Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (1999-2000 PATHOLOGY SERVICES TABLE) AMENDMENT REGULATIONS 2000 (NO. 1) 2000 NO. 61

STATUTORY RULES 2000 No. 61

Issued by the Authority of the Minister for Health and Aged Care

Health Insurance Act 1973

Health Insurance (1999-2000 Pathology Services Table) Amendment Regulations 2000 (No. 1)

Section 133 of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make regulations prescribing matters for the purpose of the Act.

The Act provides for the payment of professional services through Medicare benefits to all eligible persons.

Section 9 of the Act provides that Medicare benefits shall be calculated by reference to the fees for medical services (including pathology services) set out in the table.

Section 4A of the Act provides that a table of pathology services may be prescribed. The Health Insurance (1999-2000 Pathology Services Table) Regulations 1999, which commenced on 1 November 1999, prescribes such a table.

A number of changes have been incorporated in the Health Insurance (1999-2000 Pathology Services Table) Amendment Regulations 2000. Changes to the Regulations include a restructure of thrombophilia items, minor amendments to five items and the inclusion of a new histopathology complexity level.

The changes to the 1999-2000 Pathology Services Table have been developed in cooperation with the two peak pathology professional bodies, the Royal College of Pathologists of Australasia and the Australian Association of Pathology Practices, through the Pathology Services Table Committee (PSTC).

These changes have no major financial implications and will be incorporated within the expenditure targets for 1999/2000 as set under the pathology Quality and Outlays Agreement for 1999/2000-20012002.

Details of the Regulations are set out in the attachment.

The Regulations commenced on 1 May 2000.

ATTACHMENT

Regulation 1 cites the regulations as the Health Insurance (1999-2000 Pathology Services Table) Amendment Regulations 2000 (No. 1).

Regulation 2 prescribes a commencement date of 1 May 2000.

Regulation 3 provides for the Health Insurance (1999-2000 Pathology Services Table) Regulations 1999 to be amended as set out in Schedule 1.

The changes under Regulation Schedule 1 are:

*       a restructure of thrombophilia items including the deletions of items 65138 and 65141 and the introduction of a series of new haematology items for the characterisation of the genotype of patients and their first degree relatives in the investigation of proven venous thrombosis or pulmonary embolism. This will lead to a new testing algorithm to further assist in the identification of patients at higher risk of thrombosis who may benefit from prevention and improved treatment strategies (items 1, 2 and 3);

*       amendment from 3 measurements to 2 measurements of blood glucose required for oral glucose tolerance test item 66542 as there was limited evidence to support the 1 hour measurement (item 1);

*       amendments to microbiology item 69324 to accurately reflect the intent of the item and microbiology item 69336 to ensure consistency with other related items (item 1);

*       minor amendments to cytology items 73049 and 73051 to remove ambiguity in the item descriptors (item 1); and

*       amendment to the histopathology complexity levels with the inclusion of a new specimen type entry for skin, eyelid, wedge resection (item 4).