'One big leap towards US-style managed care': Bupa accused of turning the screw

Health insurer to restrict cover for care offered by "non-approved" hospitals

GPs will be under further pressure to refer Bupa-insured patients to a company-approved specialist under controversial changes that have been described as “one big leap towards US-style managed care”.

The company, the biggest health insurer in Australia, says that, from August, it will only pay no-gap rates or known-gap rates (see box) for patients being treated at Bupa-contracted hospitals or facilities.

For doctors working at health providers with no formal agreements, Bupa will pay just 25% of the MBS schedule fee for treatment, with the