Proposed increases to regulated payment rates
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Cost of Treatment Regulations
46. Based on the evaluation of options summarised in Table 3 above, we propose that option D be adopted and payments made under the Cost of Treatment Regulations increase by between 4.6% and 9.36% for the services detailed in Table 4 These increases were calculated from wage movements in relevant occupational groups in the health sector since 2016, as set by DHB MECAs, less the general increase in payment rates already given of 1.56% from the 2017 review and 2.05% from the 2018/19 review.
47. The current regulations can be viewed at:
Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Regulations 2003(external link) – New Zealand Legislation
Question 1
Do you agree that adopting option D, with tailored payment increases reflecting wage increases in the main occupational groups, as detailed in Table 4 below, best meets the objectives set? If not, why not? Please provide reasons for your view.
Question 2
Do you have any concerns about the impact the regulated payment regime has on particular population groups who have difficulty in accessing treatment? If so, please provide examples and reasons for your view.
Table 4: Services eligible for payment increases
| Accident Compensation (Liability to Pay or Contribute to Cost of Treatment) Regulations 2003 | |||
|---|---|---|---|
| Provider | Regulation | Service | Proposed Increase |
| Counsellors | 9 | Consultation | 9.36% |
| Dentists | 10 and Schedule | Consultation and treatment costs | 5.70% |
| Medical practitioners | 13 and Schedule | Consultation and treatment | 5.70% |
| Nurses | 14 and Schedule | Consultation and treatment | 7.85% |
| Medical practitioners and nurses | 15 and Schedule | Combined consultation and treatment | 4.60% |
| Nurse practitioners | 15A and Schedule | Consultation and treatment | 7.85% |
| Specialists | 16 and Schedule | Consultation and treatment | 5.70% |
| Hyperbaric oxygen | 11 and Schedule | Treatment costs | 5.70% |
| Radiologists | 12 and Schedule | Consultations and imaging | 5.70% |
| Specified Treatment Provider | Regulation | Service | Proposed Increase |
| Acupuncturists | 17 and Schedule | Treatment costs | 9.36% |
| Chiropractors | 17 and Schedule | Consultation, treatment and imaging | 9.36% |
| Occupational therapists | 17 and Schedule | Treatment costs | 9.36% |
| Osteopaths | 17 and Schedule | Consultation, treatment and imaging | 9.36% |
| Physiotherapists | 17 and Schedule | Consultation, treatment and imaging | 9.36% |
| Podiatrists | 17 and Schedule | Consultation, treatment and imaging | 9.36% |
| Speech therapists | 17 and Schedule | Treatment costs | 9.36% |
Hearing Loss Regulations
48. The payments made under the Accident Compensation (Apportioning Entitlements for Hearing Loss) Regulations 2010 would have a nil increase for the services detailed in Table 5 The regulations can be viewed at:
Accident Compensation (Apportioning Entitlements for Hearing Loss) Regulations 2010(external link) – New Zealand Legislation
49. ACC recommended that no increase be made to prescribed rates payable to audiologists this review round. With on-going technology changes, which include improving the ability of clients to self-programme hearing devices, an increase in device fitting fees might be inconsistent with market trends.
50. ACC also considers that there has been no increase in cost-related access issues for clients with injury-related hearing loss but intends to assess whether a rate increase is warranted in the upcoming 2022 review.
51. Historically, adjustments to the hearing loss regulations are not generally made as frequently as other rates. In part, this is because ACC is such a large purchaser of audiology services that increases to the rates can shape the market by having an inflationary effect, without benefits to claimants. There is also wider ongoing work on hearing loss settings which is likely to affect the provision of audiology services. It is considered more appropriate to review audiologists’ costs at the next review, following the likely implementation of these wider changes.
Question 3
Do you have a view on the proposed nil increase to the payments listed in Table 5? Please provide reasons for your view.
Table 5: Hearing Loss Services
| Accident Compensation (Apportioning Entitlements for Hearing Loss) Regulations 2010 (the Hearing Loss Regulations) | |||
|---|---|---|---|
| Provider | Regulation | Service | Increase |
| Audiologists | 5, 5A, 6, 8, 9, 10, 10A | Assessment, consultations, fittings, service, repairs and replacement ear moulds | 0.00% |