those who have already had their cataracts done; who are older and whom have run out of glaucoma treatment options… Mr Hunt, this is a poor outcome for people requiring a MIGS procedure and I request a return to the situation prior to 1st May 2017, where MIGS operations were eligible for a Medicare rebate. The previous state of affairs should continue until the Medical Services Assessment Committee (MSAC) has reported and a decision has been taken on whether to allow/deny the Medicare reimbursent of MIGS procedures,” part of the first letter states.Meanwhile, the second letter adopts a more conciliatory approach: “My eye doctor has advised that my sight threatening glaucoma might be better controlled with MIGS surgery, which has evidently been proven to be safe, effective and well accepted here and overseas. I understand the changes introduced by your Department … will require me to fully fund surgical costs of MIGS which is a major financial burden that I can ill afford, especially at this stage of my life.
This decision significantly increases the risk of my vision becoming permanently worse, perhaps even resulting in me going completely blind. This will be bad for me, for my family and will ultimately cost Australian taxpayers more to care for me.”
In the past MIGS was usually only used for children with gongenital glaucoma, which limited procedures to around only 20 each year. However, the development of new stents for adults saw the number of procedures skyrocket and led to MIGS’s roval from the MBS, pending a review.The results of the review, currently being undertaken by the Department of Health and MSAC, will likely to be released later this year.
IMAGE: Image courtesy: Flickr/Community Eye Health
