1724 – Cardiac technical support services provided by industry employed allied health professionals

Page last updated: 27 September 2022

Application Detail

Description of Medical Service

Cardiac Implantable Electronic Devices (CIEDs) are battery powered electronic devices used to manage heart conditions including rhythm abnormalities. Permanent pacemakers and implantable defibrillators are the best known examples, but they also include implantable loop recorders (ILRs) and cardiac resynchronisation therapy devices (CRTs). Optimal device performance and longevity requires regular checks, with 1-4 scheduled services occurring each year, and others when needed due to new events or symptoms. Some of these services may occur remotely. Services help maintain device function, whilst communications with treating clinicians inform clinical management decisions. Industry Employed Allied Health Professionals (IEAPs) provide essential equipment and undertake a significant amount of the cardiac support servicing in the Australian private healthcare system.

Description of Medical Condition

Cardiovascular disease is the leading cause of death worldwide. Abnormalities of heart function and rhythm are common conditions that require ongoing medical care. CIEDs help diagnose, treat and monitor a range of cardiovascular conditions including bradyarrhythmias, ventricular tachyarrhythmias, atrial fibrillation and advanced systolic heart failure. Typically, these devices are implanted in patients at risk of sudden cardiac death or suffering from chronic heart failure.

Reason for Application

This application occurs in the context of the Prostheses List reforms, which aim to reduce the cost of medical devices used in the private health sector, improving affordability and value of private health insurance for Australians. A key component of the reforms is staged benefit reductions over four years commencing July 2022, reducing the gap between public hospital prices and Prostheses List (PL) benefits paid for the same devices in the private sector.

Industry contends that PL benefit reductions for CIEDs will reduce their ability to provide technical support services for these devices. This application follows an agreement between the Government and MTAA for MSAC to assess and advise on the reasonable cost to industry for CIED technical support services provided by IEAPs for patients who have their CIED funded through private health insurance.

Medical Service Type

Investigative

Previous Application Number/s

Not Applicable

Associated Documentation

Application Form

Application Form (PDF 1343 KB)
Application Form (Word 445 KB)

Consultation Survey

Consultation Survey (PDF 656 KB)
Consultation Survey (Word 27 KB)

PASC Consultation
Expedited – Bypassing PASC

MSAC Consultation
MSAC consultation input must be received by no later than Friday, 10 February 2023 for it to be considered by MSAC at its March 2023 meeting.

For further information please refer to PASC, ESC, MSAC Key Dates
For further information on the consultation process please refer to MSAC Consultation Process

PICO Confirmation

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Assessment Report

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Public Summary Document

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Meetings for this Application

PASC

Bypassing PASC

ESC

9-10 February 2023

MSAC

30-31 March 2023