The Department of Health and Aged Care is exploring reducing the number of Hearing Service Program Schedule items and says this is to minimise repetition, simplify claiming and improve patient outcomes.
The department states the proposed approach being explored is to reduce the Schedule of Service Items and Fees (the Schedule) underpinning the program to about 10 items.
It says improvements aim to make the program better for patients, simpler for providers and reduce administrative burdens.
Consultation on the draft changes with stakeholders (program providers, manufacturers, suppliers and the broader hearing sector) and patients of the program closed on 2 April 2024. Their feedback will be considered as part of broader consultation on the program.
Changes to the Schedule would give patients access to more activities and time frames in which to receive services and recognise the importance of clinical expertise and decision making, the department says. Changes would also provide greater access and flexibility for rehabilitation activities and to whom they can be provided.
Removing maintenance agreements
Revised arrangements for maintenance, battery supplies, consumables, and repairs of devices are being suggested.
In addition to a new repair service item, the department proposes to remove maintenance agreements, remove all maintenance claim items (700, 710, 711, 722, 790 and 791) and introduce a quarterly auto-payment to providers based on the number of active clients with devices that have had an approved claim within the past two years.
The set fee will cover maintenance for all clients fitted with a device.
MHLT may become Device Eligibility Criteria
The department is also considering improvements to the Minimum Hearing Loss Threshold standard (MHLT) and will consult on these in a subsequent consultation. The proposed new name is the Device Eligibility Criteria, to better reflect the intent of this standard.
Device Eligibility Criteria would incorporate:
- a new questionnaire about motivation (for initial fittings only), and
- a pure tone threshold, using a 4 FAHL (similar to the current 3 FAHL),
- or evidence of other indicators such as fatigue, hearing difficulty and/or tinnitus.
Other proposals include that clinical sessions must include:
- review/evaluation of hearing and communication status and goals.
- updating clinical and audiological history (if not checked in the past 12 months)
- training and communication strategies to manage the effects of hearing loss (unaided or aided – device/ALD) and if aided, check and comment on hearing device function.
Follow-up required six to 12 weeks after fitting
For fitting requirements, a face-to-face follow-up audiology appointment would be required six to 12 weeks after hearing aids are fitted, with the option to attend by phone or email.
A claim can only be submitted once the patient can use and has accepted the device.
If follow-up is not completed within 12 weeks, fitting and devices claims will be recovered, unless there is supporting documentation as to why a follow up did not occur such as the patient did not attend the appointment or relocated.
Remote controls costing more than $100 would require pre-approval from the program.
A second consultation phase later in 2024 will comprise remaining suggested revisions, including the proposed updated MHLT and new name, suggested device technologies and categories, and minimum specifications.
Any program changes are a decision for Australian Government consideration.
The program provides subsidised high-quality hearing services and devices to eligible Australians and has been delivered for more than 20 years.
Read the summary of proposed changes and the proposed changes to service items and standards
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