Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (1993-1994 DIAGNOSTIC IMAGING SERVICES TABLE) REGULATIONS 1993 NO. 271

STATUTORY RULES 1993 No. 271

Issued by the authority of the Minister for Health

Health Insurance Act 1973

Health Insurance (1993-1994 Diagnostic Imaging Services Table) Regulations

The Health Insurance Act 1973 (the Act) provides for payments by way of medicare benefits, payments for hospital services and payments tor matters concerning related committees and tribunals.

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

Section 4AA of the Act provides that the regulations may prescribe a table of diagnostic imaging services (the table). The Health Insurance (Diagnostic Imaging Services Table) Regulations, Statutory Rules 1992 No. 337 and 1993 No. 152 currently prescribe such a table.

Section 9 of the Act provides that medicare benefits shall be calculated by reference to the fees for diagnostic imaging services sat out in the table.

The regulations replace and amend the current table (Statutory Rules 1992 No. 337, and 1993 No. 152) by introducing a new service, amending the descriptions of other services and adjusting the fees for all services in the table.

Changes to the table result largely from ongoing reviews by the Medicare Benefits Consultative Committee designed to ensure that it reflects current medical practice. The major area reviewed was ultrasound services.

Details of the regulations are as follows.

Regulation 2 provides for the regulations to commence on 1 November 1993.

Regulation 3 repealed Statutory Rules 1992 No. 337 and 1993 No. 152 which authorised the current table of diagnostic imaging services.

Regulation 4 prescribes a new table of diagnostic imaging services and rules of interpretation. The rules and table have been amended as follows:

Rules of interpretation:

The dollar amounts quoted in rules 9, 10, 14 and 15 have been amended to reflect the 1.09 per cent general fee increase. The remaining rules are unchanged.

Table of Services and Fees

The table of services and tees has been amended as follows:

(a)       a new service (item 55303) has been introduced to enable monitoring of transrectal ultrasound services performed by certain practitioners on their own patients (that is nonreferred patients). The description of the existing transrectal ultrasound service (item 55300) has been amended so as to restrict the item to patients who have been assessed by another practitioner;

(b)       the general ultrasound services (items 55028 to 55057 Inclusive) were amended with effect from 1 July 1993 (Statutory Rules 1993 No 1521 so as to describe the Services on an anatomical basis. An unforeseen consequence of this restructure was the prevention of payment of benefits for ultrasound scans on more than one area at the same attendance. The regulations reinstate the payment of benefits where such examinations are necessary;

(c)       the fees for all services listed in the table have been Increased by 1.09 per cent.

(d)       the descriptions of all other services are unchanged.

The Regulations come into effect on 1 November 1993.