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HEALTH INSURANCE (GENERAL MEDICAL SERVICES TABLE) AMENDMENT REGULATION 2012 (NO. 5) (SLI NO 296 OF 2012) - SCHEDULE 1

Amendments

(section 3)

 

[1]           Schedule 1, paragraph 1.1.4 (1) (a)

substitute

                (a)    items 104 to 131, 133, 384 to 388, 2799, 2801 to 2840, 3003, 3005 to 3028, 6004, 6007 to 6015, 16401, 16404, 16406, 51700 and 51703; and

[2]           Schedule 1, subclause 1.2.2 (1)

substitute

         (1)   Use this clause for items 99 to 137, 141 to 149, 288 to 389, 2799, 2801 to 2840, 3003, 3005 to 3028, 6004, 6007 to 6016, 13210, 16399, 16401, 16404, 17609 and 17640 to 17655.

[3]           Schedule 1, subclause 1.2.3 (1)

substitute

         (1)   Use this clause for items 3 to 338, 348 to 389, 410 to 417, 501 to 600, 900, 903, 2497 to 2840, 3003, 3005 to 3028, 5000 to 5267, 6004, 6007 to 6016, 10900 to 10929, 13210, 16399, 16401, 16404, 16406, 16590, 16591 and 17609 to 17690.

[4]           Schedule 1, subclause 1.2.4 (1)

substitute

         (1)   Use this clause for items 3 to 149, 173 to 338, 348 to 536, 597 to 600, 2100 to 2220, 2497 to 2840, 3003, 3005 to 3028, 4001 to 10816, 11012 to 11021, 11212, 11304, 11500, 11600, 11627, 11701, 11724, 11921 to 12003, 12201, 13030 to 13112, 13209, 13210, 13290 to 13700, 13815 to 13888, 14100 to 14200, 14203 to 14215, 14224, 15600, 16003 to 16512 and 16515 to 51318.

[5]           Schedule 1, paragraph 1.2.4 (3) (c)

substitute

                (c)    participating in a video conferencing consultation referred to in items 99, 112 to 114, 149, 288, 384, 389, 2100, 2122, 2125, 2126, 2137, 2138, 2143, 2147, 2179, 2195, 2199, 2220, 2799, 2820, 3003, 3015, 6004, 6016, 13210, 16399 and 17609.

[6]           Schedule 1, paragraph 1.2.5 (4) (c)

substitute

                (c)    participating in a video conferencing consultation referred to in items 99, 112 to 114, 149, 288, 384, 389, 2100, 2122, 2125, 2126, 2137, 2138, 2143, 2147, 2179, 2195, 2199, 2220, 2799, 2820, 3003, 3015, 6004, 6016, 13210, 16399 and 17609.

[7]           Schedule 1, item 99, column 2, paragraph (b)

substitute

  (b)  the attendance is for a service:

         (i)   provided with item 104 lasting more than 10 minutes; or

        (ii)   provided with item 105; and

[ 8 ]           Schedule 1,clause 2.5.1, except the table

substitute

2.5.1        Limitation of items 112 to 114

                Items 112, 113 and 114 do not apply if the patient, specialist or physician travels to a place to satisfy the requirement in:

                (a)    for item 112--sub-subparagraph (d) (i) (B) of the item; and

               (b)    for items 113 and 114--sub-subparagraph (c) (i) (B) of the item.

[9]           Schedule 1, item 112, column 2, paragraph (b)

substitute

  (b)  the attendance is for a service:

         (i)   provided with item 110 lasting more than 10 minutes; or

        (ii)   provided with item 116, 119, 132 or 133; and

[10]         Schedule 1, after item 112

insert

113

Initial professional attendance of 10 minutes or less in duration on a patient by a specialist practising in his or her specialty if:

   (a)  the attendance is by video conference; and

  (b)  the patient is not an admitted patient; and

   (c)  the patient:

         (i)   is located both:

                (A)    within a telehealth eligible area; and

                (B)    at the time of the attendance--at least 15 kms by road from the specialist; or

        (ii)   is a care recipient in a residential care service; or

       (iii)   is a patient of:

                (A)    an Aboriginal Medical Service; or

                (B)    an Aboriginal Community Controlled Health Service;

for which a direction made under subsection 19 (2) of the Act applies; and

  (d)  no other initial consultation has taken place for a single course of treatment

