As the peak professional organisation representing medical practitioners in Australia, the Australian Medical Association (AMA) welcomes the opportunity to provide a brief submission to the MBS Review Aboriginal and Torres Strait Islander Health Reference Group. Theirr suggestions cover mental health, chronic conditions management, substance misuse rebates, and Aboriginal health checks.

Key points:
 

• AMA proposes that rebate items should allow for group therapy work by GPs who often work collaboratively with Aboriginal workers in wellbeing groups, and increase rebate sessions to more than 10 for GPs as well as psychologists..
• Shared Medical Appointments (SMAs) to provide advice on healthy living, risk factors and managing common chronic conditions would be in line with wellbeing programs run in Aboriginal community-controlled health services. Clinicians supporting this approach should have a Medicare item they can use.
• Indigenous communities are disproportionately afflicted by substance misuse disorders that are often complicated by associated co-morbidities including mental illness as well as polysubstance abuse. This presents a significant challenge for the treating clinician. In this context a Medicare rebate item that pays better than a standard long consult (40) would reflect the higher management skills of the clinician treating Indigenous clients with substance misuse disorders.
• There needs to be a re-design of the Aboriginal Health Check template that incorporates better qualifiers as well as creating Medicare associated reviews similar to care plans.