Reimbursement for internet based eye care

Medicare, Australia’s universal health insurance system, assures access to public health services. Although it is now 20 years since Medicare was introduced, marginal improvements to Medicare are indicated.¹ Fulfilling the specialist healthcare needs of millions of rural Australians is crucial to the debate over Medicare’s future. Clinicians in Australia are worried about inequity in terms of access and outcome for their patients and are willing to be partners in healthcare governance to improve the situation.² Yet, services like internet based eye care, with a wide range of usages, are candidates for regulation.³ The term internet based eye care refers to the delivery of eye care services, especially to remote and rural communities, by means of modern telecommunications technology.⁴

Meanwhile, in the United States, the Congress has acknowledged internet based healthcare as a viable, potentially life saving technology.⁵ Payers are signing on to this trend, as major medical centres come to see the benefits. Beginning in October 2001, the Health Care Financing Administration (HCFA) extended Medicare coverage to a wide range of internet based healthcare services and providers, allowing for medical visits, consultations, mental health services, and pharmacological monitoring of patients living in rural areas.⁶ Payment to providers was at a rate similar to that paid without the use of internet based care. Furthermore, Medicare paid a facility fee of $20 per internet based care session to the originating site in the remote region. Internet based care services are well integrated to regular healthcare systems …