‘Stupid’ Medicare rules force Australians to wait six months and pay $4,000 to see a psychologist
- Patients unable to get Medicare reimbursements to see psychologist due to ‘dumb’ rules
- Private healthcare providers want rules changed to make it easier to access treatment
- But the corps of doctors and Health Minister Mark Butler defend the existing system
Patients can’t get Medicare reimbursements to see a psychologist because of “stupid” bureaucratic rules that cost them up to $4,000 a year, according to a private healthcare provider.
The solution could be a relaxation of the rules around telehealth consultations, but Health Minister Mark Butler and the Royal Australian College of General Practitioners have opposed any relaxation of the regulations.
With mental health issues soaring during the Covid pandemic and lockdowns, some people have had to wait up to six months to see a psychologist.
Patients can get up to 20 services with Medicare reimbursements with a psychologist if they have a mental health care plan established by a referring physician.
But Australia’s shortage of GPs means long wait times to see a doctor, which in turn means delays in referrals to psychologists.
“Stupid” bureaucratic rules cost patients up to $4,000 a year for mental health treatment, according to a private healthcare provider. Pictured is an image of a woman who looks distressed
The Australian Psychological Society said allowing some sessions with a psychologist without a mental health plan would help reduce long waiting times.
“Getting patients to psychologists faster by no longer requiring a referral for the first three sessions for the next 12 months is common sense and a win-win situation for everyone,” said APS President Tamara Cavenett, to the Courier Mail.
Another Medicare rule is costing patients thousands of dollars out of pocket for their treatment because it prevents them from getting reimbursed.
A company called InstantScripts charges $49 for a telehealth consultation with a doctor, but because it operates outside of the Medicare system, patients can’t get reimbursed.
InstantScripts can provide a mental health plan, but since their consultation does not allow reimbursement, the patient cannot obtain reimbursement from the psychologist they are referred to either.
When a patient sees a psychologist, he must then pay the entire cost himself – varying from $180 to $300 per session.
InstantScripts founder Dr Asher Freilich wants the rule changed, calling it “dumb”.
“We don’t want to be paid $1 by Medicare. We just want our patients to get funded access to psychology services,” he said.
MyMirror, which provides mental health treatment online, also wants Medicare rules updated.
Private healthcare providers want telehealth sessions with a psychologist to be eligible for Medicare reimbursements. Pictured is an image of a doctor on a phone call
If the rules were changed, it said people could do a telehealth consultation with InstantScripts and speak to one of its 60 telehealth psychologists within hours.
“Every politician and every mental health advocate…insists on wanting new solutions, but we…we need solutions to simple problems,” said My Mirror founder Dr. Matthew Zoeller.
But Mr Butler said a Medicare review found telehealth was not appropriate for a mental health diagnosis.
“That’s why, under the Medicare benefits program, the initial consultation to consider a diagnosis of a mental disorder and develop a treatment plan should be conducted only through face-to-face and video consultations, rather only by phone,” he said.
Health Minister Mark Butler (pictured) said a Medicare review found telehealth was not appropriate for a mental health diagnosis
The Royal Australian College of General Practitioners agreed with Mr Butler.
RACGP President Dr Karen Price said allowing patients to bypass their doctors to get Medicare-subsidized psychology sessions was not the answer.
“What might seem like depression can be something else entirely, like incipient dementia or hypothyroidism,” she said.
Fifty percent of patients with mental health issues also have other chronic conditions, she said.
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