The Australian Competition and Consumer Commission report on ‘anti-competitive and other practices by health funds and providers in relation to private health insurance’ has been tabled in the Senate.
The ACCC produces an annual report on ‘any anti-competitive or other practices by health insurers or providers which reduce the extent of health cover for consumers and increase their out-of-pocket medical and other expenses’ in accordance with a Senate order.
This year the report focused on the practice by insurers of not recognising certain types of allied healthcare provider who offer the same or similar services as other types of ‘recognised’ provider.
Insurers’ recognition practices can impact consumers who choose to obtain services from a non-recognised provider and potentially incur higher costs as compared to using a recognised provider and receiving a rebate on their medical expenses.
The ACCC found that insurers’ recognition decisions involve the application of commercial and clinical assessments. The ACCC did not identify any category of allied healthcare provider was being systematically excluded by all insurers. The ACCC also found that transparency around the categories of allied healthcare providers recognised by an insurer and recognition decisions would be in the interests of consumers, allied healthcare providers and insurers.