EXPLANATORY STATEMENT

 

Select Legislative Instrument 2007 No. 98

 

 

Subject: Health Insurance Act 1973

 

Health Insurance Amendment Regulations 2007 (No. 3)

 

 

Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides, in part, that the

Governor-General may make regulations, not inconsistent with the Act, prescribing all matters required or permitted by the Act to be prescribed, or necessary or convenient to be prescribed for carrying out or giving effect to the Act.

 

The Act provides for payments of Medicare benefits in respect of professional services rendered to eligible persons. Section 19AA provides that a Medicare benefit is not payable in respect of a professional service, if the person who rendered the service first became a medical practitioner on or after 1 November 1996 and was not, within the meaning of the Act, a “specialist”, a “consultant physician”, a “general practitioner”, a person registered under section 3GA of the Act, or a person (not being an Australian citizen or permanent resident) covered by an exemption under subsection 19AB(3). Section 19AA was introduced in 1996 with the aim of ensuring that the long term medical workforce in Australia is of a high quality and to assist in dealing with workforce distribution problems.

 

Section 3GA of the Act provides for the registration of certain medical practitioners in approved placements as recorded in the Register of Approved Placements that is maintained by Medicare Australia. In particular, paragraph 3GA (5) (a) requires the entry of a practitioner's name on the Register of Approved Placements where the practitioner applies and a body specified in the regulations gives written notice to the Medicare Australia CEO that the applicant is enrolled in, or undertaking, a course or program of a kind specified in the regulations, together with the duration and location of the applicant’s course or program. For the purposes of paragraph 3GA(5)(a), the relevant bodies and courses are specified in Schedule 5 to the Health Insurance Regulations 1975 (the Principal Regulations).

 

Entry of a medical practitioner's name in the Register of Approved Placements allows the payment of Medicare benefits for professional services rendered by the practitioner where section 19AA of the Act otherwise prevents the payment of Medicare benefits in respect of the practitioner's services.

 

The Health Insurance Amendment Regulations 2007 (No. 3) amend Part 2 of Schedule 5 of the Principal Regulations to include a new item identifying the Remote Vocational Training Scheme Limited as a specified body and the Remote Vocational Training Scheme (the Program) as the corresponding specified program for the purposes of section 3GA of the Act. This is necessary to reinstate the entitlement of the Program participants to access the higher A1 Medicare rebate for relevant services, made unavailable as a result of the recent change in governance of the Program, as detailed below.

 

The Program provides vocational training, almost entirely by distance education for medical practitioners working in remote areas and solo doctor towns. Prior to the change in governance, the Program was administered by a governance group consisting of members of the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM).

 

Prior to the change in governance, participants in the Program were able to provide services in respect of which Medicare benefits may be payable according to section 19AA of the Act, as participants in the Program could be registered as undertaking an approved placement under section 3GA of the Act by virtue of the Program being approved by the RACGP as a part of the RACGP Training Program (which is specified in Item 2 of Part 2 of Schedule 5 of the Principal Regulations).

 

As of 1 May 2007 the management of the Program ceased to be under the auspices of the RACGP and ACRRM, and was assumed by a newly incorporated entity, the ‘Remote Vocational Training Scheme Limited’. As a result, the Program is no longer to be approved by the RACGP as a part of the RACGP Training Program, and participants in the Program are no longer entitled to provide services for which Medicare benefits are payable according to section 19AA of the Act.

 

The Regulations are required to once again permit participants in the Program to become registered as participants in an approved placement under section 3GA of the Act.

 

Consultation for these amendments included the Australian Medical Association, relevant professional medical craft groups and Medicare Australia. Relevant professional medical craft groups consulted included the Australian College of Rural and Remote Medicine and the Royal Australian College of General Practitioners.

 

The Act specifies no conditions that need to be met before the power to make the Regulations may be exercised.

 

The Regulations commence on 1 May 2007.