Re: INFORMATION
FOR OBSTETRICIANS AND GPs
Dear Doctor
This letter is being sent to doctors who have worked with midwives in providing
access to Medicare rebates for antenatal and postnatal private midwifery
services. We understand that this new
option, which has been available since November 2010, has brought about changes
in the way midwives and doctors collaborate in maternity care.
Collaboration
Midwives who have achieved notation on the Nursing and Midwifery Board of
Australia (NMBA) Midwives’ Register as ‘eligible’ are able to apply for
Medicare provider numbers. Certain
antenatal and postnatal items attract rebate; the proviso being that there is a
collaboration arrangement with a doctor for that particular woman. The requirement for collaborative
arrangements between participating midwives and medical practitioners is to
provide pathways for consultation, referral or transfer if or when the woman’s
care requires it. Midwives in Victoria are not, at present,
able to provide intrapartum care that attracts Medicare rebate for our clients
in hospitals.
Midwife
prescribers
Midwives are also able to undertake a course in pharmacology which leads to
endorsement on the public register. Once endorsed, the midwife may apply for a
Pharmaceuticals Benefits Scheme (PBS) number and prescribe certain medications for
mothers and babies. The changes to
Victoria’s drugs and poisons legislation which enables endorsed midwives to
become prescribers was gazetted 30 November 2012 http://www.gazette.vic.gov.au/gazette/Gazettes2012/GG2012S410.pdf#page=1 . This document contains the list of medicines
from the poisons schedules 2,3, 4 and 8, which midwives are now able to
prescribe.
A participating midwife can order
some pathology tests and investigations, and can refer women and babies
directly to obstetricians and paediatricians.
The midwife is required to send a copy of the results to the
collaborating doctor.
Home birth services provided privately
by a midwife do not attract Medicare rebates, even if the midwife is
participating in the Medicare scheme. Homebirth services may be claimable
through certain private health funds.
Hospital backup arrangements for women planning homebirth are made with
the nearest suitable public maternity hospital, and may involve a booking in
process. Arrangements for referral and
transfer of care to hospital in acute situations are made by the midwife in
attendance.
Midwives and insurance
All midwives are required to have
professional indemnity insurance. Privately practising midwives purchase insurance
that covers them for antenatal and postnatal services. Midwives with Medicare eligibility
have access to a Commonwealth-subsidised professional indemnity insurance (http://www.miga.com.au/content.aspx?p=160 ) for the ante and postnatal
care they provide, as well as the birth services that they provide in hospitals
to their private clients.
If you have any further questions
about midwives and Medicare; what services they may provide, or how to work
with a midwife who has Medicare, you could contact the Australian College of
Midwives.
The midwives whose names and
practices are listed below are Victorian midwives who are Medicare-eligible, or
who are in the process of obtaining notation for Medicare. We look forward to continuing professional
cooperation between midwives and medical practitioners, in providing effective
and safe maternity services for mothers and babies in our communities.
We also take this opportunity to
extend to you Season’s Greetings.
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