Evolution Pilates Newsletter 
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Wishing everyone a Happy New Year.
Looking forward to working with you on all your
exercise goals


Happy Australia Day!
We reopen Tue 29/1/2019

Information regarding health fund claims for Pilates

from Susie Bond
Physiotherapist and Pilates Practitioner

Some of you may have received notification from your health fund outlining changes to health fund rebates for certain ‘natural therapies’ from April 2019.
I want to assure everyone, that overall, nothing will change at my practice, in terms of health fund rebates. You will still be able to claim for physiotherapist supervised small group exercise sessions, under physiotherapy benefits, and physiotherapy standard consultations. This is no change from what many of you have been receiving over the last few years, since these codes were updated.
Our Name Rebrand Update
I want to make things clear about what we do at Evolution Pilates. I have always used Pilates with my physio techniques for over 20 years. My aim is to provide my clients with the best care possible. I work alongside excellent instructors, in an atmosphere of mutual respect and cross communication. My business name has always been ‘Activate Exercise Rehab P/L’ trading as Evolution Pilates.
From now on health fund statements will be under the name Activate Ex. Rehab, until we have better clarity about the implications of the April 2019 legislation.
 Who is driving these changes to health fund claims for ‘Natural Therapies?
These changes are the result of a review that was chaired by the Commonwealth Chief Medical officer and conducted by the National Health and Medical Research Council (NHMRC). The report suggests that there is not sufficient evidence to demonstrate the efficacy of the therapies in management of medical conditions, listed below, including Pilates. The report was written in 2015 and covers scientific literature from 1994 to 2013.

Why we think this is unfair.
Many people who are highly trained and experienced Pilates instructors, including physiotherapists, do not agree with this report and are seeking a review. There are new research studies since 2013, that do show evidence for Pilates exercise effectiveness in management of certain clinical conditions. Full health management is another issue. There is ample evidence to show physio supervised exercise and exercise generally is effective in giving pain relief, positive improvements in functional ability, strength, balance reactions, mood improvement and postural awareness. This is especially the case for management of potentially chronic conditions like low back pain, osteoarthritis and postural strain. Designing effective studies for these conditions has always been challenging.
What therapies will no longer be covered under this new legislation?
The following therapies will no longer receive private health insurance rebate: Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi, and yoga.

What health fund rebates are affected by the legislation?
The main area affected will be the extra bonus or 'health management' section, also referred to as ‘Healthy Lifestyle’. Here you are required to complete a form with a medical or health practitioners’ signature. This is different to the ‘extras’ area of health fund rebates for registered health professionals (eg. physio, dental, chiro.) Pilates, yoga, tai chi etc. will no longer included. These are claimed under a Pilates provider number that was issued to a Pilates association membership. 
This small amount could be claimed each year for items like gym memberships, sports shoes etc. This does not affect claims through a ‘group physiotherapy’ code. You will have to check with your health fund about each individual health fund’s decisions concerning this.
News from the Australian Physiotherapy Association.
The APA has been part of advocacy groups to the Government. The APA reports that it has come to an arrangement with the advisory board of the Department of health and Private Health insurers.
The Department considers that 'physiotherapy is physiotherapy’, and that we decide what comes in our accepted scope of clinical practice.
My understanding is that ‘Pilates’ classes that are for general exercise maintenance are not covered by health fund benefits. Physio supervised exercise rehabilitation that is part of management of a specific assessed condition being treated by a physio, is covered. This may include Pilates exercise modality within the treatment. This complies with what we have always done. 
There is ample scientific evidence for treatment of conditions like low back pain,
pre and post-natal pelvic pain and instability, pre and post operation knee and hip, tendon problems, shoulder girdle postural dysfunction, osteoporosis with specific exercise rehab and sports and dance injuries with therapeutic exercise intervention, including Pilates principles and equipment.
Attitudes of Pilates Instructors in the Community
Many Pilates studios run on the premise that their clients do not claim health fund rebates (eg. MG Pilates, Erskineville). Most Pilates instructors do not see that their businesses will be affected by the decision, according to the recent online discussions and conference networking.
They do feel it is unfair that physiotherapists can still get health fund claims when including Pilates in their work, as some physiotherapists are not fully trained or experienced Pilates instructors.
The Pilates Associations only issued provider numbers to instructors who have full certification, experience and continuing education points.
Doctors and many registered health professionals refer clients to physio and Pilates studios, for supervised long-term exercise management. Many of you have first hand experience of benefits of detailed supervised exercise sessions.
This why Pilates Associations will be continuing to fight this law going through. Mike Green and I are part of a committee looking at strategies to put a halt to the law going through in April 2019, until the decision is reviewed. Some of you may remember Mike who worked with us for a number of years. He is studying Osteopathy in Melbourne, and still teaches Pilates there.
What you can do

  • You may want to use up your health management plan benefit before 1st April 2019. Please advise the admin staff so they can receipt your sessions accordingly from now on.
  • You may need to discuss the importance of a physiotherapy re assessment with the hicaps 500 or 505 code. This will assist your desire to continue to claim through ' group physio’ for a particular injury and condition management exercise prescription review. At this stage our understanding is that this needs to be done at least once a year, but some funds may require after every 10 exercise rehab sessions for specific conditions.
  • You may like to contact your health fund CEO or local MP. I have an outline letter to help guide your information and questions to them
  • Main urgency: lobby to stop the law going through in April 2019, without amendments that allow therapeutic Pilates by fully qualified Pilates instructors and acknowledge that there is evidence that Pilates is effective 
  • Does anyone know an MP who would table a question in parliament before April 2019, to ask for a halt to legislation, until a review of the unfair decision which used out of date evidence information can be completed?
  • Continue to lobby through natural therapy websites, journalists,
What we will do
  • Make sure we are complying with health fund law requirements, if this applies to your health needs and claim needs
  • Continue to review your physiotherapy management to include the most up to date evidence-based treatment. (an ongoing interesting challenge!)
  • Provide a new pack option of one private assessment and 10 exercise studio sessions
  • Continue to incorporate a range of exciting group classes that address specific health and wellbeing eg. Spinal, lower limb, shoulder girdle conditions, Dance Science, Pre-ski and sports exercise such as ‘Get Fit to Ski’, Balance and Strength for Neurological conditions, osteoporosis, Woman’s health issues, Runners stretch and core stability

Sorry this letter is so long winded. I wanted to give you as much detail about the issue as possible. We will keep you notified about any further information we have. Please be re assured that you will continue to be able to claim health fund rebates for your Physio supervised exercise studio sessions. I am happy to discuss this if you have queries.
Kind regards
Susie Bond

Director Activate Physio and Evolution Pilates.
Copyright © 2019 Evolution Pilates, All rights reserved.

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