What we're doing with the Prescribed List

Reforms

Reforms are under way to continue to improve the Prescribed List into the future. 

See a full list of reform measures.

Evaluation

An independent evaluation of the reforms is under way to ensure our reforms are on track. 

Find out what the evaluation is assessing and see the baseline report.

Post-listing reviews

We are introducing regular reviews of listed products. We have completed 4 pilot post-listing reviews. 

See our active and completed reviews. 

Consultation

We encourage stakeholders to actively participate in consultations and provide any ideas for improving the Prescribed List.

Find out how you can get involved. 

Policy development

Since we established the (then) Prostheses List in 1985, we’ve continued to develop the policy that underpins it. 

Learn more about this background and the work we’ve been doing to improve the Prescribed List.

Compliance and assurance

We work to ensure that medical device companies (sponsors), private hospitals and private health insurers comply with the Prescribed List Rules and legislation.

We prioritise action to tackle practices that:

• distort the benefit price settings
• encourage artificial listing structures
• create benchmark benefit pricing for discontinued or dormant devices (such as product substitution)
• support fraudulent listing
• lead to unfair listing arrangements (for example, applying for incorrect grouping)
• show repeated or wilful non-compliance (for example, providing false and misleading information during application) 
• retain device listings on the Prescribed List for products that are no longer active on the Australian Register of Therapeutic Goods (ARTG) 
• make false or misleading claims in application for listing
• reject insurance claims for devices listed on the Prescribed List 
• process an insurance payment for less than the Prescribed List benefit.

Through a process of public consultation, we developed the Prescribed List Compliance Strategy. 

The strategy applies to all stakeholders and identifies the principles that govern our compliance and enforcement functions and priorities.