Insurer Report

Visit Workers' Compensation Regulator Website
 

Issue 18

Summer 2012

Insurer Report, Summer 2012

Return to work assist good-news story

David is a 50 yr old Terminal Operator who sustained serious injuries to his right leg after he was hit by a truck while riding his motorbike to work.

Read More
 

Medical fee review 2011

You may have noticed a few changes to the medical fees for GP's and Specialists.

In November 2010 Q-COMP commenced a medical fee review to research current fees for medical services and to establish whether the fees listed in the Q-COMP medical tables of costs were appropriate. The Allen Consulting Group (ACG) was commissioned in January 2011 to conduct this review. Their final report took into consideration:

  • analysis of the usage and payment of Q-COMP fees
  • a comparison with similar schemes and the relationship of the medical fees to AMA (Australian Medical Association) rates, the MBS (Medical Benefits Schedule) and the market rate.


ACG also consulted with relevant stakeholders including Insurers, the Department of Justice and Attorney General, medical associations and schemes in other states.

 

The outcome of the report was that Q-COMP fees should be aligned closely to the AMA list of medical services and fees and that any future increases also follow the AMA fee schedule. ACG also indicated that the Brisbane Health CPI (which has been used to increase fees in the past) was not an appropriate method of indexation for medical fees going forward. As a result the following recommendations were put to the Q-COMP Board and subsequently passed:

 

  • AMA 2011 fees will be introduced for all Q-COMP items, except for those items  where the Q-COMP fee is already above the AMA recommended fee
  • those Q-COMP items that have a fee currently above the AMA fee are to receive no increase until such time that the AMA fee surpasses the current Q-COMP fee
  • future increases to the supplementary services table of costs for General Practitioners and Specialists will also be a reflection of any increase that has occurred in standard consultations for General Practitioners and Specialists.

 

The new fee schedules are available on the Q-COMP website.  As a result you will notice that some fees have increased while others have remained unchanged. The table below provides an example of some of these items.

 

Item

 

Q-COMP fee 2010

Q-COMP fee 2011

23

GP Level B Consult

$70

$70

36

GP Level C Consult

$132

$132

44

GP Level D Consult

$194

$194

10996

Wound management - GP/Nurse

$24

$34

104

Specialist Initial Consult

$160

$160

30029

Repair of wound on skin (not more than 7cm)

$169

$194

48960

Shoulder reconstruction

$2,741

$2,741

47618

Calcaneum or Talus - Treatment of intra articular fracture by open reduction

$1,342

$1,515

47642

Metatarsals, 2 of, treatment of fracture

$342

$390

49561

Knee arthroscopic surgery

$2,182

$2,182

 

Most notably of these unchanged items are consultations and reports. The analysis has indicated that implementing these changes will bring cost savings to the scheme over the next 5 years while ensuring that access to medical professionals for injured workers continues.

 

A timing change to the Q-COMP medical fees will also occur. Historically medical fees have been increased on 1 November each year. The new tables of costs for medical services will now be effective from 1 December 2011 and will continue to be updated annually on this date.

 

Q-COMP will continue to monitor the tables of costs to make sure access to quality treatment and better return to work outcomes for injured workers is maintained while also ensuring an affordable scheme for insurers.

 

You can access the fees on our website at qcomp.com.au. If you don't have access to the fees online and require a hard copy, contact us on 1300 789 881.


If you have any questions about the new tables of costs, please call us on the same number.

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