Commonwealth Numbered Regulations - Explanatory Statements

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

HEALTH INSURANCE (1991 DIAGNOSTIC IMAGING SERVICES TABLE) REGULATIONS 1991 NO. 86

STATUTORY RULES 1991 No. 86

HEALTH INSURANCE ACT 1973

HEALTH INSURANCE (1991 DIAGNOSTIC IMAGING SERVICES TABLE) REGULATIONS

The Health Insurance Act 1973 (the Act) provides in part for the payment of Medicare benefits for professional services rendered by medical practitioners, and certain professional services rendered by dental practitioners and optometrists.

Section 133 of the Act provides that the Governor-General may make regulations for the purposes of the Act.

The Community Services and Health Legislation Amendment Act (No.2) 1990, which received Royal Assent on 28 December 1990, amended the Act by introducing new provisions governing the payment of Medicare benefits for diagnostic imaging services (i.e. diagnostic radiology, computerised tomographic scanning, ultrasound, magnetic resonance imaging and nuclear scanning).

The diagnostic imaging provisions of the Act provide that, except in certain circumstances, Medicare benefits are only payable for a diagnostic imaging service if it is rendered by a medical practitioner pursuant to a written request from another practitioner who has no financial interest in the rendering of that service. The services which are subject to the written request requirement are classified as "R-type" services. Practitioners entitled to request "R-type" imaging services are medical practitioners, dental practitioners and chiropractors, although the last two may only request, certain services.

Services not subject to the written request requirement are classified as "NR-type" services. The services in this category are those which have historically been recognised as falling within the competence of general practitioners. They include X-rays of the extremities, shoulder, chest and abdomen.

Section 4AA of the Act provides for the making of regulations to prescribe a new table of diagnostic imaging services which sets out items of R-type and NR-type diagnostic imaging services, the amount of fees applicable in respect of each item and the rules for interpretation of the table. Other provisions of the Act provide for the making of regulations to administer various matters in the new diagnostic imaging legislation. These matters are dealt with in the Health Insurance Regulations (Amendment).

The Health Insurance (1991 Diagnostic Imaging Services Table) Regulations bring together the items of diagnostic imaging service currently listed in the general medical services table. These items classify services as either R-type or NR-type diagnostic imaging services and a fee is set in respect of each item. The Regulations also introduce Rules of Interpretation for the new table.