Medical Purchaser Provider Agreements

Medical Purchaser Provider Agreements

3.24 The Committee recognizes the concerns expressed by the medical profession about the potential impact that can be expressed in the Australian context, modelled on care management agreements in the United States. However, the Committee considers that these differences would make it unlikely that management care arrangements would be introduced on the American model in that country, given that there are large differences between health systems in the United States and Australia. The Committee also considers that it is difficult to assess the potential impact of a system of contracts or protocols in Australia, given that few contracts have been concluded to date. The Committee considers that the medical profession`s opposition to the contracts has relied heavily on conclusions drawn from the care management rules in place in the United States, which may not apply to the Australian situation. To register, simply fill out the MPPA billing registration form to get a billing number, save your EFT and contact information. Send your completed form by email to mppa@medibank.com.au with details about which providers should be associated with your account number. 3.31 The Committee considers that the concerns of the medical profession regarding the possible consequences of the reform law on the freedom of treatment of patients for physicians should be given due consideration. Therefore, the Committee considers that all contracts proposed by the Funds should include a clear obligation not to interfere in the clinical treatment of patients, in order to assure the profession that the relationship between physician and patient is respected at all times and that the means are not to influence or attempt to influence a patient`s treatment by a physician. 3.101 Several opinions of the governments of the federal states have argued that the reform of health insurance has little incentive for health funds to enter into MPPAs with public hospitals. [147] The Victorian Minister of Health stated that some Victorian health funds had informed Victorian public hospitals that they “did not wish to enter into buyer agreements leading to serious competition between public and private hospitals.” [148] To register, you must complete the MPPA billing registration form and send it back to us with the supplier information you want to be covered. 3.46 The ASA and the Complaints Commissioner expressed concerns about the lack of public control of contracts between doctors and Denfonds. The ASA argued that consumers should have access to contracts, including existing royalty schedules. [65] The association argued that access to contracts was essential to ensure that the contracts did not contain provisions that jeopardize the provision of appropriate care.

The ASA proposed that the contracts be available at approved sites across the country. [66] The Complaints Commissioner argued that consumers should have access to MPPAs and HPPA by removing the calculations, especially since these agreements would be negotiated on behalf of fund members. [67] 3.25 The Committee wishes to avoid the worst features of the situation in the United States and firmly believes that this should be avoided. The Committee opposes any health care system that jeopardizes the quality of patient care. It recognizes, however, that practitioners, hospitals and health insurance funds have a common interest in ensuring that patient care is of the highest clinical quality while remaining as inexpensive as possible. Providers, especially physicians, must recognize that anyone who pays medical bills (Medicare or funds) has the right to claim responsibility, efficiency and value for money. 3.35 Some evidence for the Committee suggests that physicians be allowed to negotiate contracts with group funds.


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