Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE AMENDMENT REGULATIONS 2003 (NO. 4) 2003 NO. 357

EXPLANATORY STATEMENT

STATUTORY RULES 2003 NO. 357

Issued by the Authority of the Minister for Health and Ageing

Health Insurance Act 1973

Health Insurance Amendment Regulations 2003 (No. 4)

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 Regulations is to allow medicare benefits to be paid in respect of professional services rendered by medical practitioners registered as participants in the Metropolitan Workforce Support Program.

Section 19AA of the Act provides that a medicare benefit is not payable in respect of a professional service unless the person who rendered the service first became a medical practitioner before 1 November 1996, or unless the person is, within the meaning of the Act, a "specialist", a "consultant physician", a "general practitioner" or a person registered under section 3GA of the Act.

Section 19AB of the Act prevents the payment of medicare benefits in respect of professional services rendered by certain overseas trained doctors who were first recognised as medical practitioners on or after 1 January 1997. Subsection 19AB(3) of the Act allows the Minister to grant exemptions from the operation of section 19AB.

Section 3GA of the Act provides for the registration of certain medical practitioners in approved placements and the establishment and maintenance of a Register of Approved Placements. Paragraph 3GA(5)(a) provides for the entry of a practitioner's name on the Register of Approved Placements where the practitioner applies and a body specified in the regulations gives written notice to the Managing Director of the Health Insurance Commission that the applicant is undertaking a course or program of a kind specified in the regulations, together with the duration and location of the course or program.

Entry of a practitioner's name in the Register of Approved Placements allows the payment of medicare benefits for professional services rendered by the practitioner where section 19AA of the Act would otherwise prevent the payment of medicare benefits in respect of the practitioner's services.

Regulation 6E of the Health Insurance Regulations 1975 (the Principal Regulations) provides:

"For paragraph 3GA(5)(a) of the Act, the following bodies, courses and programs are specified:

(a)       a body mentioned in an item in Part 1 or 2 of Schedule 5;

(b)       a course that leads to a qualification in an item in Part 1 of Schedule 5 from the body specified in the item;

(c)       a program in an item in Part 2 of Schedule 5 approved by the body specified in the item."

The Regulations include the Metropolitan Workforce Support Program in Part 2 of Schedule 5 of the Principal Regulations and hence specify that Program for the purposes of the Register of Approved Placements.

The objective of the Metropolitan Workforce Support Program is to utilise the services of permanent resident overseas trained doctors (and other target groups of practitioners identified from time to time) to provide medical practitioner services in nominated districts of workforce shortage. The Program is administered by the Department of Health and Ageing.

The operation of sections 19AB and 19AA of the Act currently prevents the payment of medicare benefits in respect of professional services provided by the medical practitioners targeted by the Program. The addition of the Program to Schedule 5, Part 2 of the Regulations address restrictions under section 19AA and allow medicare benefits to be paid in respect of professional services provided by these medical practitioners. Participating practitioners who are overseas trained doctors or former overseas medical students would also require an exemption under subsection 19AB(3).

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

Details of the Regulations are set out in the Attachment.

The Regulations commence on gazettal.

ATTACHMENT

DETAILS OF THE PROPOSED HEALTH INSURANCE AMENDMENT REGULATIONS 2003 (No. 4)

Regulation 1 provides for the Regulations to be referred to as the Health Insurance Amendment Regulations 2003 (No. 4).

Regulation 2 provides for the amended Regulations to commence on Gazettal.

Regulation 3 provides for the Health Insurance Regulations 1975 to be amended as set out in Schedule 1.

Schedule 1 inserts a new Item 19 into the table in Schedule 5, Part 2 of the Health Insurance Regulations 1975. The new Item adds the Metropolitan Workforce Support Program as a specified program and the Australian Government Department of Health and Ageing as the specified body for the Program.


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