Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE AMENDMENT REGULATIONS 2002 (NO. 1) 2002 NO. 246

STATUTORY RULES 2002 No. 246

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

Health Insurance Act 1973

Health Insurance Amendment Regulations 2002 (No. 1)

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

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

Section 9 of the Act provides that Medicare benefits shall be calculated by reference to the fees for medical services, including diagnostic imaging services, set out in prescribed Tables.

Regulation 10 of the Health Insurance Regulations 1975 (the Principal Regulations) specifies diagnostic imaging services that may be requested by dental practitioners who are registered or licensed under relevant State or Territory laws. The services are identified by reference to items contained in the Diagnostic Imaging Services Table (DIST) made under section 4AA of the Act.

The purpose of the Regulations is to amend Regulation 10 of the Principal Regulations in respect of diagnostic imaging services that dental practitioners are able to request under 4AA of the Act.

Details of the Regulations are outlined in the attachment.

The Regulations commence, or are taken to have commenced, on 1 November 2002 other than amendments contained in Schedule 1, which are taken to have commenced on 1 November 2001.

ATTACHMENT

Schedule 1, items 1 and 2 of the Regulations amends Regulation 10 of the Principal Regulations by:

•       omitting items 56001 to 56216 (inclusive), 56250 and 56256 from those items which oral and maxillofacial specialists can request and replacing with items 56001 to 56220 (inclusive), 56224, 56227, 56230 and 56259.

•       adding four items - 57948, 57951, 57954 and 57957 which dentists can request.

The amendments to the Principal Regulations commence on 1 November 2001 when these items were amended in the Diagnostic Imaging Services Table. This retrospectivity will ensure the validity of Medicare benefits paid in respect of these items when requested by dental practitioners.

Schedule 2, item 1, of the Regulations amends Regulation 10 of the Principal Regulations by:

•       omitting four items, 57948, 57951, 57954 and 57957; and

•       substituting with four new items which dentists can request - 57960, 57963, 57966 and 57969.

The items in Schedule 2, item 1, were reviewed by a working group comprised of diagnostic imaging and dental practitioner representatives which was established by the Diagnostic Imaging Management Committee. The four substituted items are a result of that review and reflect best practice in ordering based on clinical indicators.

The amendments to the Principal Regulations dealing with the omitted and substituted items in Schedule 2, item 1, commence on 1 November 2002.

The Health Insurance (Diagnostic Imaging Services Table) Regulations 2002 reflect these amendments.