EXPLANATORY STATEMENT

 

Select Legislative Instrument 2006 No. 269

 

Issued by the Authority of the Minister for Health and Ageing

 

Health Insurance Act 1973

 

Heath Insurance Amendment Regulations 2006 (No. 3)

 

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.

 

Subsection 3C(1) of the Act enables the Minister to make a written determination in respect of a health service, or a health service in a specified class of health services, for the purposes of payment of Medicare benefits. Subsection 3C(8) defines the health services that may be subject to a determination under subsection 3C(1), and paragraph 3C(8)(b) enables other types of health services to be prescribed by regulations.

 

The Regulations will amend the Health Insurance Regulations 1975 (the Principal Regulations) to prescribe three additional classes of allied health services as health services for the purposes of section 3C of the Act. The Regulations are necessary to give effect to changes to Medicare announced by the Australian Government in March and April 2006, which enable Medicare benefits to be payable for these allied health services in specified circumstances.

 

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 Principal Regulations currently lists those services that attract a Medicare benefit equal to 100% of the Medicare schedule fee. These services comprise 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.

 

The Regulations will also list several new services in Schedule 6 to the Principal Regulations, as a consequence of amendments being made to other regulations.

 

Among the amendments included in the Health Insurance (General Medical Services Table) Regulations 2006, seven new items for General Practitioner (GP) over 45 health checks, GP mental health care, pregnancy counselling and practice nurse preventive checks will be introduced into the General Medical Services Table. The Regulations will prescribe these seven items as items that attract 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 take effect on 1 November 2006, in line with the amendments to the General Medical Services Table.

 

 

Authority: Subsection 133(1) of the

Health Insurance Act 1973

ATTACHMENT

 

DETAILS OF THE HEALTH INSURANCE AMENDMENT REGULATIONS 2006 (No 3)

 

Regulation 1 provides for the Regulations to be referred to as the Health Insurance Amendment Regulations 2006 (No. 3).

 

Regulation 2 provides for the Regulations to commence on 1 November 2006.

 

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

 

Schedule 1 – Amendment

 

Item [1]

This item amends regulation 3A by substituting it with a new regulation 3A. The new regulation 3A prescribes three additional classes of allied health services as “health services” for the purposes of section 3C of the Act. These are:

·        focussed psychological strategies;

·        non-directive pregnancy support counselling; and

·        psychological therapy.

 

Item [2]

This item amends item 7 of Schedule 6 to the Principal Regulations to include item 717 as a service that attracts a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Item 717 is a new GP item for a health check for people 45-49 years of age who may be at risk of developing a chronic disease.

 

Item [3]

This item amends item 12 of Schedule 6 to the Principal Regulations to include items 2710, 2712 and 2713 as services that attract a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Items 2710, 2712 and 2713 improve access to and encourage a multidisciplinary approach to the care of people with mental disorders. More specifically, these items aim to encourage more GPs to undertake early intervention, assessment and management of patients with mental disorders and to streamline access to appropriate psychological interventions in primary care.

 

Item [4]

This item inserts item 14AA of Schedule 6 to the Principal Regulations to include item 4001 as a service that attracts a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Item 4001 is for the provision of non-directive pregnancy support counselling services by eligible medical practitioners, including a general practitioner, but not including a specialist or consultant physician.

 

Item [5]

This item amends item 14A of Schedule 6 to the Principal Regulations to include items 10994 and 10995 as services that attract a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Items 10994 and 10995 provide for more practice nurses to undertake a wider range of procedures including pap smears and other preventive checks.