PHI 30/24 General use items on the Prescribed List

General use items (GUI) will continue to be listed and funded under Part D of the Prescribed List (PL) after 1 July 2024.

Date published:
PHI circular type:
Prostheses announcement
Audience:
Health sector

The Minister of Health and Aged Care, the Hon Mark Butler MP, has announced that GUI will continue to be funded through the PL after 1 July 2024.

This decision means that 475 billing codes for GUI, which were scheduled to be removed from the PL will now be retained.

Following challenges to implement proposed bundling arrangements by some private hospitals, GUI were retained on the PL for a further 12 months, to 1 July 2024. This additional time provided stakeholders with further opportunity to negotiate alternative funding arrangements.

Stakeholders continued raising issues with negotiating alternative funding arrangements for GUI, and raised the negative clinical implications and potential adverse outcomes to patients should PL GUI funding cease.

After careful consideration of stakeholder feedback, the Minister decided that GUI will remain on Part D of the PL.

The Private Health Insurance (Medical Devices and Human Tissue Products) Rules and Prescribed List Guide will be updated to reflect this change.

Next steps

Sponsors may now submit new applications for listing GUI on the PL, if they have a comparative GUI already listed on Part D. These devices will be listed in existing Part D groups, commencing from the November 2024 PL. Sponsors may also submit amendment applications for the existing billing codes listed on Part D.

Sponsors should note that there will be no new groupings added to Part D going forward.

Sponsors will need to resubmit new or amendment applications for any GUI applications previously assessed and rejected or withdrawn. Sponsors may seek reconsideration of their devices for listing on the PL or for amendment of existing billing codes.

GUI applications submitted for the July 2024 PL, where a decision has not been made, will not need to be resubmitted. This group of applications will be considered in line with the policy change commencing from the November 2024 PL. This is to ensure the applications are considered under the Part D listing criteria, which the department will develop and communicate in the coming weeks.

The intent of the listing criteria for GUI will be to maintain the existing scope of the Part D grouping scheme.

Medicines are not eligible for listing on the PL, so applications for listing of medicines or their accessories will not be accepted.

Please note: Applications for the PL are now managed through the Health Products Portal (HPP), which has replaced the Prostheses List Management System (PLMS). Sponsors are required to use the HPP to submit any new, variation (amendment, expansion, or compression), sponsors transfer or deletion applications.

For more information refer Health Products Portal.