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HEALTH INSURANCE LEGISLATION AMENDMENT REGULATION 2012 (NO. 1) (SLI NO 57 OF 2012) - SCHEDULE 1

Amendments of Health Insurance (Diagnostic Imaging Services Table) Regulations 2011

(section 3)

 

[1]           Schedule 1, paragraph 1.2.5 (1) (a)

omit

Division 2.1 to 2.5

insert

Divisions 2.1 to 2.4

[2]           Schedule 1, subclause 1.2.5 (3)

omit

subsection 10 (2)

insert

paragraph 10 (2) (aa)

[3]           Schedule 1, clause 1.2.5, note

omit

regulation 6EF

insert

subparagraph 6EF (b) (ii)

[4]           Schedule 1, after clause 1.2.5

insert

1.2.5A      Bulk-billing--magnetic resonance imaging

         (1)   This clause applies if:

                (a)    a service that is mentioned in an item in Division 2.5 of this table is provided; and

               (b)    the service is not provided in a hospital; and

                (c)    the service is bulk-billed.

         (2)   The fee for the service is 100% of the fee mentioned in this table for the service.

         (3)   For paragraph 10 (2) (aa) of the Act, the benefit payable is the amount calculated under subclause (2).

Note    Under subparagraph 6EF (b) (ii) of the Health Insurance Regulations 1975 , the medicare benefit payable is 100% of the amount calculated under subclause (2).

[5]           Schedule 1, clauses 2.5.1 and 2.5.2

substitute

2.5.1       MRI and MRA services--eligible services

                Items 63001 to 63482 apply to an MRI or MRA service performed:

                (a)    at the request of a specialist or consultant physician in accordance with clause 2.5.2; and

               (b)    in a permissible circumstance mentioned in clause 2.5.3; and

                (c)    using eligible equipment mentioned in clause 2.5.5.

2.5.2       MRI and MRA services--request

                For paragraph 2.5.1 (a), a request must:

                (a)    be made in writing; and

               (b)    identify the clinical indications for the service.

[6]           Schedule 1, Clause 2.5.3

omit

clause 2.5.1,

insert

paragraph 2.5.1 (b),

[7]           Schedule 1, clauses 2.5.4 and 2.5.5

substitute

2.5.4       MRI and MRA services--eligible provider

                For paragraph 2.5.3 (a), the table sets out eligible providers for an MRI or MRA service.

Item

Person

   1

A specialist in diagnostic radiology who satisfies the Chief Executive Medicare that he or she is a participant in the Royal Australian and New Zealand College of Radiologists' Quality and Accreditation Program

2.5.5       MRI and MRA services--eligible equipment

         (1)   For paragraph 2.5.1 (c), the table sets out eligible equipment for an MRI or MRA service.

Item

Equipment

   1

Equipment that:

   (a)  is located at premises of a comprehensive practice; and

 

  (b)  is made available to the practice by a person:

 

         (i)   who is subject to a deed with the Commonwealth that relates to the equipment; and

 

        (ii)   for whom the deed has not been terminated

         (2)   For the table in subclause (1), a comprehensive practice is a medical practice, or a radiology department of a hospital, that provides x-ray, ultrasound and computed tomography services (whether or not it provides other services).

[8]           Schedule 1, clause 2.5.6

omit



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