EXPLANATORY STATEMENT

 

 

Select Legislative Instrument 2010 No. 5

 

Health Insurance Act 1973

 

Health Insurance (General Medical Services Table) Amendment Regulations 2010 (No. 1)

 

 

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.

 

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 are 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 (other than diagnostic imaging services and pathology services) which sets out items of medical services, the amount of fees applicable for each item, and rules for interpreting the table. The Health Insurance (General Medical Services Table) Regulations 2008 prescribe such a table. (The retrospective date of these amendments means that the 2008 Regulations were in force at the time the amendments commenced).

 

The Regulations amend the descriptors for nine deep brain stimulation (DBS) items to allow Medicare benefits to be payable for the treatment of essential tremor and dystonia, both of which are neurological disorders.

 

The Regulations are taken to have commenced on 1 July 2009. The Office of Legislative Drafting and Publishing has provided advice that the Regulations do not contravene subsection 12(2) of the Legislative Instruments Act 2003. The amendments have the effect of including treatment of patients with essential tremor or dystonia (that may not amount to Parkinson’s) in the items that are being amended. This potentially allows more for claims for benefits and does not remove or reduce any right to claim that existed before the amendments.

 

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.

Consultation was undertaken by correspondence with Medicare Australia, the Australian Medical Association, the Australian and New Zealand Association of Neurologists and the Neurosurgical Society of Australasia. The fees committees of the medical organisations considered the amendments to the existing items and agreed to support them.