Fee Transparency in Health Care: Informed Financial Consent and Split Billing Practices

1. Which of the following best describes you? (Select one)

Medical practitioner/specialist Junior doctor / doctor in training Allied health professional Nurse or midwife Health service administrator / manager Consumer or member of the community Consumer advocate / representative organisation Regulator or government agency representative Other (please specify)

2. If you are a medical practitioner, what is your primary area of practice?

Surgical specialty Medical specialty Diagnostics (e.g. radiology, pathology) General practice Other

3. Which setting do you primarily work in or interact with? (Select all that apply)

Public healthcare Private healthcare Both public and private Not applicable

4. Which state or territory are you based in?

NSW VIC QLD WA SA TAS ACT NT Not Australia based

5. Do you think Informed Financial Consent (IFC) should be legally enforceable in Australia?

Yes No Unsure

6. Do you think medical providers should be penalised for not providing IFC to their patients?

Yes No Unsure

7. Which regulatory approach do you consider most effective for strengthening IFC? Please rank the options below from 1 (most preferred) to 6 (least preferred).

Expand function of Professional Services Review

Expand the role of the Department of Health, Disability and Ageing compliance mechanisms

Ahpra and/or health complaints agency enforcement of IFC using National Law Provisions

Establish a new regulator to investigate IFC complaints

Expand existing regulators such as the Australian Competition and Consumer Commission (ACCC) to enforce IFC obligations

Education, guidance and voluntary compliance (no legal change)

8. Should IFC require disclosure of the total expected cost of an episode of care, including costs billed separately by other providers (e.g. anaesthetists, pathology, devices)?

Yes, in all cases Yes, for higher cost or planned care only No, IFC should remain limited to individual provider fees Unsure

9. Who should IFC obligations apply to? (Select all that apply)

All registered health practitioners Medical practitioners only Medical practitioners in the private setting Specific specialties or types of care Only high cost or discretionary services

10. Which information should IFC reasonably require providers to disclose? (Select all that apply)

Expected fees charged by the provider Likely out of pocket costs Costs billed by other practitioners Range of possible costs and uncertainties Treatment alternatives and cost implications Timing and format of disclosure Relevant Medicare Benefits Schedule (MBS) item/rebate Private health insurance benefit Other (please specify)

11. Should IFC be provided in writing?

Yes always Only above a certain monetary threshold Only if requested by the patient No, verbal discussion sufficient At the discretion of the provider Yes but with exceptions (please specify)

12. Do you think existing professional codes of conduct provide sufficient clarity on IFC?

Yes No Unsure

13. What supports would be most important to enable stronger IFC requirements? (Select up to three)

Clearer guidance for providers regarding their obligations, including standard templates Clearer guidance for patients in how to participate in discussions about the cost of their care Guidance to support culturally safe dialogues between patients and providers Digital systems to support cost disclosure Other, please specify:

14. Are there key risks or unintended consequences that IFC reforms should seek to avoid?

15. What role could digital tools play in supporting IFC?

16. Should providers be required to issue a single bill for all items/services associated with an episode of care?

Yes No Unsure

17. Are there any system level incentives or changes in regulation that would support providers to issue a single bill?

18. Are there any key issues or considerations missing from this paper?

19. Do you have any additional comments on IFC or options for reform?

Consultation questions