Commonwealth Numbered Regulations - Explanatory Statements

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


HEALTH INSURANCE (1993-1994 PATHOLOGY SERVICES TABLE) REGULATIONS) 1993 NO. 270

EXPLANATORY STATEMENT

STATUTORY RULES 1993 No. 270

Issued by the authority of the Minister for Health

Health Insurance Act 1973

Health insurance (1993-1994 Pathology Services Table) Regulations)

Section 133 of the Health Insurance Act 1973 (the Act) provides that the GovernorGeneral may make regulations for the purposes of the Act.

Section 9 of the Act provides, in effect, that medicare benefits shall be calculated by reference to the fees for medical services (including pathology services) set out in the table (which includes the pathology services table) in Schedule 1A to the Act.

Section 4A of the Act provides, among other things, that the regulations may prescribe a table of pathology services in accordance with the form of table set out in Schedule 1A and that, upon commencement of a regulation prescribing a table of pathology services, the table so prescribed has effect as if it were set out in Schedule 1A in place of the table in that Schedule. The Health Insurance (1993-1994 Pathology Services Table) Regulations prescribe such a table.

Regulation 3 repeals Statutory Rules 1992 No. 336, and Statutory Rules 1993 No. 125 which constitute Health Insurance (1992-93 Pathology Services Table) Regulations.

Regulation 4 prescribes the Pathology Services Table for 1993-94 which sets down the pathology tests eligible for payment of medicare benefits and the amount of the rebates.

The Pathology Services Table includes an across-the-board tee increase, an amendment to five of the Rules, the replacement of eleven items by twenty-six new ones, and the revision of the descriptions of another five items.

Details of the Regulations are an follows

Provision has been made for an across-the-board fee increase of 1.09 percent for all items In the Pathology Services Table.

A minor gramatical error has been corrected in Rule 1.

A reference to item 66273, which has been omitted from this Table, has been removed from Rule 3A and replaced by a reference to item 66365.

A reference to item 66313, which has been omitted from this Table, has been removed from Rule 5A and two new items, 66389 and 66403, have been added to the list of "designated pathology services". Also, the words "comprised in" have been replaced with "comprising".

In Rule 8 the numbers 71025, 71027, 71029 and 71031 have been replaced by 71119, 71121, 71123, and 71125 as items in the old "Immunology Group" were replaced by revised items from 1 September 1992.

New rule 11B is intended to prevent a person or company which owns more than one "Approved Pathology Authority" (APA) from claiming items from Group P10 and Group P11 for the same patient episode by referring requests for tests between two different laboratories which they own.

Some superfluous wards have been omitted from item 66201 as they might have permitted laboratories to contravene the rules concerning fee relativities within Items 66201 and 66331.

Item 66231 has been amended to exclude the possibility of the Item being improperly used to provide benefits for further drug assays for patients when all the 21 assays permitted under item 66343 have been performed.

Eleven composite items, 66259, 66260, 66273, 66275, 66301, 66303, 66305, 66307, 66309, 66311 and 66313, have been omitted and replaced by twenty-six new items, 66353, 66355, 66357, 66359, 66361, 66363, 66365, 66367, 66369, 66371, 66373, 66375, 66377, 66379, 66381, 66383, 66385, 66387, 66389, 66391, 66393, 66395, 66397, 66399, 66401, and 66403, in which tests are grouped according to their clinical indications.

In item 66317 the phrase "4 episodes" has been substituted for "4 estimations" to prevent both HDL cholesterol tests and B/A1 ratios being eligible for medicare benefits when performed in the same patient episode.

A prohibition has been Inserted into item 69207 to prevent laboratories from obtaining two different Medicare benefits for a fungi examination on a single specimen using this item and item 73810.

These Regulations (with effect from 1 November 1993) will replace all previous Regulations.


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