Commonwealth Numbered Regulations - Explanatory Statements

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HEATH INSURANCE AMENDMENT REGULATIONS 1999 (NO. 6) 1999 NO. 343

STATUTORY RULES 1999 NO. 343

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

Health Insurance Act 1973

Heath Insurance Amendment Regulations 1999 (No. 6)

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

The Act provides in part for the payment of Medicare benefits for professional services rendered by medical practitioners and for certain professional services rendered by dental practitioners and optometrists.

Subsection 16B(1) of the Act provides in part that Medicare benefits are not payable for an R-type diagnostic imaging service unless the service rendered by the providing medical practitioner was requested in writing by another medical practitioner, a dental practitioner, a chiropractor, a physiotherapist or a podiatrist.

Subsection 16B(11) of the Act provides in part that R-type diagnostic imaging services specified in the regulations may be rendered by a medical practitioner without the requirement for a written request from another medical practitioner, a dental practitioner, a chiropractor, a physiotherapist or a podiatrist and provided the service is rendered prior to a "sunset" date and the rendering medical practitioner meets requirements for an exemption as a pre-existing practice.

Paragraph 16B(11)(d) of the Act provides that the sunset date is 1 January 1997 or a later date if prescribed by regulation.

Regulation 12A of the Health Insurance Regulations prescribes 1 January 2000 for the purposes of paragraph 16B(11)(d) of the Act.

The purpose of the regulations is to:

*       change the sunset period for general practitioner radiologists until new arrangements can be implemented; and

*       include new items in the Diagnostic Imaging Services Table for which prosthodontists are able to refer.

Details of the regulations are attached.

The regulations commence on 1 January 2000.

ATTACHMENT

Details of the Health Insurance Amendment Regulations 1999 (No. 6)

Regulation 1 provides that the name of the regulations will be the Health Insurance Amendment Regulations 1999 (No. 6).

Regulation 2 provides for the regulations to commence on 1 January 2000.

Regulation 3 provides that the Health Insurance Regulations 1975 will be amended by Schedule 1 of the Regulations.

Changes to the Regulation detailed in Schedule 1

Changes to the sunset period

The purpose of the regulations is to extend by twelve months the date before which a medical practitioner who meets the pre-existing practices requirement can render a service specified in the regulations and have Medicare benefits paid in respect of that service.

The extension of the sunset provision, by twelve months, will enable general practitioners with a preexisting diagnostic imaging exemption to join the Royal Australian College of General Practitioners (RACGP) program.

For patients, the effect of the regulation will be to preserve benefit entitlements for R-type diagnostic imaging services rendered on and from 1 January 2000 to 31 December 2000, where the referral is provided by a practitioner operating under the exemption.

The regulation amends regulation 12A of the Health Insurance Regulations by omitting the date "1 January 2000" and substituting the date "I January 2000".

Changes to the Diagnostic Imaging Services Table

Item 1 of the Regulations amends Regulation 10(1)(b) of the Principal Regulations by adding four MBS item numbers (56053, 56056, 56062, and 56068) which prosthodontists can request. These items are capital sensitive versions of Computed Tomography items that prosthodontists were previously eligible to request, prior to the amendments to the Table that commenced on 1 March 1999, and consequently it is appropriate that they continue to be eligible to claim for these services.