Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE AMENDMENT REGULATIONS 1998 (NO. 10) 1998 NO. 372

EXPLANATORY STATEMENT

STATUTORY RULES 1998 NO. 372

Issued by authority of the Minister for Health and Aged Care

Health Insurance Act 1973

Health Insurance Amendment Regulations 1998 (No. 10)

The Health Insurance Act 1973 (the Act) provides in part for the payment of Medicare benefits for professional services rendered by medical practitioners and for certain professional services rendered by dental practitioners and optometrists.

Section 133 of the Act provides that the Governor-General may make regulations for the purposes of the Act.

Subsection 16B(1) of the Act provides in part that Medicare benefits are not payable for an R-type diagnostic imaging service unless the service rendered by the providing medical practitioner was requested in writing by another medical practitioner, a dental practitioner, a chiropractor, a physiotherapist or a podiatrist.

Subsection 16B(11) of the Act provides in part that R-type diagnostic imaging services specified in the regulations may be rendered by a medical practitioner without the requirement for a written request from another medical practitioner, a dental practitioner, a chiropractor, a physiotherapist or a podiatrist and provided the service is rendered prior to a "sunset" date and the rendering medical practitioner meets requirements for an exemption as a pre-existing practice.

Paragraph 16B(11)(d) of the Act provides that the sunset date is 1 January 1997 or a later date if prescribed by regulation.

Regulation 12A of the Health Insurance Regulations prescribes 1 January 1999 for the purposes of paragraph 1611(11)(d) of the Act.

The regulations extend by twelve months the date before which medical practitioners who meet the preexisting practices requirement can render a service specified in the regulations and have Medicare benefits paid in respect of that service.

The exemption was included in the Act following representations from The Royal Australian College of General Practitioners (RACGP) who were concerned that, unless the needs of some of theirs members were given special consideration, the proposed requesting arrangements would disadvantage those who had been providing diagnostic imaging services for many years.

Following discussions with the RACGP, it was agreed that an exemption would be provided for medical practitioners who had been providing x-rays for many years on the basis that a sunset provision would apply and the RACGP would develop accreditation guidelines. It has taken longer than envisaged to develop the guidelines.

In September 1998, the RACGP and The Royal Australian and New Zealand College of Radiologists reached agreement on a detailed program for continuing medical education and quality assurance for general practitioners providing radiology services under the remote and pre-existing diagnostic imaging practices exemptions. The program is capable of being implemented effectively and promptly.

The extension of the sunset provision, by twelve months, will enable general practitioners with a pre-existing diagnostic imaging practice exemption to join the RACGP program. It will also enable the passage through Parliament of amendments to the legislation which will introduce the continuing medical education and quality assurance requirements to the exemption. A bid has been lodged to introduce the amendment to the Act in the Autumn Session in 1999.

For patients, the regulation will preserve benefit entitlements for R-type diagnostic imaging services rendered on and from 1 January 1999 to 31 December 1999.

The regulation amends regulation 12A of the Health Insurance Regulations by on-fitting the date "1 January 1999" and substituting the date "I January 2000".

The regulations commence on 1 January 1999.


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