EXPLANATORY STATEMENT

 

Select Legislative Instrument 2005 No. 128

 

Issued by the Authority of the Minister for Health and Ageing

 

Health Insurance Act 1973

 

Health Insurance Amendment Regulations 2005 (No. 3)

 

Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides, in part, 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.

 

Paragraph 10(2)(aa) of the Act enables a Medicare benefit equal to 100% of the Medicare schedule fee to be paid for certain services, as prescribed in regulations.  Schedule 6 to the Health Insurance Regulations 1975 (the Principal Regulations) currently prescribes those services that attract a Medicare benefit equal to 100% of the Medicare schedule fee.  These services are non-referred consultations provided by vocationally and non-vocationally registered general practitioners, and services provided by a practice nurse on behalf of a general practitioner.

 

Amendments to the Health Insurance (General Medical Services Table) Regulations 2004 recommended under a separate Minute introduces six new items for chronic disease management services.   The purpose of the Regulations is to prescribe these six items as items that attract a Medicare benefit equal to 100% of the Medicare schedule fee. 

 

The six items fall within the category of items which currently attract a Medicare benefit equal to 100% of the Medicare schedule fee, as they are non-referred consultations provided by vocationally and non-vocationally registered general practitioners.  The inclusion of the six new items in Schedule 6 to the Principal Regulations ensures a consistent approach to payment of a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Details of the Regulations are set out in the Attachment. 

 

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

 

The Regulations are a legislative instrument for the purposes of the Legislative Instruments Act 2003.

 

The Regulations commence on 1 July 2005.

 

Consultation

The proposed new chronic disease management items recommended under a separate Minute have been developed in consultation with representatives of General Practice organisations.  Consultation has occurred both through a specific advisory group, established to advise on the detailed design and implementation  of changes to the Practice Incentives Program and EPC Medicare items arising from recommendations of the Red Tape Taskforce, and through the Medicare Benefits Consultative Committee, which formally considered the new Medicare items.  This consultation has enabled the development of the new items to be informed by the knowledge of persons with expertise in general medical practice and for general practitioners, as persons directly affected by the new items, to have opportunities to comment and contribute to the detailed design of the new items.  Consultation has included the proposed fee structure for the new items, including the payment of Medicare benefits equal to 100% of the Medicare schedule fee.

ATTACHMENT

 

DETAILS OF THE HEALTH INSURANCE AMENDMENT REGULATIONS 2005 (No. 3)

 

Regulation 1 provides for the Regulations to be referred to as the Health Insurance Amendment Regulations 2005 (No. 3).

 

Regulation 2 provides for the Regulations to commence on 1 July 2005.

 

Regulation 3 provides for Schedule 1 to amend the Health Insurance Regulations 1975 (the Principal Regulations).

 

 

Schedule 1 – Amendment

 

Item [1]

This item amends item 8 of Schedule 6 to the Principal Regulations to include

items 721, 723, 725, 727, 729 and 731 as services that attract a Medicare benefit equal to 100% of the Medicare schedule fee.