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Medical Benefits Division (MBD)

Information on the Medical Benefits Division (MBD)

The division has responsibility for providing policy advice to Government on the Medicare Benefits Schedule and its use and costs, new and emerging technologies, and funding for:

• specialist services including pathology, diagnostic imaging and radiation oncology;
• special access programs such as medical treatment overseas and disaster health care assistance; and
• healthy kids check.

The division has the lead role in the delivery of Outcome 3: Access to Medical Services and is responsible for a small component of funding under Outcome 5: Primary Care.

First Assistant Secretary

Richard Bartlett
Telephone: (02) 6289 1016

Medical Benefit Division's Organisation Chart (PDF 46 KB)

The organisational structure for the Division comprises:

Diagnostic Services Branch

Assistant Secretary, Fifine Cahill, Telephone: (02) 6289 7163

The Diagnostic Services Branch is one of five branches within the Medical Benefits Division which has prime responsibility for Outcome 3 : Access to Medical Services.

The aim of the branch is to promote the provision of quality, accessible and affordable patient care through enhancing the quality, safety and availability of pathology and diagnostic imaging services, including the appropriate use of services. This is achieved through the provision of evidence based policy advice, program management and consultation and engagement with key stakeholders including State and Territory Governments.

Medicare Benefits Branch

Assistant Secretary, Penny Shakespeare, Telephone: (02) 6289 6945
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The primary purpose of the Medicare Benefits Branch is to improve health outcomes for eligible Australian residents by providing affordable access to medical care by:

• working across the Department on structural and eligibility issues relating to the Medicare program;
• administering and advising on policy relating to Medicare services and claiming, the extended Medicare safety net, compliance (including the Professional Services Review) and disaster assistance health care schemes;
• management and oversight of the non-diagnostic specialist components of the Medicare Benefits Schedule; and,
• managing legislation and publishing pertaining to the Medicare Benefits Schedule.

Medicare Financing & Analysis Branch,

Assistant Secretary, Shane Porter, Telephone: (02) 6289 8642

Medicare Financing and Analysis Branch oversees:

• The supply of inputs to policy development and program monitoring and evaluation. Products include MBS-related data, estimates, modelling, costings, MBS fees, analysis and research;
• Policy development and implementation for primary care services funded through the MBS including GP, practice nurse, allied health, midwifery and nurse practitioner services. Specific areas of responsibility include items concerning chronic disease management; mental health, optometry, pervasive development disorders (including autism), and follow-up items stemming from health checks for Aboriginal and Torres Strait Islander people; and
• Policy oversight of the Commonwealth's suite of medical indemnity programs, which collectively have the dual aims of premium affordability and industry stability. The Branch is also responsible for the Midwife Professional Indemnity program.

Health Technology and Medical Services Group

Executive Manager, Dr Brian Richards,Telephone: (02) 6289 8076

The Health Technology and Medical Services Group (HTMSG) is responsible for a range of policy and program functions relating to the assessment and funding of medical services and procedures, with an emphasis on those associated with the use of new and emerging medical technologies. This includes managing the Medical Treatment Overseas Program (MTOP); managing Health Program Grants which provide funding and support for a targeted range of services to groups with special needs; overseeing implementation of a cross-portfolio response to the Review of Health Technology Assessment in Australia (HTA Review); providing advice to the Minister for Health and Ageing and other key stakeholders about medical services involving new and emerging medical treatments and technologies; providing secretariat and project support for the Medical Services Advisory Committee (MSAC), the Health Policy Advisory Committee on Technology (HealthPACT) and the Radiation Oncology Reform Implementation Committee (RORIC); and providing advice and implementing programs to support the quality, safety and availability of radiation oncology services, including the appropriate use of services.

Private Health Insurance Branch

Assistant Secretary, Doug Fawns, Telephone: (02) 6289 9490

The Private Health Insurance Branch seeks to ensure that Australians have a choice of health care services within a world-class health system by supporting the private sector to provide affordable, quality care.

Objectives:

• Administer the private health insurance rebate with Medicare Australia and the Australian Taxation Office.
• Promote the affordability of private health insurance and the sustainability of the private health insurance sector by ensuring that premium costs maintain insurer solvency and prudential requirements, while supporting benefit outlays.
• Encourage insurers and providers of private health products to provide better value for money to consumers, through improvements in the regulatory framework.
• Improve information for consumers of private health services, enabling informed decision-making.

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