Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE REGULATIONS (AMENDMENT) 1991 NO. 314

STATUTORY RULES 1991 No. 314

HEALTH INSURANCE ACT 1973

HEALTH INSURANCE REGULATIONS (AMENDMENT)

ISSUED ON THE AUTHORITY OF THE MINISTER FOR HEALTH, HOUSING AND COMMUNITY SERVICES

Section 133 of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make regulations for the purposes of the Act.

Subsection 19A(1) of the Act provides that such regulations may provide that, unless the Minister otherwise directs, medicare benefits are not payable in respect of professional services rendered in prescribed circumstances. Subsection 19A(2) provides that, in the case of professional services other than pathology services, such regulations shall not be made except in accordance with a recommendation made to the Minister by the Medicare Benefits Advisory Committee.

Subregulation 2ADB(1) of the Health Insurance Regulations provides that, unless the Minister otherwise directs, medicare benefits are not payable in respect of professional services rendered in prescribed circumstances. Subregulation 2ADB(2) sets out what these prescribed circumstances are.

The Minister for Health, Housing and Community Services has approved a recommendation made by the Medicare Benefits Advisory Committee that medicare benefits should not be payable for certain organ transplants. These amending Regulations have, therefore, amended Regulation 2ADB of the Health Insurance Regulations to implement this recommendation. Specifically, subregulation 2ADB(2) has been amended to include, as 'prescribed circumstances' for the purposes of subregulation 2ADB(1), professional services rendered for the purpose of, or in relation to:

(i)       the transplantation of a thoracic or abdominal organ, other than a kidney, or of a part of an organ of that kind; or

(ii)       the transplantation of a kidney in conjunction with the transplantation of a thoracic or other abdominal organ, or of a part of an organ of that kind;

if the services are rendered to an in-patient of a hospital.