We recently posted a blog about the government’s system of funding for physiotherapy treatment of chronic musculoskeletal conditions.
To get up to speed, please CLICK HERE to read the story.
It appears that the rules for gaining access to this funding are complicated and often interpreted in differing ways. The main differences in interpretation of the laws are related to determining who should qualify for these government funded resources.
Under a Chronic Disease Management plan (CDM), patients are entitled to a Medicare Rebate of $52.95 for each allied health treatment up to a maximum of FIVE treatments per year.
This essentially is a resource of $52.95 x 5 = $264.75 per year towards allied health treatment…
- You must have a chronic disease. An example of this is a musculoskeletal condition causing pain that has lasted for longer than six months. We treat these types of people EVERY DAY!
- This program is NOT means tested. (That is, it is not based on your income in any way).
- These five treatments cannot be jointly funded by the Medicare program AND your private health fund simultaneously.
- Unfortunately, these five treatments must be shared across all Allied Health professionals over one calendar year.
- Your GP must organise this Chronic Disease Management program for you. In fact, there is government funding supplied to the GP’s for this service.
In our experience, many GPs interpret these laws differently. The law states that every case must currently have at least two health care practitioners involved in treating the person.
Some GP’s interpret this as meaning themselves and one allied health professional. Other GP’s interpret this as meaning two separate health care professionals excluding themselves.
Finally, some GP’s are reluctant to provide this service due to the complicated nature of paperwork that is required. Others arbitrarily decide who gets the funding based on whether they think the condition is serious enough or whether the person is financially challenged enough to have difficulty affording the cost of physiotherapy.