Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

I table a supplementary explanatory memorandum relating to the government amendment to be moved to the Private Health Insurance Legislation Amendment (Medical Device and Human Tissue Product List and Cost Recovery) Bill 2022.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

I would like to get a better idea of the time frames that are sitting around the additional information around the time frame in which the new bundling arrangements are to come into place. Could the minister advise when we expect to have an idea of the mechanism of the bundling and the timing of that bundling?

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

I'm advised that two weeks ago we initiated consultation on these questions. It's expected that that consultation will run for another six weeks. Sometime after that the government will be in a position to make public the relevant information. The bills commence on 1 July.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

I'm wondering if the minister could advise whether the substantive minister has had any issues raised by the sector as to the ability for the IT changes that are going to be necessary to enable the change in the bundling application by 1 July. I'm wondering whether you've had any concerns raised by the sector about your ability to meet those time frames.

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Senator Ruston, thanks again for the question and apologies for taking time to consult officials. I am advised that the bundling issues that you refer to are not in fact contained in this bill but that they are being dealt with through a separate process.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Could you give us an idea about the time frame of the requirements in relation to bundling? Is it 1 July or is it not until September?

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

I am advised that the relevant time period is the second half of this year, of course, after 1 July.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

In relation to the changes that are going to take effect as a result of this particular legislation, in relation to the levy and, obviously, the changes to the cost recovery framework—I suppose they're the two main components—what requirements does the government believe that industry will have to put in place by 1 July?

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

I wonder if you could be more specific about the kinds of changes you're contemplating, because—

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

I'm not contemplating any changes.

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

You are seeking information about certain steps that you believe may need to be taken by industry, and I'm wondering if you could elucidate what they are.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

The industry has expressed concerns to me that they have IT requirements that they will need to put in place by 1 July in order to meet the requirements of this legislation. I'm wondering whether that's correct or not.

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

The advice I have is that that is not correct.

David Pocock (ACT, Independent) Share this | Link to this | Hansard source

tor DAVID POCOCK () (): I'm seeking an explanation from the government as to why you don't want the ACCC to report on whether these savings are going to be passed onto consumers. There's $900 million on the table from the med-tech industry. My amendment didn't touch this bill at all; all it said was: 'Here's some transparency around what happens to that $900 million.'

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Thanks for the question, Senator Pocock. I did step through that in my second reading remarks, but I am happy to touch on it in brief terms again. I think, for a number of reasons, we didn't support the Senate making a direction of this kind. The first reason is that, essentially, this power exists with the ACCC. The Treasurer has a capacity to require an inquiry of this kind, but, in the end, the ACCC has a capacity for investigation, and they establish their priorities according to their resources and the issues before them. I think the second one was really about time frames. There is a new compliance framework being developed. It includes the ability to gather information from stakeholders and share information with relevant regulators on matters of noncompliance. There is a framework which is being brought forward. In the meantime, as I indicated in the second reading remarks, there are a number of existing powers which apply to participants in this market.

David Pocock (ACT, Independent) Share this | Link to this | Hansard source

OCK () (): To follow on from that, I understand that there is a longstanding OPD for the ACCC to report to the Senate on a number of things regarding private health insurance. Given there's a new agreement, with $900 million on the table and people keen to ensure they're getting value for money with their premiums, why can't we at least know if that money is being passed on, given the ACCC is looking at this anyway?

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Thank you for the question, Senator Pocock. I'm advised that the issues that you are raising interact in complicated ways with the health portfolio because, of course, the ACCC is a Treasury agency. The public sector advisers who are here to provide advice today in the Senate are drawn from the health department. However, I think Minister Gallagher would be happy to have a further discussion with you about this, but we would need some time to obtain the necessary advice.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

In relation to the decision to take a number of items off the Prostheses List and put them into general-use bundling, the Clinical Implementation Reference Group went through a process to make a decision on these particular items. I'm wondering if there's any brief summary you can give us on the determination of those items. There must have been some sort of clinical definition as to why they were removed, and I'm wondering whether it's possible to get the meeting papers in relation to the removal of those items.

