Commonwealth Numbered Regulations - Explanatory Statements

[Index] [Search] [Download] [Related Items] [Help]


NATIONAL HEALTH AMENDMENT REGULATIONS 1999 (NO. 2) 1999 NO. 140

EXPLANATORY STATEMENT

STATUTORY RULES 1999 No. 140

Issued by the Authority of the Minister for Health and Aged Care

National Health Act 1953

National Health Amendment Regulations 1999 (No. 2)

Section 140 of the National Health Act 1953 (the Act) allows the Governor-General to make regulations prescribing matters that are required or permitted by the Act to be prescribed, or that are necessary and convenient to be prescribed for carrying out or giving effect to the Act.

Section 67 of the Act prohibits a person (other than a registered organization) from carrying on health insurance business. The term "health insurance business" is defined in subsection 67(4) of the Act. In so far as is relevant, paragraph 67(4)(e) of the Act provides that health insurance business does not include business of a kind prescribed.

Regulation 48 of the National Health Regulations (the Principal Regulations) prescribes various types of business for the purposes of paragraph (e) of the definition of "health insurance business". In other words, regulation 48 allows for an insurer that is not a registered organization under the Act to provide health insurance for certain situations/events that would otherwise fall within the standard definition of "health insurance business".

The amending regulations:

*       Amend references to "health insurance business" in regulation 48 of the Principal Regulations to reflect amendments made to that term in the Act;

*       Amend regulation 48(1)(a)(i) of the Principal Regulations to clarify that health insurance for a person who is covered by a reciprocal health care agreement but who is not otherwise an eligible person is not health insurance business, thereby allowing both registered organizations and other insurers to provide such insurance; and

*       Amend regulation 48(1)(b)(iv) of the Principal Regulations to update the reference to "employment programs" following the changes in administrative arrangements and to also include specialist employment services provided by the Department of Family and Community Services to cover job seekers with disabilities.

Details of the Regulations are set out in the Attachment.

The Regulations commenced on 1 July 1999.

A Regulatory Impact Statement is attached.

ATTACHMENT

Regulation 1 provides that the Regulations may be cited as the National Health Amendment Regulations 1999.

Regulation 2 provides that the Regulations commence on 1 July 1999.

Regulation 3 provides that the National Health Regulations 1954 are amended by Schedule 1.

Item 1 of Schedule 1 amends the reference to "health insurance business" in subregulation 48(1) to include a reference to paragraph 67(4)(ab) of the Act. Paragraph 67(4)(ab), which was inserted into the Act by the Health Legislation Amendment Act (No. 2) 1998, extended the definition of "health insurance business".

Item 2 of Schedule 1 substitutes a new subparagraph 48(1)(a)(i). The effect of the substitution is to provide that health insurance for a person who is covered by a reciprocal health care agreement made under section 7 of the Health Insurance Act 19 73 but who is not otherwise an eligible person is not health insurance business. This will allow both registered organizations and other insurers to provide such insurance.

Item 3 of Schedule 1 substitutes a new subparagraph 48(1)(a)(vi). At present the regulations prescribe an event occurring while a person is undertaking an activity that is part of a program known as a labour market program that is part of the program known as the Employment Program administered by the then Department of Employment, Education and Training. The amended regulation refers to an employment, education, training or youth program or initiative administered or funded by the Commonwealth. The effect of the substitution is to update the reference to "employment programs" following the changes in administrative arrangements and to also include specialist employment services provided by the Department of Family and Community Services to cover job seekers with disabilities.

Item 4 of Schedule 1 amends the reference to "health insurance business" in paragraph 48(2)(a) to include a reference to paragraph 67(4)(ab) of the Act. Paragraph 67(4)(ab), which was inserted into the Act by the Health Legislation Amendment Act (No. 2) 1998, extended the definition of "health insurance business".

REGULATION IMPACT STATEMENT

AMENDMENTS TO REGULATION 48 (NATIONAL HEALTH ACT 1953) PERTAINING TO

SPECIALIST DISABILITY EMPLOYMENT PROGRAMS RUN BY DEPARTMENT OF

FAMILY AND CHILDREN'S SERVICES (FACS)

Background

As way of background, Regulation 48 essentially allows for an insurer that is not a registered health benefits organisation under the National Health Act (NHA) 1953 to provide health insurance for certain situations/events that would not normally fall within the standard definition of health insurance. For example, it allows an insurer to provide insurance for persons travelling to/from an activity or whilst attending that activity. Health insurance coverage is used by services providing employment programs to cover the possible health costs that may result from a job seeker being injured while travelling to and from or while participating in work experience placements with an employer. As the job seeker is not an employee, the employer's workers compensation and occupational health and safety arrangements do not apply to work experience participants.

Some of the present wording of this regulation is out of date and doesn't meet all of the current requirements. Paragraph 1(b)(vi)(A) relates to a person who is taking part in an activity such as a labour market program which is part of the Employment Program administered by the then Department of Employment, Education, Training and Youth Affairs (DEETYA). In October 1998 there were changes in administrative arrangements with responsibility for the majority of the employment programs being transferred to the Department of Employment, Workplace Relations and Small Business (DESWRB), with the remainder being administered by the Department of Education, Training and Youth Affairs (DETYA). Consequently, this has prompted a need to amend this Regulation in order to cover those employment programs currently run by both DESWRB and DETYA.

