AUSactive and Private Healthcare Australia Drive Health Insurance Reforms

The legislative changes were reinstated after a 2024 independent review of their clinical effectiveness, recommending the re-inclusion of seven therapies previously excluded in 2019. This development provides 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, these processes are expected to be in place in early 2026.

AUSactive has proposed a national model for delivery that prioritizes 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 Chief Executive Barrie Elvish emphasized the timely opportunity for private health insurers to take a proactive role in preventive health. By supporting structured, evidence-based services delivered by accredited professionals, the health of Australians can be improved while also reducing long-term healthcare costs.

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.

This collaboration underscores a commitment to integrating preventive health services into the private health insurance framework, ultimately benefiting both consumers and the broader healthcare system.