Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE AMENDMENT REGULATIONS 2009 (NO. 4) (SLI NO 306 OF 2009)

EXPLANATORY STATEMENT

 

Select Legislative Instrument 2009 No. 306

 

Health Insurance Act 1973

 

Health Insurance Amendment Regulations 2009 (No. 4)

 

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.

 

Regulation 11 of the Health Insurance Regulations 1975 (the Principal Regulations) outlines the diagnostic imaging services that allied health professionals (AHPs) (chiropractors, osteopaths, physiotherapists) may request.

 

The Health Insurance (Diagnostic Imaging Services Table) Regulations 2009 (the DIST Regulations) contain x-ray items that cover the four areas of the spine, being the cervical, thoracic, lumbosacral and sacrococcygeal regions. They allow a health professional to request a single or multi-region (being two, three or four region) x-ray for diagnostic purposes. There is some evidence to suggest that AHPs are requesting excessive and unnecessary numbers of three and four region spinal x-rays.

 

The Regulations aim to reduce unnecessary patient exposure to radiation by limiting the number of three and four region spinal x-rays that can be requested by AHPs for a particular patient in a calendar year.

 

The Regulations remove from regulation 11 of the Principal Regulations, requesting rights for AHPs for items 58108 (four region spinal x-ray) and 58115 (three region spinal x-ray) and replace them with references to two new items, 58120 and 58121 to be inserted into the DIST Regulations. These items will only be provided to a patient once in a calendar year, which limits requesting rights of AHPs to either one three region (58121) or one four region (58120) spinal x-ray per patient each calendar year.

 

Radiology stakeholders have previously raised concerns about inappropriate requesting of multi-region spinal x-rays by Allied Health Professionals (AHPs – chiropractors, physiotherapists, osteopaths).

 

Anecdotal evidence of over requesting of items 58108 (four region spinal x-ray) and 58115

(three region spinal x-ray) was provided from the Royal Australian and New Zealand College of Radiologists; the Australian Diagnostic Imaging Association; the Western Australian Department of Health and Diagnostic Imaging Pathways Project; and the Australian Radiation Protection and Nuclear Safety Authority.

 

This specific proposal was not subject to wide spread consultation because of Budget and Cabinet confidentiality requirements.

 

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 January 2010.


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