In addition to the changes outlined above, The Department of Family and Community Services (FaCS) are also seeking an amendment to the same part of this regulation to cover employment services funded by FaCS to provide specialist employment programs to people with disabilities. The main objective of this proposed change is to rectify an inequity in an organisation's ability to obtain non-Medicare health expenses insurance as a result of the definition of employment programs under the existing regulation.

Problem

Under current arrangements, the regulation's coverage is limited to labour market programs within the "Employment Program administered by the Department. of Employment, Education and Training".

Under current employment provision arrangements, the Department of Employment, Workplace Relations and Small Business (DEWRSB) retains responsibility for the provision of mainstream employment programs through Job Network, while the Department of Family and Community Services is responsible for the provision of specialist employment services to people with moderate to severe disabilities.

Unless the regulation coverage is altered to include specialist employment services for people with disabilities, not all of the Commonwealth's employment programs will be included within the scope of the regulation, resulting in inequitable treatment of organisations providing. similar Commonwealth funded services.

If the regulatory change were not undertaken it is unlikely to impact on the number of job seekers with disabilities currently being provided with work experience by specialist employment services. However, the proposed changes may encourage organisations providing specialist employment services to people with disabilities to either broaden the number of job seekers to whom work experience is provided, or to provide work experience as a component of employment assistance programs for the first time.

Objectives

To include specialist employment services for people with disabilities in the amended coverage of Regulation 48(1)(b)(vi)(A) to enable specialist disability employment services to obtain non-Medicare health expenses coverage in the same manner as services funded by DEWRSB and DETYA.

There is no regulation or policy currently in place to address access to non-Medicare health expenses insurance for specialist employment services for people with disabilities.

Options

Option 1

Maintain existing regulatory coverage. This would continue existing arrangements where general insurers are able to cover organisations funded by DEWSRB and DETYA for nonMedicare health expenses. However, organisations funded by FaCS to provide similar services would be excluded.

Option 2

Include specialist employment services for people with disabilities within the coverage of regulation 48 (1)(b)(vi)(A). This will enable general insurers to offer non-Medicare health expenses coverage to all organisations providing employment, education and training programs funded by the Commonwealth, including those providing specialist employment services for people with disabilities.

Impact Analysis

Currently. regulation 48 has enabled organisations funded by the former Department of Employment, Education and Training to provide employment programs to obtain nonMedicare health expenses insurance coverage, which has been used to cover work experience programs for job seekers run by these services. However, organisations funded by the Department of Family and Community Services to provide employment programs for people with disabilities have been unable to obtain the same insurance coverage by virtue of the narrow wording of Regulation 48 (1)(b)(vi)(A).

Option 1

Status quo - no impact/change from current regulation arrangements.

Option 2

The proposed amendments to Regulation 48 (1)(b)(vi)(A) of the National Health Regulation Act 1954 will have no impact on the Australian community. The, extension of the regulation to include specialist employment services will marginally increase the number of organisations to whom general insurers can provide non-Medicare health expenses insurance coverage. At a maximum this is estimated to be in the order of 200 organisations nationally.

Benefits to consumers may be a potential increase in organisations providing specialist employment services who are willing to provide work experience programs for people with disabilities. No costs are envisaged.

Benefits to Business include a small increase in the number of organisations seeking nonMedicare health expenses insurance coverage from general insurance brokers, and improved capacity to adequately insure against some of the risks associated with the provision of work experience programs for job seekers with disabilities. Costs will involve the purchase of insurance coverage by organisations providing specialist employment services. However, the decision to incur these insurance costs will be voluntary, as an organisation is not required to take out non-Medicare health expenses insurance under the regulation.

Benefits to government include improved equity in the treatment of access by funded organisations to appropriate insurance cover.

Consultation

The inclusion of specialist employment services for people with disabilities under regulation 48 is being sought in response to lobbying by the disability employment sector about the inequitable access to insurance coverage for non-Medicare health expenses.

Recommended Option

Given the current inequitable access to non-Medicare health expenses insurance afforded to organisations providing employment programs, it is recommended that that Option 2 be implemented, in which Regulation 48 (1)(b)(vi)(A) is amended to include specialist employment services for people with disabilities.

Implementation

In order to enable all organisations providing employment programs, including specialist employment services for people with disabilities, to access non-Medicare health expenses insurance, an amendment to Regulation 48 (1)(b)(vi)(A) of the National Health Regulation Act 1954 is required.

Once the Regulation has been tabled, the Department of Health and Aged Care, the Department of Family and Community Services, and the Departments of Employment Workplace Relations and Small Business and Education, Training and Youth Affairs will meet to determine how best to inform funded organisations about the change. At a minimum, organisations funded by the Department of Family and Community Services to provide specialist employment services for people with disabilities will be notified of the change in policy and its implications for them.

As part of any broader review of private health insurance, the continued relevance of regulations such as Regulation 48, which form part of the rules which limit access to insurance, will be reviewed on the basis of their associated costs and benefits.


[Index] [Related Items] [Search] [Download] [Help]