Australia & NZ

Minister promises to clamp down on surprise gap fees


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9/10/2008 - Federal Health Minister Nicola Roxon is vowing to clamp down on doctors who fail to tell patients about out-of-pocket gap fees.

The minister has sparked controversy within the private health insurance industry with her push to lift the Medicare levy surcharge threshold, a move tipped to cause an exodus of more than half a million policy holders in its first year.

In an address on Wednesday to the Australian Health Insurance Association annual conference in Sydney, Roxon will promise to work with the industry to strengthen consumers' knowledge about gap fees.

A gap fee is an out-of-pocket expense consumers must cover if their doctor decides to charge over the Medical Benefits Schedule fee.

A survey of 4,164 private health insurance claimants has found 42 per cent of all private patients last year incurred a gap fee and the average fee was $787.

The Informed Financial Consent Consumer survey commissioned by the former Howard government and conducted last year will be released on Wednesday.

In 2004, there was a surprise gap for more than one in five hospital episodes.

This improved to 16 per cent in 2006, and then rose again slightly to 17 per cent last year.

"Despite much effort and attention, the instances of surprise gaps are still too common," Roxon's speech says.

"I firmly believe that more could be done to ensure that consumers obtain unambiguous informed financial consent from their doctors prior to receiving a service. This is every patients' right."

Roxon says the vast majority of doctors are good at telling patients about any out-of-pocket costs but there is a small minority that failed to adequately inform patients.

"Unfortunately, that minority casts an undeserved shadow over the entire medical community, and importantly for your industry - this is seen to devalue insurance," she said.

"Which is no doubt especially frustrating for you (the private health insurance industry) when you, alone, cannot fix it."

Roxon says she will seek industry feedback on the best way to tackle the issue of informed financial consent.

"I know your industry has campaigned for better informed financial consent and we would like to work with you, as well as hospitals and the medical profession, to take the next steps to make this reality.

"It is time to get this right, and provide some certainty for consumers."

Source: AAP NewsWire

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