2019 ‘Pilates’ Legislation Changes and Information

 

We write to draw your attention to some changes in the industry.

 

First off, there will be no change to your ability to claim rebates for our classes at Bluff and North Road Physio.

Recent Government legislation has removed the requirement for Private Health Insurers to pay for services considered ‘Natural Therapies’. As you may be aware, Clinical Pilates has now been deemed as a ‘Natural Therapy’, and thus not claimable under Private Health Insurance. The Australian Physiotherapy Association engaged in negotiation with the Department of Health to argue that Clinical Pilates remains an essential service within the repertoire of physiotherapy. As a result of these negotiations, the Department of Health has clarified its position, recognising that Clinical Pilates exercises remain a valid and acceptable aspect of physiotherapy, itself a scientifically backed healthcare.

Physiotherapy exercise classes have always been claimable under private health, and remain so. Our classes at BRP/NRP have always been clinical exercise programs tailored to patient’s needs. So while our exercise classes are based around Pilates, they are an exercise program involving whatever techniques will best achieve our desired outcomes.

Whilst this is good news for physiotherapy treatment, it has been decided that Pilates-only treatment – that is, treatment sessions consisting solely of Pilates instruction – is to remain non-claimable under Private Health Insurance.

 

What does this mean for Bluff/North Road Physiotherapy?

 

Initially, the following implications of this new legislation are important to note:

1) From April 1st, people will no longer be able to claim for Pilates-only treatment sessions, or if a treatment session is named as a ‘Pilates’ session. This means gym based Pilates is no longer covered.
2) There will be no change to BRP/NRP patients’ ability to claim where Clinical Pilates forms part of physiotherapy exercise sessions, whether that is a 1:1 session or a class/group session.
3) There is no impact on Unsupervised sessions, as these have always been non-claimable.

 

With the above in mind, BRP/NRP is determined to ensure that our patients experience as little impact of this legislation as possible, whether that is regarding their patient experience or their financial commitments. Therefore, we encourage our patients to take note of the following:

– What were previously referred to as ‘Pilates’ Sessions/Classes will now be referred to as ‘Exercise’ Sessions/Classes.
Importantly, this change does not impact claims to Private Health Insurance in any way, as consultation codes remain the same.

– The structure of our Exercise program remains the same, including:
1:1 Sessions
4:1 Exercise Class Sessions
Unsupervised Sessions
Continuation of our Membership Options

– BRP/NRP Physios have always, and will continue to meet all Australian Physiotherapy Association requirements with regards to patient care, note-taking, and professionalism.

 

HCF Patients:

HCF Private Health Insurance appears to be taking a more stringent approach to claims for exercise classes from April 1st. We encourage our patients insured by HCF to seek further clarification regarding your Private Health Insurance cover in relation to this matter.

 

Should you have any questions about this, please feel free to speak with your physiotherapist at your next appointment.

We look forward to continuing to provide the highest quality of healthcare for our patients in 2019 and beyond!

 

Kind Regards,
Bluff/North Road Physiotherapy

 

 

 

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