Australian Government Response to the Recommendations of the Evaluation of the National External Breast Prostheses Reimbursement Program – Impact Evaluation Report

The National External Breast Prostheses Reimbursement Program (the Program) commenced on 1 December 2008 to provide a nationally consistent reimbursement program for the purchase of external breast prostheses for Australian women who have had a mastectomy as a result of breast cancer. An evaluation of the Program was conducted after the first year of its operation.

Page last updated: 22 June 2017

In July 2015 the Department of Health engaged Urbis Pty Ltd (Urbis) to undertake a second independent evaluation of the Program. This evaluation found that overall, the Program has had a positive impact on the quality of life of women who have accessed it. In particular, it made it easier for eligible women to afford an external breast prosthesis. Also, the simplicity of the Program, including the claiming process, was praised and considered as key to its success.

The Australian Government welcomes the findings of the Evaluation of the National External Breast Prostheses Reimbursement Programme – Impact Evaluation Report (the Report). It’s response to the Report’s three recommendations is as follows:

Recommendation one: The amount of reimbursement allowed under the National External Breast Prosthesis Reimbursement Programme should be reviewed on an annual basis, including a comparison of average annual amount claimed to specified limit.

Response:
The Government agrees with Recommendation One, committing to monitor the average annual amount claimed per prosthesis under the Program. This annual review will be performed in-house by the Department of Health, commencing from 2016-17.

Recommendation two: The advance payment options available to women receiving income support payments should be explicitly promoted as an option for obtaining the funds for an external breast prosthesis prior to reimbursement.

Response:
The Government agrees in principle with Recommendation Two, supporting the provision of a link to information on any advance payment options that may be available to women receiving an income support. The Department of Health undertakes to work closely with the Department of Social Services and the Department of Human Services regarding this recommendation.

Recommendation three: The claim submission process for the National External Breast Prosthesis Reimbursement Programme should be expanded to include an online submission portal.

Response:
The development of an online portal to support payments under the Program will be considered as part of the broader Government approach to replace health, aged care and related veterans’ payments, under the Medicare and Aged Care Payments (MACP) Program.

The MACP Program is a digital payments IT system replacement project for Australian health, aged care and related veterans’ payments, announced by the Government in October 2016.

PDF version: Australian Government Response to the Recommendations of the Evaluation of the National External Breast Reimbursement Program – Impact Evaluation Report (PDF 39 KB)