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HEALTH INSURANCE AMENDMENT REGULATIONS 2003 (NO. 2) 2003 NO. 254
Issued by the Authority of the Parliamentary Secretary to the Minister for Health and Ageing
Health Insurance Amendment Regulations 2003 (No. 2)
Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make regulations, not inconsistent with the Act, prescribing all matters required or permitted by the Act to be prescribed, or necessary or convenient to be prescribed for carrying out or giving effect to the Act. The purpose of the proposed Regulations is to amend the list of diagnostic imaging services which may be requested by registered or licensed dental practitioners under the Medicare scheme.
The Act provides, in part, for the payment of Medicare benefits in respect of certain professional services rendered by dental practitioners. Section 9 of the Act provides that Medicare benefits shall be calculated by reference to the fees for medical services, including diagnostic imaging services, set out in prescribed tables. Section 4AA of the Act provides that regulations may prescribe a table of diagnostic imaging services, including items of R-type diagnostic imaging services and subsection 16B(2) of the Act provides that regulations may prescribe certain R-type diagnostic imaging services that may be requested by a dental practitioner.
R-type (requested) services comprise the majority of services in the Diagnostic Imaging Services Table. The proposed Health Insurance (Diagnostic Imaging Services Table) Regulations 2003, recommended under a separate Minute, would prescribe a revised Table. Regulation 10 of the Health Insurance Regulations 1975 (the Principal Regulations) specifies diagnostic imaging services that may be requested by dental practitioners who are registered or licensed under relevant State or Territory laws. These services are identified by reference to items contained in the Diagnostic Imaging Services Table.
The Regulations:
• insert three additional diagnostic imaging services, 63003, 63103, 63273, in Regulation 10(1)(a), which specifies the diagnostic imaging services that can be requested by dental practitioners approved by the Minister under paragraph (b) of the definition of professional service in subsection 3(1) of the Act (ie, oral and maxillofacial surgeons); and
• omit item 59924 from the services specified in paragraphs 10(1)(a) and 10(1)(d) as this item has been removed from the Table.
Further details of the Regulations are outlined in the Attachment.
The Royal Australian and New Zealand College of Radiologists, the Australian Diagnostic Imaging Association, the Australian and New Zealand Association of Oral and Maxillofacial Surgeons and the Health Insurance Commission have been consulted regarding the Regulations.
The Act specifies no conditions that need to be met before the power to make the Regulations may be exercised.
The Regulations commence on 1 November 2003.
ATTACHMENT
DETAILS OF THE HEALTH INSURANCE AMENDMENT REGULATIONS 2003 (No. 2)
Regulation 1 provides that the name of the regulations will be the Health Insurance Amendment Regulations 2003 (No. 2).
Regulation 2 provides that the regulations commence on 1 November 2003.
Regulation 3 provides that Schedule 1 amends the Health Insurance Regulations 1975 (the Principal Regulations) in the following ways:
Schedule 1, item 1 of the Regulations amends paragraph 10(1) (a) of the Principal Regulations by omitting item 59924 from those items which oral and maxillofacial surgeons can request. This item is no longer an item of service specified in the Diagnostic Imaging Services Table.
Schedule 1, item 2 of the Regulations amends paragraph 10(1) (a) of the Principal Regulations by inserting items 63003, 63103 and 63273 to the list of items that oral and maxillofacial surgeons can request.
Currently, under paragraph 10(1) (a), oral and maxillofacial surgeons are only able to request Magnetic Resonance Imaging (MRI) services 63621, 63671 and 63712. The Australian and New Zealand Association of Oral and Maxillofacial Surgeons (ANZAOMS) has sought access to request additional, clinically relevant, MRI items.
A submission was made by ANZAOMS to the Royal Australian and New Zealand College of Radiologists and considered by the Radiology Management Committee (RMC) at its meeting on 12 August 2003. The RMC, which consists of representatives from the Department of Health and Ageing, the radiology profession, and the Health Insurance Commission, noted that under paragraph 10(1) (d), oral medicine and oral pathology specialists currently have access to MRI items 63003, 63103 and 63723 as well as 63621, 63671 and 63712. Therefore, based on the information provided, the RMC agreed that oral and maxillofacial surgeons also be given requesting access to MRI items 63003, 63103 and 63723.
Schedule 1, item 3 of the Regulations amends paragraph 10(1) (d) of the Principal Regulations by omitting item 59924 from the items which oral medicine and oral pathology specialists can request. This item is no longer an item of service specified in the Diagnostic Imaging Services Table.