Discontinuation of Medicare Dental Items (85011 - 87777)
Medicare Dental Items for people with chronic conditions and complex care needs, introduced by the previous Government in November 2007, are to be withdrawn from the Medicare Benefits Schedule (MBS).
The following letter is from the Department of Health and Ageing notifying GPs of the discontinuation of Medicare Dental Items no. 85011 - 87777, which will be closed to new patients after 30 March 2008.
Discontinuation of Medicare Dental Items for People with Chronic Conditions and Complex Care Needs (Items 85011-87777)
This notice is to advise that the Medicare dental items for people with chronic conditions and complex care needs, introduced by the previous Government in November 2007, are to be withdrawn from the Medicare Benefits Schedule (MBS). This affects referrals by GPs, and services by dentists, dental specialists and dental prosthetists.
This is the first step in establishing the Government’s new Commonwealth Dental Health Program, which will be introduced from 1 July 2008. The Government is replacing the previous Government’s limited chronic care dental scheme with a scheme that works cooperatively with States to address public dental waiting lists and provides up to one million additional services.
In introducing the Commonwealth Dental Health Program, the Government will negotiate with the States and Territories to provide priority services to patients with chronic disease, allowing patients who previously qualified for the closing chronic care dental items to access treatment where they are eligible for publicly funded care.
The Government will also fund its election commitment to introduce a new Teen Dental Plan. This program will provide $150 per person towards an annual preventative check for around 1.1 million teenagers aged 12-17 years in families receiving Family Tax Benefit A, and teenagers in the same age group receiving Youth Allowance or Abstudy. The Teen Dental Plan will not require a referral from a GP. The Department will be consulting with the dental profession about the implementation arrangements for this new program.
Arrangements for discontinuation of the Medicare dental items
Patients who have already commenced treatment under Medicare dental items 85011‑87777 (ie patients who have received services between 1 November 2007 and 30 March 2008) will be able to continue to receive Medicare benefits for dental services provided up to and including 30 June 2008. A GP referral dated before 30 March 2008 is not, by itself, sufficient for a patient to be considered to have commenced treatment.
The Medicare dental items will be closed to new patients after 30 March 2008. This applies to any person who has not any received services under the Medicare dental items 85011-87777 on or before 30 March 2008. This means that no Medicare benefits will be payable for dental services to new patients after 30 March 2008.
No Medicare benefits will be payable for any dental services provided under items 85011-87777 after 30 June 2008. The cost of any future services identified in the patient’s treatment plan will need to be met by the patient.
GP referrals
The Medicare dental items will continue to be available to new patients who meet the eligibility criteria up to and including 30 March 2008. However, GPs are encouraged not to refer patients for dental services if the patient is not able to commence the dental treatment by 30 March 2008. Patients who have not commenced dental treatment by this date will not be eligible for a Medicare rebate. If the patient has any questions about their eligibility or the discontinuation, they can call Medicare Australia on 132 011.
It is important to note that patients can continue to receive GP services under the chronic disease management items (eg GP Care Plans and Team Care Arrangements) and eligible patients can continue to be referred for allied health services. These Medicare items are not affected by the discontinuation of the dental items.
DVA dental arrangements
The dental arrangements funded by the Department of Veterans' Affairs (DVA) are not affected by the discontinuation of the Medicare items. Eligible members of the veteran community will continue to receive dental treatment from dentists, dental specialists and dental prosthetists under the DVA dental scheme.
Further information
Information about the discontinuation arrangements is being sent to patients who have received services under the Medicare dental items, GPs, dentists, dental specialists, dental prosthetists, and relevant professional groups.
For further questions about the discontinuation arrangements, please contact Medicare Australia on 132 150 (GPs) or 132 011 (patients).
