Station: ABC Radio Adelaide
Program: Afternoons
Date: 4/05/2020
Time: 2:00 PM
Compere: Sonya Feldhoff
Interviewee: Dr Rachel David, CEO, Private Healthcare Australia


SONYA FELDHOFF: We were contacted by a listener last week, who was scratching their head. Previously to coronavirus, they were able to claim for a physio run class or a class run by their physio. The same class is now available online to do with coronavirus but they’re told they can’t claim for that class. So what’s going on here?

Dr Rachel David is Chief Executive of Private Healthcare Australia, the peak representative body for the private health insurance industry here in Australia. Dr David, thank you for your time.

SONYA FELDHOFF: Look, we know that there’s been some question marks over private health cover in this current environment. Can you clarify whether this remains the case, about a physio class that was available in person but not online?
RACHEL DAVID: Yeah. Look, there are a couple of complexities here. First when the crisis hit and the social distancing measures came in place, we had to work very quickly to work with all the allied health groups that we do fund to see what percentage of their services could be provided via telehealth and online. So we contacted all the peak groups, including the peak group for physiotherapists, the APA, and asked them to provide us with some evidence or list of services that they knew would be able to work in an online environment. So we actually have switched over funding for quite a few physio services to the telehealth model and most funds are paying for some one on one physio claims so long as it’s not something that requires hands-on work. It is something that the funds are supporting as well as psychology, OT, speech pathology and a range of other things.

But we’re working with the Australian Physiotherapy Association to get some more information on the effectiveness and safety of some of the online classes, and then, should that be forthcoming, I think you’ll see more funds actually paying those claims.

SONYA FELDHOFF: And would that be retrospective then?
RACHEL DAVID: I can’t answer that but it’s possible [indistinct]
SONYA FELDHOFF: [Talks over] But you are seeing that funds are agreeing that there is an anomaly there?
RACHEL DAVID: Yeah it is. It’s something that we’re actually looking into with the physiotherapist peak body.
SONYA FELDHOFF: And what further efforts have been made? I know that there’s been some debate over recent weeks about either giving money back to people or that. I know you’ve certainly put a hold on increases in premium levels. But what about the continued discussion in the last couple of weeks about whether health funds will in fact return money to some of their members?
RACHEL DAVID: Yeah it’s a possibility. We’re still waiting for the data to come in over the last six weeks about what has happened particularly with extra cover and allied health. It’s a bit more complex for in-hospital treatment because there’s a lot of pent up demand for elective or essential non-emergency surgery and we’re expecting we need a provision for that demand to come back, which is a requirement- not only is it something that we know is going to happen. It’s a regulatory requirement for the funds as well.

But on excess cover, there’s a couple of things we can do. One is to roll over the benefits that people might have been expected to spend this year, which expire at the end of the year. We might be able to roll them over until next year. The other thing we could do is actually to give some money back. We will know what the situation is with how many- the reduction in benefits in the next four weeks or so and at that point, the funds will be able to make a decision on that.

SONYA FELDHOFF: In the next four weeks or so?
SONYA FELDHOFF: And so, what would your advice be? Would you just keep all your receipts for any services you’re using at the moment, on the off chance that that might happen?
RACHEL DAVID: Look, I don’t think it’ll be based on services used. I think it’ll be based on simply looking at whether the funds had more money in the bank than they expected as a result in the decline in claims. Allied health services may look at a way of giving that back to their members.
SONYA FELDHOFF: Dr David, thank you for your time. Dr Rachel David is chief executive officer of the Private Healthcare Australia.
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