Commonwealth Numbered Regulations - Explanatory Statements

[Index] [Search] [Download] [Related Items] [Help]

HEALTH INSURANCE AMENDMENT REGULATIONS 2003 (NO. 3) 2003 NO. 356

Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make regulations 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 Regulations is to add the Special Approved Placements program to the list of approved programs for the purpose of payment of Medicare benefits to doctors subject to section 19AA of the Act.

Section 19AA of the Act generally requires doctors to have postgraduate (Fellowship) qualifications before they are eligible to access Medicare benefits. This requirement was introduced by the Government in 1996 with the aim of ensuring that the long term medical workforce in Australia is of a high quality and to assist in dealing with workforce distribution problems.

The only exception to the Fellowship requirement is if doctors are working in approved placements in programs established under section 3GA of the Act. Section 3GA of the Act permits medical practitioners undertaking approved postgraduate vocational training or approved workforce programs to provide professional services that attract Medicare benefits. Approved placement programs are prescribed in the Health Insurance Regulations 1975 (the Principal Regulations).

The approved training programs allow doctors to receive access to Medicare benefits while undertaking vocational training to receive Fellowship from the Royal Australian College of General Practitioners or one of the medical specialist colleges. The approved workforce programs are limited to areas where significant general practice workforce shortages have occurred. Doctors working in the areas concerned must have achieved medical registration but do not have Fellowship.

The major workforce program for which an exemption is provided is the Rural Locum Relief Program. Metropolitan areas are not covered by any workforce program except for the Approved Medical Deputising Service Program which is for after hours services only.

The Regulations list the Special Approved Placements Program as an eligible workforce program under section 3GA of the Act. It is anticipated that this program would be restricted to small numbers of doctors who can demonstrate exceptional circumstances that make them unable to participate in any other section 3GA program.

An example would be a medical practitioner whose spouse had a serious illness, such as cancer, that requires ongoing treatment (where it is demonstrated such treatment is only available in a particular metropolitan location). Currently there is no program available to enable the doctor to bill Medicare in a metropolitan area of workforce shortage during normal working hours in such a situation. The provision would introduce the flexibility to consider and approve such requests.

The Regulations also make minor amendments to the table in Part 2 of Schedule 5 to the Principal Regulations, to update the name of the Department of Health and Ageing where ever it occurs in that Part.

The Act specifies no conditions that need to be met before the power to make the Regulations may be exercised.

The Regulations commence on gazettal.