MBS Review: Advisory Committee report on surgical assistants
15 May 2023
The Department of Health and Aged Care has recently released a report into out-of-pocket costs for surgical assistants. This is part of a rolling program of reform of the Medicare Benefits Schedule (MBS).
Surgical assistants are health professionals with clinical skills who assist surgeons during procedures.
Surgeons can choose their own surgical assistant.
Surgical assistants can be medically trained, such as another surgeon or a general practitioner (GP). These are called medical surgical assistants.
Surgical assistants do not need to be medically trained. A surgeon can choose to work with a non-medical surgical assistant, such as a registered nurse or nurse practitioner with perioperative training.
There is a lack of available medical surgical assistants in both rural and metropolitan areas so consumers living in these areas are more likely to have a non medical surgical assistant involved in their care.
Currently consumers who undergo surgery can be reimbursed some of the cost of the medical surgical assistant through the MBS. There is no MBS rebate for non-medical surgical assistants and consumers pay for the surgical assistant out of their own pocket.
The Federal Government understands out-of-pocket costs for surgery may drive more people to wait to have surgery in public hospitals, where there is no out-of-pocket expense. This puts more pressure on the public system and can lead to increased pain, distress and deterioration of the person’s condition while they wait. We know many people are waiting longer than clinically recommended times for planned surgery.
The MBS Review Advisory Committee (MRAC) established the Surgical Assistant Working Group (the Group) to look at out of pocket costs associated with Surgical Assistants and whether patients should receive a Medicare rebate when a surgeon chooses to use an appropriately experienced and qualified non-medical surgical assistant.
The Group reviewed the fees charged by medical surgical assistants and found that they are not excessive and recommended no change to the MBS item.
They also recommended that patients should be reimbursed by Medicare if they agree to have a suitably qualified non-medical surgical assistant. They stated that introducing an MBS item for non medical Surgical Assistants would reduce out-of-pocket costs for consumers and ensure that all patients have equal access to reimbursement.