EXPLANATORY STATEMENT

 

Select Legislative Instrument 2010 No. 262

 

Health Insurance Act 1973

 

Health Insurance Amendment Regulations 2010 (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.

 

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 implement a 2010-11 Budget measure to recognise Addiction Medicine, Sexual Health Medicine and Sport and Exercise Medicine as medical specialties.

 

Schedule 5 to the Principal Regulations is made for the purposes of section 3GA of the Act and provides for the establishment of a register of 'approved placements' by Medicare Australia. Practitioners who are enrolled in or undertaking a course or program of a kind specified in Schedule 5 are eligible for registration on the register of approved placements. Part 1 of Schedule 5 lists specified bodies and qualifications whilst Part 2 of Schedule 5 lists bodies and programs. 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. 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 is amended by the Regulations to list the specialties of Addiction Medicine, Sexual Health Medicine and Sport and Exercise Medicine so that specialist trainees are able to provide Medicare-eligible services whilst on private sector placements.

 

Part 2 of Schedule 5 is amended by the Regulations to omit the Australasian College of Sports Physicians Training Program and the Department of Health and Ageing’s Approved Placements for Sports Physicians Training Program. As a specialty, Sport and Exercise Medicine is listed in Schedule 4 (as a specialty) and Part 1 of Schedule 5 (as a provider of specialist training), and may therefore be removed from Part 2 of Schedule 5.

 

Details of the Regulations are set out in the Attachment.

 

The Department consulted with the specialist medical colleges, the Australasian College of Sports Physicians and the Royal Australasian College of Physician’s Australasian Chapter of Addiction Medicine and Australasian Chapter of Sexual Health Medicine in relation to recognition as a medical specialty. In addition, the Department consulted with Medicare Australia and the Department of Veterans’ Affairs in relation to administering the amended legislation.

 

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 November 2010.

 

 

ATTACHMENT

 

Details of the HEALTH INSURANCE AMENDMENT REGULATIONS 2010 (NO. 4)

 

Regulation 1 – Name of Regulations

Regulation 1 provides for the Regulations to be referred to as the Health Insurance Amendment Regulations 2010 (No. 4).

 

Regulation 2 – Commencement

Regulation 2 provides for the Regulations to commence on 1 November 2010.

 

Regulation 3 – Amendment of Health Insurance Regulations 1975

Regulation 3 provides that Schedule 1 amends the Health Insurance Regulations 1975 (the Principal Regulations).

 

Schedule 1 – Amendments

 

Item [1] Schedule 4, after item 101

This item inserts the speciality of Sport and Exercise Medicine so Medicare Australia, the agency administering the Principal Regulations, is aware that medical practitioners who hold this qualification are specialists and entitled to specialist rebates.

 

Item [2] Schedule 4, after item 102A

This item inserts the specialties of Addiction Medicine and Sexual Health Medicine so that Medicare Australia is aware that medical practitioners who hold these qualifications are specialists and entitled to specialist rebates.

 

Item [3] Schedule 5, Parts 1 and 2

This item substitutes the table in Part 1 of Schedule 5 to the Principal Regulations to reflect the inclusion of the Australasian Chapter of Addiction Medicine (item 1), the Australasian Chapter of Sexual Health Medicine (item 3) and the Australasian College of Sports Physicians (item 6) so that specialist trainees in these specialties are able to provide Medicare-eligible services whilst on private sector placements.

 

This item also substitutes the table in Part 2 of Schedule 5 to omit the Australasian College of Sports Physicians Training Program (item 13) and the Commonwealth Department of Health and Ageing’s Approved Placements for Sports Physicians Training Program (item 21) from the table. As a specialist organisation and qualification that is recognised in Schedule 4, it is unnecessary to list item 13 in Part 2 of Schedule 5. As a specialist training course that is recognised in Part 1 of Schedule 5, it is unnecessary to list item 13 in Part 2 of Schedule 5.

 

A number of Rural Workforce Agencies have changed their names since they were established in 1998. Items 6,7,8,9 and 10 in Part 2 of Schedule 5 are amended to reflect these changes.

 

Items in the table are now listed alphabetically and renumbered.