Medicare Australia is intending to undertake a post-implementation review of the CDM items during the first half of 2007, for completion around mid-year. This was flagged when the items were introduced.

A CDM items checklist is available that GPs can use to help assess how well their CDM plans measure up to MBS requirements. The intention of this checklist is to provide easy-to-use general guidance on the formal MBS requirements which GPs must meet when using the CDM items.

Click here to view the CDM Items Checklist

This item will be available from 1 November 2006, for GPs to provide a preventive health check for people between the ages of 45 and 49 (inclusive) who are at risk of developing a chronic disease.

The following links provide further information on this new item number:

http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health-epc-45check

http://www.health.gov.au/internet/wcms/publishing.nsf/Content/mbsonline-downloads

This “Better Access” initiative aims to increase community access to GPs, psychiatrists, clinical psychologists and other allied mental health professionals for mental health care. This includes 3 new item numbers for GPs.

1.       GP Mental Health Care Plan                   (Item 2710, $150.00 – 100% rebate)

2.       GP Mental Health Care Plan Review        (Item 2712, $100.00 – 100% rebate)

3.       GP mental Health Care Consultation        (Item 2713, $66.00 – 100% rebate)

“Better Access” also provides GPs with new referral pathways:

• All GPs can refer patients who are being managed under a mental health care plan  - there are no mandatory training requirements to access the new GP Items
• GPs can refer patients to clinical psychologists, general psychologists, social workers and occupational therapists who are registered with Medicare Australia.
• Patients will be eligible for up to 12 sessions of “Focused Psychological Strategies” or “Psychological Therapies” per calendar year (6 initial sessions, with the option of re-referral after a GP review).

Patients are eligible to claim Medicare Rebates for these services where they are referred by a medical practitioner who is managing the patient under a GP Mental Health Care Plan (Item 2710) and/or a Consultant Psychiatrists Assessment and Management Plan (Item 291 $400, 85% rebate), or on direct referral from a psychiatrist or pediatrician.

The ADGP has developed additional resources to assist to orient divisions, GPs and other practice members to the new Medicare mental health items.

At the following link (http://www.primarymentalhealth.com.au/site/index.cfm?display=15129) you will find:

• Overview information
• Patient pathways – an explanation of GP referral options
• GP fees and patient rebates – an explanation of patient fees and rebates
• Better Access flowchart – sets out the three components in detail.

It has been noted that throughout the network some patients have been aiming to access the MBS rebates through allied health service providers but have found when they get to Medicare after paying their account they can not claim because they are a DVA patient and sadly patients are losing their money.

When referring a DVA patient to allied health:

Patients who pay for their own visit to the allied health professional thinking they will get a rebate from Medicare will infact receive no refund. Medicare does not pay a refund to DVA card holders.

• GPs referring patients to allied health who are DVA cardholders (with the exception of white DVA card holders as these are disease specific and would need to relate to the disease) either the GPs surgery or the patient needs to ring and confirm with that provider that they are:

Registered with DVA to participate, and

1. that the provider actually accepts to follow the DVA rules to see this patient and bill them using their DVA card.

For more information please look at the fact sheets on the DVA website at www.dva.gov.au or feel free to ring with any questions on 13 32 54.

ADGP commissioned the development of templates for GP Management Plans, Team Care Arrangements and the review of those plans. These templates are now available on ADGP’s website at: http://www.adgp.com.au/site/index.cfm?display=5260 Detailed instructions for downloading the templates are also available on the website. The templates can be imported into the letter writer facility in Medical Director. The National Coordinator will consult with State-Based Organisations and Division about General Practice and the Network’s information, education and training requirements and will develop a suite of downloadable resources such as flowcharts, checklists and frequently asked questions. The resources will be uploaded onto the ADGP website as they become available. For more information please contact Megan Hansford on (02) 6228 0829 or mhansford@adgp.com.au

From 1 July 2005 New Medicare Chronic Disease Management items have replaced Enhanced Primary Care (EPC) care planning items. Please visit the following links for factsheets, forms and other supporting information: MBS Items - Fact sheet MBS Items - Chronic Disease Descriptors MBS Items - Notes MBS Items - Questions and answers MBS Items - Scenarios MBS Items - Changes from existing EPC CDM Items Q&A Update 22/8/05 Forms (Templates) Checklists More information can also be accessed from the Department of Health & Ageing website.