$64.20

114

Initial professional attendance of 10 minutes or less in duration on a patient by a consultant physician practising in his or her specialty if:

   (a)  the attendance is by video conference; and

  (b)  the patient is not an admitted patient; and

   (c)  the patient:

         (i)   is located both:

                (A)    within a telehealth eligible area; and

                (B)    at the time of the attendance--at least 15 kms by road from the physician; or

        (ii)   is a care recipient in a residential care service; or

       (iii)   is a patient of:

                (A)    an Aboriginal Medical Service; or

                (B)    an Aboriginal Community Controlled Health Service;

for which a direction made under subsection 19 (2) of the Act applies; and

  (d)  no other initial consultation has taken place for a single course of treatment

$113.20

[11]         Schedule 1, paragraphs 2.5A.2 (c) to (e)

substitute

                (c)    deafblindness;

               (d)    cerebral palsy;

                (e)    Down syndrome;

                (f)    Fragile X syndrome;

               (g)    Prader-Willi syndrome;

               (h)    Williams syndrome;

                (i)    Angelman syndrome;

                (j)    Kabuki syndrome;

               (k)    Smith-Magenis syndrome;

                (l)    CHARGE syndrome;

              (m)    Cri du Chat syndrome;

               (n)    Cornelia de Lange syndrome;

               (o)    microcephaly.

[12]         Schedule 1, clause 2.11.1, except the table

substitute

2.11.1      Limitation of items 384 and 389

                Items 384 and 389 do not apply if the patient or physician travels to a place to satisfy the requirement in:

                (a)    for item 384--sub-subparagraph (c) (i) (B) of the item; and

               (b)    for item 389--sub-subparagraph (d) (i) (B) of the item.

[13]         Schedule 1, before item 385

insert

384

Initial professional attendance of 10 minutes or less in duration on a patient by a consultant occupational physician practising in his or her specialty of occupational medicine if:

   (a)  the attendance is by video conference; and

  (b)  the patient is not an admitted patient; and

   (c)  the patient:

         (i)   is located both:

                (A)    within a telehealth eligible area; and

                (B)    at the time of the attendance--at least 15 kms by road from the physician; or

        (ii)   is a care recipient in a residential care service; or

       (iii)   is a patient of:

                (A)    an Aboriginal Medical Service; or

                (B)    an Aboriginal Community Controlled Health Service;

for which a direction made under subsection 19 (2) of the Act applies; and

  (d)  no other initial consultation has taken place for a single course of treatment           

$64.20

[14]         Schedule 1, Clause 2.11.1 table, item 389, column 2, paragraph (b)

substitute

  (b)  the attendance is for a service:

         (i)   provided with item 385 lasting more than 10 minutes; or

        (ii)   provided with item 386; and

[ 15 ]         Schedule 1, subclause 2.18A.1 (2)

substitute

         (2)   For subclause (1), the items are 99, 112, 113, 114, 149, 288, 384, 389, 2799, 2820, 3003, 3015, 6004, 6016, 13210, 16399 and 17609.

[16]         Schedule 1, clause 2.21.5, except the table

substitute

2.21.5      Limitation of items

                Items 2799, 2820, 3003 and 3015 do not apply if the patient, specialist or physician travels to a place to satisfy the requirement in:

                (a)    for items 2799 and 3003--sub-subparagraph (c) (i) (B) of the item; and

               (b)    for items 2820 and 3015--sub-subparagraph (d) (i) (B) of the item.

[ 17 ]         Schedule 1, before item 2801

insert

2799

Initial professional attendance of 10 minutes or less in duration on a patient by a specialist or consultant physician practising in his or her specialty of pain medicine if:

   (a)  the attendance is by video conference; and

  (b)  the patient is not an admitted patient; and

   (c)  the patient:

         (i)   is located both:

                (A)    within a telehealth eligible area; and

                (B)    at the time of the attendance--at least 15 kms by road from the specialist or physician; or

        (ii)   is a care recipient in a residential care service; or

       (iii)   is a patient of:

                (A)    an Aboriginal Medical Service; or

                (B)    an Aboriginal Community Controlled Health Service;

for which a direction made under subsection 19 (2) of the Act applies; and

  (d)  no other initial consultation has taken place for a single course of treatment

