Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (1994-1995 PATHOLOGY SERVICES TABLE) REGULATIONS (AMENDMENT) 1995 NO. 133

STATUTORY RULES 1995 No. 133

Issued by the Authority of the Minister for Human Services and Health

Health Insurance Act 1973

Health Insurance (1994-1995 Pathology Services Table) Regulations (Amendment)

Section 133 of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make regulations for the purposes of the Act.

Section 9 of the Act provides, in effect, that Medicare benefits shall be calculated by reference to the fees for medical services (including pathology services) set out in the table (which includes the pathology services table) in Schedule 1A to the Act.

Section 4A of the Act provides, among other things, that the regulations may prescribe a table of pathology services in accordance with the form of table set out in Section 4A(1) and that, upon commencement of a regulation prescribing a table of pathology services, the table so prescribed has effect as if it were set out in Section 4A(1) 1A in place of the table in that Section. The Health Insurance (1994-1995 Pathology Services Table) Regulations (the principal regulations) prescribe such a table.

Details of the Regulations, which have been developed with the co-operation and support of the two peak pathology professional groups, are as follows:

As part of 1995 Budget initiatives, 26 pathology items (Including item 66201) have had fee adjustments (15 fee decreases and 11 fee increases). The effect of these amendments is expected to be savings in the order of 0.7 per cent which amounts to $6 million in 1995-96 prices.

Item 66201 has been amended to enable bilirubin, including neonatal bilirubin, to be ordered separately as either a total or a fraction and is in line with current technology, Item 66365, which previously covered neonatal bilirubin, has been omitted.

The wording of item 66419 has been amended to clarify the original intention that the item be only used for the diagnosis of diabetes mellitus.

Item 73921 has been amended to ensure that only those receiving referred tests can claim this item (referred tests are where one practitioner refers tests that he is unable to perform on to another practitioner). The amendment specifies the use of the item and enables it to be more easily enforced.

These Regulations will have effect from 1 July 1995.