EXPLANATORY STATEMENT

 

Select Legislative Instrument 2009 No. 368

 

Health Insurance Act 1973

 

Health Insurance Amendment Regulations 2009 (No. 5)

 

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.

 

Section 3D of the Act provides for the recognition of members of certain organisations as specialists for the purpose of attracting Medicare rebates at the specialist level. These organisations are currently specified under Schedule 4 to the Health Insurance Regulations 1975 (the Principal Regulations).

 

The purpose of the Regulations is to amend Schedule 4 to the Principal Regulations to accurately reflect the current names of organisations, specialties and qualifications. Part 1 of Schedule 5 to the Principal Regulations also is updated so that intensive care medicine specialist trainees are able to provide Medicare-eligible services whilst on private sector placements.

 

Over a period of time, various administrative changes within the specialist medical colleges have resulted in changes to several of the names of colleges and specialties, and thus their recognised qualifications. Medicare Australia has accommodated these irregularities by querying each discrepancy directly with the related specialist medical college as they have arisen.

 

The changes also allow for the addition of a new medical college to provide training in intensive care medicine. To ensure that no medical practitioners are disadvantaged by this update, the revision of Schedule 4 incorporates transitional and retrospective arrangements.

 

Private sector training is a large component of specialist training across all disciplines, and access to Medicare items is essential in order not to impede effective training. Fee-for-service arrangements involving Medicare-eligible services are vital to the funding of these training placements.

 

Part 1 of Schedule 5 to the Principal Regulations lists bodies and qualifications so that specialist trainees may be added to the Register of Approved Placements maintained by Medicare Australia, in order to enable those trainees to access Medicare rebates. Medicare Australia will issue a medical practitioner in an approved placement whose name is on the Register with a provider number in order to access Medicare benefits from the location at which the placement has been approved.

 

Details of the Regulations are set out in the Attachment.

 

The specialist medical colleges listed in Schedules 4 and 5 of the Health Insurance Regulations 1975 were contacted to provide advice on the accuracy of their college’s listings on the Regulations. The Australian Medical Council was also consulted to confirm the accuracy of the advice provided by the specialist colleges, particularly in relation to the recognition and accreditation of the specialist training programs.

 

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.

 

 

 

 

 

ATTACHMENT

 

Details of the Health Insurance Amendment Regulations 2009 (No. 5)

 

Regulation 1 – Name of Regulations

 

This regulation provides for the Regulations to be referred to as the Health Insurance Amendment Regulations 2009 (No. 5).

 

Regulation 2 – Commencement

 

This regulation provides for the Regulations to commence on 1 January 2010.

 

Regulation 3 – Amendment of the Health Insurance Regulations 1975

 

This regulation provides that Schedule 1 amends the Health Insurance Regulations 1975.

 

Schedule 1 – Amendments

 

Item [1] Schedule 4, item 102

This item amends the college name from the Royal Australasian College of Physicians:

·                 Division of Adult Medicine and Division of Paediatric and Child Health, to

·                 Division of Adult Medicine and Division of Paediatrics & Child Health.

 

It also includes amending ‘Intensive Care’ to ‘Intensive Care Medicine’ and includes three specialties which were omitted from Schedule 4 when it was amended in 2007. These are: Community Child Health; Neonatal/Perinatal Medicine; and Paediatric Medicine.

 

Item [2] Schedule 4, item 103

This item substitutes the name of the organisation, specialty and qualification to reflect an amendment to the organisation name from:

·                 The Royal Australasian College of Physicians, Australasian Faculty of Occupational Medicine, to

·                 The Royal Australasian College of Physicians, Australasian Faculty of Occupational and Environmental Medicine.

 

Item [3] Schedule 4, item 106, table, column 3

This item omits Intensive Care as a specialty of the Australian and New Zealand College of Anaesthetists. The College no longer provides this training program.

 

Item [4] Schedule 4, item 113

This item substitute the specialties so that Forensic Pathology is a separate and distinct specialty from the Anatomical Pathology (including Cytopathology) specialty training program.

 

Item [5] Schedule 4, item 115

This item substitutes the organisation name and qualification from the Australian and

New Zealand College of Anaesthetists and Royal Australasian College of Physicians, Joint Faculty of Intensive Care Medicine and will be known by the name College of Intensive Care Medicine of Australia and New Zealand. This change will occur on 1 January 2010.

 

 

Item [6] Schedule 4, after item 203

This item inserts Australasian Faculty of Occupational Medicine and acronym FAFOM as an item under the former organisations and qualifications so that Medicare Australia, the agency administering the Regulations, is aware that medical practitioners who hold this qualification are entitled to specialist rebates.

 

Item [7] Schedule 4, after item 207

This item inserts the Joint Faculty of Intensive Care Medicine and acronym FJFICM as an item under the former organisations and qualifications so that Medicare Australia, the agency administering the Regulations, is aware that medical practitioners who hold this qualification are entitled to specialist rebates.

 

Item [8] Schedule 5, Part 1, item 4

This item amends the organisation name and qualification from The Royal Australasian College of Physicians:

·                 Australasian Faculty of Occupational Medicine, FAFOM, to

·                 Australasian Faculty of Occupational and Environmental Medicine, FAFOEM.

 

Item [9] Schedule 5, Part 1, after item 7

This item inserts the new College of Intensive Care Medicine of Australia and New Zealand.

 

Item [10] Schedule 5, Part 1, item 9

This item omits the Joint Faculty of Intensive Care Medicine, which is replaced by the new College of Intensive Care Medicine of Australia and New Zealand.