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Telehealth inaction frustrates sector

Medicare MBS Review Taskforce

The optometric sector has expressed disappointment over a lack of progress to introduce Medicare coverage for telehealth services during the COVID-19 pandemic, after hoping the measure would have been in place by now, if not several weeks ago.

According to industry figures, health officials are concerned that optometric care cannot be effectively provided via telehealth. This is despite efforts to help the government understand how optometrists can perform virtual consultations and the fact Medicare rebates would be relatively low for the service.

The sector has also had a tested platform, Oculo, in place since the beginning of April, with some optometry providers reporting that telehealth has already helped save the sight of patients in some instances.

More than six weeks ago, the Federal Government expanded Medicare telehealth items to encompass allied health professionals. The move fuelled hope that optometrists, many whom have moved to an urgent care model or closed their practices, would soon have access to a similar scheme.

Lyn Brodie.

OA, Specsavers, Luxottica and Diabetes Australia have lobbied for telehealth-related modifications to item numbers 10916 and 10918. However, this proposal still remains under government consideration. In the meantime, optometrists performing telehealth have been told to charge appropriate fees for the services, while others, such as OPSM, have been providing virtual consultations free of charge.

“We are disappointed that there is not yet Medicare support for telehealth services provided by optometrists,” Ms Lyn Brodie, CEO of OA, told Insight. “And [we] had hoped Medicare coverage for some optometry consultations provided by telehealth would have been introduced a number of weeks ago.”

Brodie said tele-optometry provides an important avenue during the pandemic crisis, enabling patients to access the eye care they need, while minimising infection risk associated with travelling to access care.

She said tele-optometry could be undertaken in a manner to support ongoing chronic disease management, and provide effective triage of new or acute presentations.

Adopting free remote video consultations, OPSM optometrists have already intervened and saved the sight of some patients.

“Commonwealth Department of Health officials have indicated in public forums that they have concerns that optometric care cannot be effectively provided via teleheath. We have sought to ensure that the department understands how optometrists can provide care via telehealth,” Brodie said.

The Medicare items that Optometry Australia, and the optometry sector, have sought to be permitted to be billed when provided via telehealth, attract relatively low rebates, and we do not expect that total cost associated with billing these items for telehealth consults would be high, particularly in relation to billing of optometry items outside the pandemic crisis.”

The COVID-19 telehealth items for other health professions are valid until 30 September. If Medicare coverage of telehealth optometry was enabled, Brodie expects it would be for the same timeframe.

Industry poised for telehealth approval 

Specsavers director of communications Mr Charles Hornor said having worked so hard in a united approach to government, the entire industry is disappointed that the telehealth item numbers have not come to fruition.

Charles Hornor.

“Together we have presented a clear battery of tests that could be performed under the 916 and 918 item numbers,” he said.

“We have a fantastic industry-inclusive platform in Oculo that is ready to go for telehealth and there is no real work required to convert the two item numbers for telehealth usage. And, of course, the big reason behind all the effort is to make sure that people with essential and often urgent requirements can access the care they need whether that be in-practice or, if it is not possible to leave home, online.”

Looking ahead, Hornor said is important to note the backlog of patients that will need to be seen. This includes people with diabetes who have fallen behind on their regular eye check or patients with a range of other conditions and anxieties that could have been managed via telehealth from the end of March.

“Our optometry team is currently working through what the overall numbers look like so that we can work out how to recall patients when that becomes allowable as restrictions loosen,” he said.

“With ongoing social distancing likely to be the norm for the foreseeable future, it won’t be a matter of opening practices again and simply seeing the same numbers as before.”

Telehealth proving its worth

OPSM’s director of eyecare and community for Australia and New Zealand Mr Peter Murphy said the company strongly believes that all Australians should have access to eyecare services, no matter the circumstances.

Last month, OPSM launched tele-optometry in Australia and decided to offer it free of charge, despite the lack of Medicare coverage.

“Over the past few weeks we have already seen some instances of serious eye health conditions where our optometrists have been able to intervene and saved someone’s sight thanks to a remote video consultation,” he said.

“In the long term, even after the current health emergency has subsided, we see tele-optometry and telehealth remaining a crucial solution for those whom maybe homebound, or unable to visit one of our stores for a variety of reasons, and hence we expect the conversations on this topic to continue.”

Department of Health responds

Asked about the lack of progress, a Department of Health spokesperson said the COVID-19 telehealth items announced to date were able to be implemented quickly because they mirrored the clinical requirements for existing face-to-face MBS items.

The department is now considering whether to introduce additional telehealth services where mirroring existing item numbers is not possible, because the MBS item contains clinical elements that require face-to-face contact.

“The department is engaging with representatives of the relevant professions, including optometry, to discuss what services can be safely and appropriately delivered by telehealth. The department will then provide advice to the government,” the spokesperson said.


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