This week, we welcomed the federal government’s announcement that it will not proceed with the proposed private health insurance procedure type reclassification for some intravitreal eye injection (IVI) services under the Medicare Benefits Schedule (MBS).
This proposed change related to IVI performed as an independent procedure without an anaesthetist (previously MBS item 42738, now MBS items 43030 and 43032) moving from Type B to Type C on 1 July 2026.
Our submission to the consultation emphasised reforms must not increase patient costs or reduce access, particularly for vulnerable patients. It also called for transparent, nationally-consistent certification processes, and monitoring of out‑of‑pocket costs and treatment adherence, with a commitment to remedial action if unintended consequences emerged.
The Department of Health, Disability and Aged Care noted the consultation raised ongoing concerns about patient impacts, particularly for those receiving private health insurance benefits for IVI services performed in hospital. These patients could have been financially disadvantaged by the reclassification, facing higher out‑of‑pocket costs if shifted to out‑of‑hospital arrangements.
The health minister has asked the department to consider wider access and affordability issues for specialist services, including ophthalmology.
The AMA strongly supported maintaining current MBS fee levels for IVI to protect service viability and access, particularly in rural and remote areas, and urged investment in bulk‑billing and public outpatient IVI services (especially in regional settings) to reduce financial and geographic barriers.
We also opposed any expansion of IVI provision to non‑medical practitioners without rigorous clinical governance, regulatory oversight, and evidence of safety and efficacy.
We will continue to advocate for a system that safeguards patient affordability and clinically appropriate access to sight‑saving care, and we will keep members informed as the Department progresses its broader work on specialist access and affordability.
