The Albanese Government is strengthening Medicare with a range of new Medicare rebates to ensure more Australians can access the latest advances in genetic testing.
From 1 November, 112,000 people each year will benefit from 34 new, expanded or increased Medicare rebates for genetic testing to diagnose, prevent and treat conditions.
This is a $148.5 million investment over four years to strengthen Medicare and make healthcare more affordable and available.
As part of the changes, 85,000 people each year are expected to benefit from new Medicare rebates for couples to determine their combined risk of having a child born with cystic fibrosis (CF), spinal muscular atrophy (SMA) or fragile X syndrome (FXS).
The genetic testing is known as reproductive carrier testing and it identifies whether someone is a genetic carrier for a particular condition, despite showing no symptoms.
The new items mean women who are pregnant or are planning a pregnancy, as well as their reproductive partners, can take a blood, saliva, or cheek swab sample to determine their risk.
Through Medicare, each parent will receive a rebate of between $300-$340 for the test, depending on whether they are treated in or out of hospital.
Unlike most other genetic tests funded by Medicare which require patients to satisfy certain clinical or family history criteria, the new rebates will be available to everyone, even with no symptoms or family history.
In addition, Medicare rebates for genetic testing to diagnose mitochondrial disease will become available. Mitochondrial disease is difficult to diagnose, and often requires a muscle biopsy. Genetic testing would minimise the need for such invasive procedures.
A range of other changes to genetic testing through Medicare also begin on 1 November:
- Amendment to genetic testing for cardiac arrhythmia to align with genetic testing for cardiomyopathy
- Genetic testing for childhood hearing loss
- Gene panel testing for haematological malignancies
- Small gene panel testing for non-small cell lung carcinoma
- Targeted carrier testing for severe monogenic conditions
- Detection of measurable residual disease in patients with acute lymphoblastic leukaemia
- Prognostic gene expression profile test to determine the risk of early and late metastasis in node negative and positive breast cancer under endocrine treatment
- Expansion of eligibility for testing for breast, ovarian, fallopian tube or primary peritoneal cancer.
The regular addition of new genetic and genomic services to the Medicare Benefits Schedule (MBS) is in response to recommendations of the independent Medical Services Advisory Committee.
In 2022-23, more than 376,000 genetic and genomic tests were subsidised under Medicare, totalling approximately $76.8 million in Medicare benefits.
Quotes attributable to Minister Butler:
“These new Medicare rebates for cutting-edge genetic testing will strengthen Medicare and make healthcare more affordable and available.”
“The new Medicare rebate for reproductive carrier testing will provide confidence to women and their partners as they plan a pregnancy and start a family.”
“Many children affected by genetic conditions are born to families with no history of disease because of the rare nature of the conditions and how they are inherited.”
