EXPLANATORY STATEMENT

 

Select Legislative Instrument 2008 No. 188

 

Health Insurance Act 1973

 

Health Insurance (General Medical Services Table) Amendment Regulations 2008 (No. 3)

 

 

Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make regulations prescribing all matters required for carrying out or giving effect to the Act. Part II of the Act provides for the payment of Medicare benefits for professional services rendered to eligible persons. Section 9 of the Act provides that Medicare benefits be calculated by reference to the fees for medical services set out in prescribed tables.

 

Subsection 4(1) of the Act provides that the regulations may prescribe a ‘table of medical services’ which sets out the ‘items’ of medical services, the fees for each item and rules for interpreting the table.

 

A table of general medical services is currently prescribed by the Health Insurance (General Medical Services Table) Regulations 2007 (the Principal Regulations) which commenced on 1 November 2007.

 

The purpose of the Regulations is to add a new rule to the Principal Regulations which prohibits the use of items 11000–12217 and 12500–12533 in the General Medical Services Table (GMST) for home-based sleep studies (i.e. overnight investigations for sleep apnoea, for a period of at least 8 hours duration). This rule will further clarify the original purpose of these items which is that they not be used for home-based sleep studies.

 

The amendment is part of the on-going management of the GMST. The Australian Medical Association, Medicare Australia, and the relevant craft groups have been consulted in the development of this rule.

 

The Department of Health and Aging consulted the Australian Medical Association, the Australasian Sleep Association, the Thoracic Society of Australia and New Zealand, the Royal Australian College of General Practitioners and the Rural Doctors Association of Australia regarding the introduction of a rule governing home-based sleep studies. Individual representations by medical practitioners were also submitted to the Department, which were noted and responded to.

 

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

 

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

 

The Regulations commence on 1 October 2008.