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Thanks very much, Senator Ruston. If I may, I'll take the question about the papers on notice. We will review them and see what may be appropriately provided.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

On that basis, does the CIRG have an ongoing role—either in the short term or in the longer term—in relation to not just what is currently included or not included on the Prostheses List but what happens into the future in terms of exclusions and inclusions?

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Thanks, Senator Ruston. I'm advised that they only have a role for the duration of the reforms, which will end in 2025.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

We could take up more time if we keep doing this! I'm wondering if you could provide an update as to where this current situation is in relation to the alternative funding arrangements and mechanisms in relation to these items that are now going to go into general use.

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Senator Ruston, I understand from your question that you're referring to the bundling. I refer to my earlier answer, which indicated that there's a consultation process on foot at the moment, which I understand will extend for approximately six weeks.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Is there any truth in the view that the department's preferred mechanism for bundling is by facility type?

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

I'm advised that the consultation paper makes reference to three options. It indicates a preferred option, and that is the option that you have referred to just now.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Could you advise whether your early consultations have provided a result that would indicate that, more broadly, the industry and the sector are seeking for bundling to be done by procedure, not by facility type?

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

The consultation process, as I've indicated, has just begun. We intend to let that take its course before drawing any conclusions about the preferences of stakeholders.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

That's interesting: you have the preference of the department already out there and trying to lead the consultation, yet you haven't sought to find out the preferred mechanism of your stakeholders, the very people who are required to actually implement these changes. So that is disappointing.

The minister announced in December that the alternative payment structure, whatever it happens to be, would be mandated. Can you advise how long it will be mandated for?

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Senator Ruston, I missed the specific nature of the question. Were you asking how long?

Helen Polley (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

Senator Ruston, do you want to clarify that for us?

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

RUSTON (—) (): Thank you. In December, when questioned in relation to the removing of these particular items into the general use bucket, the minister said, in response to their funding, that the payment of them by the insurers would be mandated. I'm just keen to understand the intended length of time for that mandate.

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Senator, I think we need to take that question on notice, and we'll see what we can find for you.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Thank you, Minister. You may need to take this on notice as well: I'm just keen to understand what the legislative or regulatory process would be to implement the mandate that I've asked you to find out about.

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Thank you. In similar terms, we'll take that on notice and see what information we can provide you, Senator Ruston.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Thank you. I'm wondering whether the department has assessed the impact on specific procedures as a result of these removals.

Jenny McAllister (NSW, Australian Labor Party, Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

Thank you, Senator Ruston. The questions you're asking go to matters that are really beyond the scope of the bill before us. I accept that they are related and associated with the ongoing reform process. In this question, again, we may need to come back to you and assess what may be appropriately provided.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

nator RUSTON (—) (): Thank you. I accept that you've taken it on notice, but I think what I'm trying to get to is the very nature of the fact that we have before us this bill that actually provides a whole series of enabling capabilities for the government to do things, not the least of which is the removal from the Prostheses List of in excess of 400 items that now have to be dealt with by an alternative funding model. Obviously, this is of significant concern more broadly because it could potentially have very significant impacts on the delivery of services. I accept that you're not the minister—you're a representing minister—and I appreciate you want to take these on notice, but, given that this bill is going to come back a little bit later this afternoon or maybe tomorrow, I'd really appreciate being able to understand whether you've actually assessed the impacts of how you might proceed in dealing with the funding or the payment of these particular items as it impacts on actual procedures.

As an example, I asked in my speech in the second reading debate: can you guarantee that bariatric procedures, which use a significant number of the items that will be transferred off the Prostheses List into this new general use area, will remain cost-effective for delivery by private hospitals through this insurance mechanism following the changes? The thing that I think everybody is wanting to find out about what's going on here is whether the procedures that are currently being undertaken are not going to be detrimentally impacted by the changes. That's all we're seeking to understand, so it's concerning that we're standing here today without having that information.

We're about to get gonged because we're going to the next stage of procedure in this place, so I look forward to perhaps being a bit more detailed when we come back.

Helen Polley (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

As it is 1.30 pm, the committee will report to the Senate.

Progress reported.