Commonwealth of Australia Explanatory Memoranda Commonwealth of Australia Explanatory Memoranda[Index] [Search] [Download] [Bill] [Help]
2004-2005
THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA
HOUSE OF REPRESENTATIVES
HEALTH INSURANCE AMENDMENT (MEDICAL SPECIALISTS) BILL 2005
EXPLANATORY MEMORANDUM
(Circulated by authority of the Minister for Health and Ageing,
the Honourable Tony Abbott MP)
HEALTH INSURANCE AMENDMENT (MEDICAL SPECIALISTS) BILL 2005
OUTLINE
The purpose of this Bill is to amend the Health Insurance Act 1973 in order to streamline
procedures and to amend the prerequisites for the recognition of certain medical specialists
and consultant physicians so that their patients can access Medicare rebates at the specialist
or consultant physician rates.
The reason for this amendment lies in the current cumbersome and time-consuming process
by which some medical practitioners are recognised as specialists or consultant physicians for
the purposes of Medicare. This legislative amendment does not bestow specialist or
consultant physician status on medical practitioners. Medical practitioners are identified as
specialists or consultant physicians by Medical Boards when they are registered, on the
advice of the specialist medical colleges.
Currently, a medical practitioner is recognised as a specialist for Medicare rebate purposes by
one of three pathways. These pathways are described below:
Pathway One: Automatic Recognition
One pathway is on the advice of a relevant specialist medical college to the Managing
Director of the Health Insurance Commission that the medical practitioner has met the
criteria for the specialty. Currently, there are three criteria for the specialty which the
medical practitioner must meet. These criteria are that the medical practitioner is domiciled
in Australia, has Fellowship of a specialist medical college and has a relevant qualification
from a specialist medical college.
Pathway Two: Alternative Recognition
For those Australian-trained medical practitioners who are unable to meet these criteria, an
alternative pathway of recognition as a specialist for Medicare rebate purposes is available.
In the alternative pathway, the Minister's Delegate must refer applications to an appropriate
State or Territory Specialist Recognition Advisory Committee. State and Territory Specialist
Recognition Advisory Committees are administered by the Health Insurance Commission and
meet every two months.
In the case of medical practitioners who are seeking recognition as consultant physicians,
who are a subgroup of specialists with qualifications as physicians, rehabilitation specialists
or psychiatrists, this is the only pathway for recognition. All applications for recognition as
consultant physicians are sent to the Delegate who then refers them to the appropriate State or
Territory Specialist Recognition Advisory Committee.
Referrals to the Specialist Recognition Advisory Committee may have been effective in the
past by providing a structure for the assessment of specialists who were not eligible for
automatic recognition. Since these committees were established, specialist medical colleges
and State and Territory Medical Registration Boards have developed and implemented
assessment processes which are now used by the Specialist Recognition Advisory
Committees in making their determinations.
Because Specialist Recognition Advisory Committees rely on the assessment advice of
specialist medical colleges and Medical Registration Boards in making their decision,
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Specialist Recognition Advisory Committees now add a redundant administrative layer to the
recognition process. This unnecessarily extends the period of time between the registration
of specialists and when they can provide services which attract Medicare rebates.
Pathway Three: Non-domiciled medical practitioners
There is a third pathway for recognition available to those medical practitioners not
domiciled in Australia at the time of application. This pathway provides for the Minister to
make a determination to recognise a medical practitioner as a specialist or consultant
physician.
The effect of the amendments proposed would be to streamline the recognition procedures
under pathway two by disbanding the Specialist Recognition Advisory Committees. The
amendments would make provision for the Minister for Health and Ageing's Delegate,
currently in the Health Insurance Commission, to act directly on the Minister's behalf in
order to make more timely the consideration of applications for recognition for Medicare
rebate purposes of specialists and consultant physicians.
The amendments will also include the recognition of consultant physicians domiciled in
Australia in the alternative method of recognition. Because Specialist Recognition Advisory
Committees had been the only means by which medical practitioners domiciled in Australia
could be recognised as consultant physicians, disbanding these committees would remove the
provision for the recognition of consultant physicians. To rectify this, these consultant
physicians will be included along with specialists in the alternative method of recognition.
Transitional arrangements have been provided to ensure continued recognition under
Medicare of specialists and consultant physicians previously recognised by Specialist
Recognition Advisory Committees. Transitional arrangements have also been provided to
allow the Delegate to immediately consider existing applications with Specialist Recognition
Advisory Committees at the time these committees are disbanded.
This Bill represents a minor change to current procedures. The objective of this procedural
change is to reduce the complexity and time currently involved in the recognition under
Medicare of medical specialists and consultant physicians seeking to enter the Australian
medical workforce.
Those sections of the Health Insurance Act 1973 relating to the provision of Medicare
provider numbers remain in effect.
FINANCIAL IMPACT STATEMENT
There is no financial impact.
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HEALTH INSURANCE AMENDMENT (MEDICAL SPECIALISTS) BILL 2005
NOTES ON CLAUSES
Clause 1. Short Title
This Act will be cited as the Health Insurance Amendment (Medical Specialists) Act 2005.
Clause 2. Commencement
The provisions in Sections 1 to 3 will take effect on the day on which this Act receives the
Royal Assent.
Schedule 1 will take effect on the 28th day after the day on which this Act receives the Royal
Assent.
Clause 3. Schedule(s)
This clause provides that each Act that is specified in the Schedule to the Act will be
amended as set out in the relevant Schedule, and that any other item has effect according to
its terms.
Schedule 1 - Amendment of the Health Insurance Act 1973.
