Private health insurer’s plans to be justified to ACCC in five years

11 May 2018

Persistent advocacy by the ADA has resulted in the Australian Competition and Consumer Commission (ACCC) applying a shorter, five-year timeframe to exempt HCF's planned dental clinic expansion from potential breaches of competition law.  

In late 2017, HCF informed the ACCC of plans to expand its “Dental Clinic Network” to areas where they potentially could overlap with their own contracted providers participating in the “More for Teeth” program.  

The fund sought ACCC’s authorisation to exempt these plans from the competition law, particularly those provisions related to price fixing, for a period of ten years. 

Following sustained opposition by the ADA (the only health practitioner association to do so), which argued that outright approval would not be in the public interest, the ACCC has today granted HCF authorisation for a considerably shorter five-year period, a decision that while disappointing, does acknowledge that private health insurers need to be more closely and frequently scrutinised. 

It also places the onus, notes ADA President Dr Hugo Sachs , on HCF to justify that its actions over that five-year period are of benefit to the Australian public. 

"Should HCF seek to reapply for authorisation, it will need to demonstrate over the next five years its expansion of dental clinics that overlap its own contracted providers are not a means of steering policy holders to the former; but consumers have overall benefitted through increased, better value health care. 

"Were it not for the ADA, it was very likely that the ACCC’s authorisation of HCF would be for a 10-year period instead of five." 

The ADA continues to reiterate that its position that all policyholders paying the premium and who are seeking the same treatment, should receive the same rebate regardless of which dentists they attend, and that wholesale reform of the private health insurance industry is needed to ensure all consumers have equal access their preferred healthcare provider.