$113.20

[18]         Schedule 1, item 2820, column 2, paragraph (b)

substitute

  (b)  the attendance is for a service:

         (i)   provided with item 2801 lasting more than 10 minutes; or

        (ii)   provided with item 2806 or 2814; and

[19]         Schedule 1, before item 3005

insert

3003

Initial professional attendance of 10 minutes or less in duration on a patient by a specialist or consultant physician practising in his or her specialty of palliative medicine if:

   (a)  the attendance is by video conference; and

  (b)  the patient is not an admitted patient; and

   (c)  the patient:

         (i)   is located both:

                (A)    within a telehealth eligible area; and

                (B)    at the time of the attendance--at least 15 kms by road from the specialist or physician; or

        (ii)   is a care recipient in a residential care service; or

       (iii)   is a patient of:

                (A)    an Aboriginal Medical Service; or

                (B)    an Aboriginal Community Controlled Health Service;

for which a direction made under subsection 19 (2) of the Act applies; and

  (d)  no other initial consultation has taken place for a single course of treatment

$113.20

[20]         Schedule 1, item 3015, column 2, paragraph (b)

substitute

  (b)  the attendance is for a service:

         (i)   provided with item 3005 lasting more than 10 minutes; or

        (ii)   provided with item 3010 or 3014; and

[21]         Schedule 1, clause 2.26.1, except the table

substitute

2.26.1      Limitation of items 6004 and 6016

                Items 6004 and 6016 do not apply if the patient or specialist travels to a place to satisfy the requirement in:

                (a)    for item 6004--sub-subparagraph (c) (i) (B) of the item; and

               (b)    for item 6016--sub-subparagraph (d) (i) (B) of the item.

[22]         Schedule 1, before item 6007

insert

6004

Initial professional attendance of 10 minutes or less in duration on a patient by a specialist practising in his or her specialty of neurosurgery if:

   (a)  the attendance is by video conference; and

  (b)  the patient is not an admitted patient; and

   (c)  the patient:

         (i)   is located both:

                (A)    within a telehealth eligible area; and

                (B)    at the time of the attendance--at least 15 kms by road from the specialist; or

        (ii)   is a care recipient in a residential care service; or

       (iii)   is a patient of:

                (A)    an Aboriginal Medical Service; or

                (B)    an Aboriginal Community Controlled Health Service;

for which a direction made under subsection 19 (2) of the Act applies; and

  (d)  no other initial consultation has taken place for a single course of treatment

$97.20

[23]         Schedule 1, item 6016, column 2, paragraph (b)

substitute

  (b)  the attendance is for a service:

         (i)   provided with item 6007 lasting more than 10 minutes; or

        (ii)   provided with item 6009, 6011, 6013 or 6015; and

[24]         Schedule 1, item 17609

omit each mention of

            17650, 17655 or 17690

insert

            17650 or 17655

[25]         Schedule 1, item 40303, column 3

substitute

            1,090.35

[26]         Schedule 1, item 40700, column 3

substitute

            1,744.65

[27]         Schedule 1, item 40703, column 3

substitute

            1,466.30

[28]         Schedule 1, item 41758, column 3

substitute

            117.55

[29]         Schedule 1, item 42703, column 2

omit

            prosthethis

insert

            prosthesis

[30]         Schedule 1, item 42812, column 2

omit

            sclera

insert

            scleral

[31]         Dictionary, definition of inner metropolitan area, including the note

omit

[32]         Dictionary

insert

telehealth eligible area means an area classified as a telehealth eligible area by the Minister.

Note    A diagram showing telehealth eligible areas can be can be viewed at www.mbsonline.gov.au .

[33]         Further amendments--a telehealth eligible area

                Items 99, 112, 149, 288, 389, 2100, 2122, 2126, 2137, 2143, 2147, 2195, 2199, 2820, 3015, 6016, 10983, 13210, 16399 and 17609 in Schedule 1 are amended by omitting 'outside an inner metropolitan area' in column 2 and inserting 'within a telehealth eligible area'.

[34]         Further amendments--(H) (Anaes.)

                Items 32175, 35100, 35627, 47390, 47447, 47459, 47927, 47948, 48600, 49366, 50303, 50309 in Schedule 1 are amended by omitting '(Anaes.)' and inserting '(H) (Anaes.)' at the end of column 2.




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