One of Australia's biggest private hospital providers says surgeries could be delayed if a stoush over the funding of hundreds of surgical items is not settled soon.
Staples and sponges will be among about 400 items removed from the Prostheses List in July 2023, under reforms made by the federal government following advice from an independent group of clinicians last year.
The Prostheses List is used by the federal government to outline how much private health insurers must pay for products listed.
Catholic Health Australia (CHA), which represents 75 hospitals, said an alternate funding model for the items due to be removed was yet to be established with private health insurers.
As a result, CHA health policy director Caitlin O'Dea said surgeries could be at risk due to the out-of-pocket cost hospitals would have to pay.
"Looking at the data, it looks like our regional and rural hospitals would be particularly impacted," Ms O’Dea said.
But the peak body for private health insurers, Private Healthcare Australia, has denied surgeries would be affected, calling CHA's comments "absurd".
Chief executive Rachel David said insurers would pay the cost of the items due to be removed, but not at "five times the market value" outlined in the federal government's list.
"There is no need for patients to be concerned about surgery being delayed. These items we're talking about are extremely common and the market price is low," Dr David said.
"What it means for hospitals is that like everything else they procure, whether it's bandages or band-aids, they will need to purchase these items from suppliers at the market price, not at some fixed price that comes out of Canberra."
Dr David has urged the federal government to push through the reforms to the Prostheses List, which would see required benefits payable for items reduced by streamlining the list of eligible items.
"Our desire as health funds is that those reforms take place as quickly as possible, given that health inflation and cost to consumers is a serious concern here in Australia," she said.
Deadline looms
Ms O'Dea said a decision between stakeholders needed to be reached before December to avoid adding extra pressure to the already strained sector.
She suggested if health insurers would not foot the cost of the items, the federal government should delay removing the items.
"Give us all more time to work through a solution, then if one still hasn't been found after another year, then let's look at keeping these items on the Prostheses List," she said.
Federal Health Minister Mark Butler said in a statement he was "engaging with all stakeholders to get a clear understanding of what the former minister agreed to regarding the Prostheses List".
