AUSactive is currently working closely with Private Healthcare Australia (PHA) to lead reform in private health insurance, with the goal of expanding access to evidence-based preventive health services, including Pilates, Yoga, Tai Chi, and structured exercise programs delivered by accredited professionals.
This collaboration comes in the wake of recent legislative changes that allow private health insurers to offer rebates for select natural therapies, reinstated following the 2024 independent review of their clinical effectiveness.
The review recommended the re-inclusion of seven therapies previously excluded in 2019, providing a significant opportunity to embed preventive health into the private health insurance system.
Private health insurers are working with industry associations to create accreditation, claims and other required processes to support the change. With the assistance of professional associations, the processes are expected to be in place in early 2026.
In response, AUSactive has proposed a national model for delivery that prioritises accreditation, safety, and clinical effectiveness. This includes the development of new item numbers for eligible services and a robust framework to guide implementation by both practitioners and insurers.
AUSactive CEO Barrie Elvish said it was a timely opportunity for private health insurers to take a proactive role in preventive health.
“By supporting structured, evidence-based services delivered by accredited professionals, we can improve the health of Australians while also reducing long-term healthcare costs,” Mr Elvish said.
AUSactive’s contribution to this reform includes:
- A national accreditation framework to support how accredited exercise and active health professionals can deliver services under private health insurance
- Industry consultation through surveys to ensure the model reflects current practice, billing, and consumer needs
- Practical implementation tools such as draft item schedules, rules of use, and FAQs to support both insurers and practitioners.
The partnership also aligns with broader industry efforts to establish the necessary claims processes that will allow health funds to offer rebates for clinical applications of natural therapies.
This includes meeting regulatory obligations such as defining treatment eligibility, developing referral pathways, and ensuring service quality through recognised accreditation processes.
AUSactive’s framework offers an immediate opportunity for private health insurers to:
- Deliver increased member value
- Improve long-term health outcomes
- Reduce the cost burden of chronic disease
- Modernise the delivery of preventive healthcare.
Mr Elvish said AUSactive valued the constructive collaboration with Private Healthcare Australia as both organisations work towards the next phase of implementation.
“We value the constructive collaboration with Private Healthcare Australia and look forward to progressing the next steps of this important national initiative,” Mr Elvish said.
For more information visit https://privatehealthcareaustralia.org.au/health-insurers-working-with-natural-therapists-to-develop-accreditation-and-claims-framework/
