Our submission on the post implementation review of Medicare funded cardiac imaging items (second consultation paper) highlights our continuing concerns about complex item structures and prescriptive claiming requirements.
While we support the intent of the changes, we have highlighted the possible impacts of complex structures and prescriptive claiming requirements on good clinical practice and administrative burden, particularly in regional, rural and remote settings.
Our submission supports fixing the rules that have blocked appropriate stress tests for some patients. It backs proposed updates to the “stress echo caveat” so patients with exertional breathlessness and those with known coronary artery disease and evolving symptoms can access myocardial perfusion studies (MPS) when clinically appropriate and without unnecessary delays.
It supports removing rigid repeat‑test timing rules when a patient’s condition genuinely needs it and removing strict 12‑ and 24‑month limits for repeat MPS in clinically justified cases, because blunt time rules can delay care or push patients into higher out‑of‑pocket costs or more invasive pathways.
However, our submission cautions against overly prescriptive documentation and claiming rules, and calls for clear explanatory notes, practical examples, and monitoring that looks at outcomes and appropriateness — not just service volumes.
We support structured GP access to CT coronary angiography (CTCA), with safeguards — and we want MPS to remain viable. The AMA supports, in principle, structured GP‑requested CTCA to reduce delays and improve equity, alongside safeguards and careful implementation. We have also flagged concerns that cost pressures in nuclear medicine may threaten the viability of some private SPECT services, with flow‑on impacts for access and bulk billing.
