Minister for Health and Ageing Mark Butler says specialists’ extreme fees must be reined in — but is the threat of repaying Medicare rebates the right plan?

The Grattan Institute says specialists who charge extreme fees should be identified based on meeting either one of two criteria: their average ratio of fee-to-Medicare schedule fee is above three, or their mean fee over a year is more than three times the mean MBS schedule fee for all their services.

“The first definition captures specialists who consistently charge extreme fees, and the second captures those who charge a subset of their services at exorbitant rates,” it said in a June paper called Special Treatment.

Specialists in either category at the year’s end should be forced to repay the value of all Medicare rebates paid for their services that year, it said.