ACCC Backs Price Caps, Metrics for Tas Health Insurer

ACCC

The ACCC has decided to grant authorisation to health insurer St. Luke's Medical and Hospital Benefits Association (St Lukes) to enter into and give effect to specified price capping provisions in agreements with dentists who participate in St Lukes' dental partner provider network and who are in the same local catchment areas as St Lukes' own dental practices in Tasmania. The ACCC has also granted authorisation to St Lukes to issue metrics reports to dentists in its dental partner provider network regarding their services delivery and billing to St Lukes members.

Dentists that choose to participate in St Lukes' dental partner network agree to cap fees for certain routine and preventative services provided to St Lukes members so that members can receive these services on a 'no-gap' or 'known-gap' basis. St Lukes is planning to open and operate its own dental practices in Tasmania between 2024 and 2026, some of which may be in the same local catchment areas as dentists in its dental partner provider network.

The ACCC has decided to grant authorisation for 5 years, until 14 November 2029.

Further details about the application are available on the ACCC's public register.

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