Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (1995-96 PATHOLOGY SERVICES TABLE) REGULATIONS (AMENDMENT)1996 NO. 10

STATUTORY RULES 1996 No. 10

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

Health Insurance Act 1973

Health Insurance (1995-96 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 setting out fees applicable to items of pathology services and rules for interpreting the table. The Health Insurance (1995-96 Pathology Services Table) Regulations (the principal regulations) prescribe such a table.

The 1995-96 Budget contained a package of measures designed to reduce the high level of growth in pathology outlays under Medicare. While the principal initiatives took effect took effect on 1 July 1995, the package included savings to be achieved through a measure to be developed with the peak pathology bodies in the latter half of 1995, and introduced from 1 February 1996.

This measure, which is embodied in the proposed regulations, comprises reductions in the Schedule Fees for certain items in the Pathology Services Table called Patient Episode Initiation items (PEIs). It is anticipated that it will result in savings in Medicare pathology outlays of $5.2 million in 1995/1996, and $12.5 million in 1996/1997.

This proposal was developed by the Pathology Consultative Committee which includes representatives of the two peak pathology professional bodies, the Royal College of Pathologists of Australasia and the Australian Association of Pathology Practices, and the Department of Human Services and Health, and the Health Insurance Commission,

Details of the Regulations are as follows:

Regulation 1 prescribes a commencement date of 1 February 1996 for the new regulations.

Regulation 2 provides that the 1995-96 Pathology Services Table is amended as set out in the new regulations.

Subregulation 3.1 reduces the fee for item 73901 from $7.85 to $7.10.

Subregulation 3.2 reduces the fee for item 73903 from $14.15 to $13.40.

Subregulation 3.3 reduces the fee for item 73905 from $7.85 to $7.10,

Subregulation 3.4 reduces the fees for items 73907 and 73909 from $16.25 to $15.50.

Subregulation 3.5 reduces the fees for items 73911, 73913 and 73915 from $10.00 to $9.25.

The Regulations have been developed with the co-operation and support of the two peak pathology professional bodies, the Royal College of Pathologists of Australasia and the Australian Association of Pathology Practices.

These Regulations will have effect from 1 February 1996.