Item 1. Subsection 3(1) (definition of consultant physician)
This item will amend the definition of consultant physician in subsection 3(1) so that it refers
to the relevant sections of the amended Act. The current definition of consultant physician
refers to section 61. Section 61 is to be repealed in order to disband the Specialist
Recognition Advisory Committees. The reference to section 61 will be removed and
replaced with references to sections 3DB or 3E.
Item 2. Subsection 3(1) (definition of specialist)
This item will amend the definition of specialists in subsection 3(1) so that it refers to the
relevant sections of the amended Act. The current definition of specialists refers to section
61. Section 61 is to be repealed in order to disband the Specialist Recognition Advisory
Committees. The reference to section 61 will be removed and replaced with references to
section 3E.
Item 3. Subsection 3(1) (definition of Specialist Recognition Advisory Committee)
This item will repeal subsection 3(1) (definition of Specialist Recognition Advisory
Committee) because, with the disbanding of Specialist Recognition Advisory Committees
and the consequent repealing of Division 1 of Part V, there will no longer be a need to define
a Specialist Recognition Advisory Committee.
Item 4. Subsection 3DB(1)
This item will insert the words "or consultant physician" after the words "is a specialist" in
subsection 3DB (1). This will allow medical practitioners who are domiciled in Australia to
be recognised as consultant physicians. Disbanding the Specialist Recognition Advisory
Committees requires that provision be made for the recognition of consultant physicians to be
included within this subsection.
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This item will also alter the heading to section 3DB by inserting the words "or consultant
physician" after the word "specialist". Inserting this phrase will make provision within this
section for medical practitioners who are domiciled in Australia to be recognised as
consultant physicians. Disbanding the Specialist Recognition Advisory Committees requires
that provision be made for the recognition of consultant physicians in this section.
Item 5. Subsection 3DB(2)
This item will insert the words "or consultant physician" after the word "specialist" in
subsection 3DB (2). This will allow medical practitioners who meet the criteria for a
specialty within the meaning of subsection 3D(2) to be recognised as consultant physicians.
Disbanding the Specialist Recognition Advisory Committees requires that provision be made
for consultant physicians to be included within this subsection.
Item 6. Subsection 3DB(4) and (5)
This item will repeal subsection 3DB(4) and replace it with a new subsection 3DB(4) which
will allow the Minister, after receiving an application, to determine that a medical practitioner
may be recognised for the purposes of the Act as a specialist or consultant physician in the
specialty. Disbanding the Specialist Recognition Advisory Committees requires that
provision be made for the Minister to recognise consultant physicians within this subsection.
This item repeals paragraph 3DB(4)(b) in order to remove the reference to subsection 61(1)
which is also to be repealed. Paragraph 3DB(4)(b) will be replaced with the statement that
the Minister will notify the medical practitioner, in writing, of his or her recognition as a
specialist or consultant physician in the specialty. Disbanding the Specialist Recognition
Advisory Committees also requires that provision be made for the Minister to notify medical
practitioners in writing of their recognition as consultant physicians, as well as specialists,
within this subsection.
This item also repeals subsection 3DB(5) in order to remove the definition of Specialist
Recognition Advisory Committees, since these Committees are being disbanded. Subsection
3DB(5) will be replaced with a statement that the notification under paragraph 3DB(4)(b) is
not a legislative instrument. This provision is included in subsection 3DB(5) in order to
assist the reader, as the instrument in paragraph 3DB(4)(b) is not a legislative instrument
within the meaning of section 5 of the Legislative Instruments Act.
Item 7. Subsection 3DC(1)
This item will insert the words "or consultant physician" after the word "specialist" in
subsection 3DC(1). This will make provision for the recognition of consultant physicians to
have effect on and from the day specified in the determination. Disbanding the Specialist
Recognition Advisory Committees requires that provision be made for consultant physicians
to be included within this subsection.
Item 8. Paragraph 3GC(6A)(a)
This item will omit "paragraph 3D(1)(a)" and will replace it with "section 3D" in subsection
3GC(6A) paragraph (a). This subsection will remove reference to paragraph 3D(1)(a) which
will no longer appear in the Act and will instead make provision for reference to the correct
section 3D in paragraph 3GC(6A)(a).
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Item 9. Subsection 23DNA(4) (definition of pathologist)
This item will omit "section 61" in the definition of pathologist in subsection 23DNA(4) and
replace it with "section 3DB". This will remove the reference to section 61which has been
repealed due to disbanding the Specialist Recognition Advisory Committees. This item will
make provision in the definition of pathologist for reference to the correct section 3DB.
Item 10. Division 1 of Part V
This item will repeal Division 1 and Part V in order to disband Specialist Recognition
Advisory Committees and remove reference to these committees in the Act.
Item 11. Transitional - continued recognition of specialists and consultant physicians
This item preserves the continued recognition of specialists and consultant physicians who
were recognised by a determination made under section 61 before Specialist Recognition
Advisory Committees were disbanded and section 61 was repealed. Their determinations
will have effect as if they had been made under section 3DB as in force at the time. For the
purposes of section 3DC(1), the day on which the determination was made under paragraph
61(4)(b) will be taken to have been specified in the determination. This transitional
arrangement is required with the disbanding of Specialist Recognition Advisory Committee.
Item 12. Transitional - existing applications to be determined by the Minister under
new section 3DB
This item provides for existing applications under section 3DB or section 61 prior to the
disbanding of Specialist Recognition Advisory Committees to be taken to be new
applications under section 3DB after the commencement of the new section 3DB. The
prescribed fee that accompanied the application under the old section 3DB or section 61 will
be taken to be the prescribed fee accompanying the new application. This transitional
requirement is required to accommodate those applications under consideration by Specialist
Recognition Advisory Committees at the time these Committees are disbanded.
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