Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (PATHOLOGY SERVICES TABLE) AMENDMENT REGULATIONS 2003 (NO. 3) 2003 NO. 300

EXPLANATORY STATEMENT

STATUTORY RULES 2003 No. 300

Issued by the authority of the Minister for Health and Ageing

Health Insurance Act 1973

Health Insurance (Pathology Services Table) Amendment Regulations 2003 (No. 3)

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.

The Act provides, in part, for payments of Medicare benefits in respect of professional services rendered to eligible persons. Section 9 of the Act provides that Medicare benefits shall be calculated by reference to the fees for medical services, including pathology services, set out in prescribed tables.

Subsection 4A(1) of the Act provides that the regulations may prescribe a table of pathology services setting out items of pathology services, the amount of fees applicable in respect of each item, and rules for interpretation of the table. A table of pathology services is currently prescribed by the Health Insurance (Pathology Services Table) Regulations 2003 (the Principal Regulations).

The purpose of the Regulations is to enable patients with chronic hepatitis C, who currently have access to a Medicare rebate for a quantitative hepatitis C virus test in the pretreatment evaluation of antiviral therapy, to also have access to a Medicare rebate to assess the efficacy of their antiviral therapy.

The Regulations support the listing of the combination therapy [ribavirin with peginterferon alfa-2b (Pegatron®)] for patients with chronic hepatitis C virus in the Pharmaceutical Benefits Schedule, under the Highly Specialised Drug Program. This listing took effect on 1 November 2003. Under the Regulations many patients undergoing combination therapy would have access to a Medicare rebate for a pathology test for the hepatitis C virus at week 12 of treatment to monitor the efficacy of the treatment.

Highly Specialised Drugs are medicines for the treatment of chronic conditions which, because of their clinical use or other special features, are restricted to supply through public and private hospitals having access to appropriate specialist facilities.

The change has been developed with the co-operation and support of the peak pathology bodies - the Royal College of Pathologists of Australasia (RCPA) and the Australian Association of Pathology Practices (AAPP) - through the Pathology Services Table Committee.

Details of the Regulations are set out in the Attachment.

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

The Regulations would commence on 8 December 2003.

ATTACHMENT

DETAILS OF THE HEALTH INSURANCE (PATHOLOGY SERVICES TABLE) AMENDMENT REGULATIONS 2003 (No. 3)

Regulation 1 specifies the regulations as the Health Insurance (Pathology Services Table) Amendment Regulations 2003 (No. 3).

Regulation 2 prescribes a commencement date of 8 December 2003.

Regulation 3 provides that Schedule 1 amends the Health Insurance (Pathology Services Table) Regulations 2003.

Schedule 1 incorporates the amendment to item 69442 of the Pathology Services Table to allow a Medicare rebate for the assessment of the efficacy of hepatitis C antiviral therapy as well as the existing rebate for a quantitative hepatitis C virus test in the pretreatment evaluation under that item.


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