EXPLANATORY STATEMENT

 

Select Legislative Instrument 2010 No. 261

 

Health Insurance Act 1973

 

Health Insurance Amendment Regulations 2010 (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 Health Insurance Amendment (Midwives and Nurse Practitioners) Act 2010 (the Amendment Act), which commenced on 12 April 2010, amended the Act to provide for new arrangements to enhance and expand the role of participating midwives and participating nurse practitioners, allowing for a greater role in the provision of quality health services from 1 November 2010.

 

The amendments to the Act put in place a framework to enable participating nurse practitioners and participating midwives to request appropriate diagnostic imaging and pathology services for which Medicare benefits may be paid. Amendments to secondary legislation are also required to implement the measures, including by the creation of new Medicare items, the specification of diagnostic imaging and pathology services that are appropriate for participating midwives and nurse practitioners to request and to establish rules around referrals to specialists and consultant physicians.

 

The purpose of the Regulations is to amend the Health Insurance Regulations 1975 (the Principal Regulations) to specify:

• the pathology and diagnostic imaging services a participating midwife or participating nurse practitioner can request as Medicare eligible services; and
• a period of validity for referrals to specialists and consultant physicians made by a participating midwife or participating nurse practitioner.

 

Details of the Regulations are set out in the Attachment.

 

Consultation regarding implementation of the arrangements for access by patients to midwife and nurse practitioner Medicare services and PBS prescribing occurred via advisory groups established to advise on specific issues and technical aspects. The advisory groups included practitioners from relevant medical and health professions, with experience in midwifery, nursing, general practice, obstetrics, and representatives from registration bodies, state and territory health services, regional and remote health services, Indigenous populations, and consumers. Advice included advice on Medicare and PBS eligibility, collaborative arrangements with medical professionals, authorisation as PBS prescribers, and medicines suitable for PBS prescribing.

 

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

 

The Regulations are a legislative instrument for the purposes of the Legislative Instruments Act 2003.

 

The Regulations commence 1 November 2010.

 

 

ATTACHMENT

 

DETAILS OF THE HEALTH INSURANCE AMENDMENT REGULATIONS 2010 (NO. 3)

 

Regulation 1 – Name of Regulations

 

This regulation provides that the name of the Regulations are the Health Insurance Amendment Regulations 2010 (No. 3).

 

Regulation 2 – Commencement

 

This regulation provides that the Regulations commence on 1 November 2010.

 

Regulation 3 – Amendment of Health Insurance Regulations 1975

 

This regulation provides that the Health Insurance Regulations 1975 (the Principal Regulations) are amended as set out in Schedule 1.

 

Schedule 1 - Amendments

 

Item [1] – After regulation 11

 

This item inserts new regulations 11A and 11B after regulation 11 of the Principal Regulations.

 

Subregulations 11A(1) and 11A(2) specifies the pathology services that may be requested by a participating midwife and participating nurse practitioner, respectively.

 

Subregulations 11B(1) and 11B(2) specifies the diagnostic imaging services that may be requested by a participating midwife and participating nurse practitioner, respectively.

 

Item [2] – Subregulation 31(1)

 

This item amends subregulation 31(1) of the Principal Regulations. Regulation 31 deals with the validity of referrals to specialists and consultant physicians. This item makes a consequential amendment to subregulation 31(1) to include reference to new subregulations 31(1B) and 31(1C), which specify the periods for which a referral from a participating midwife or nurse practitioner is valid.

 

Item [3] – After subregulation 31(1A)

 

This item inserts new subregulations 31(1B) and (1C) after subregulation 31(1A) of the Principal Regulations.

 

New subregulation 31(1B) provides that in the case of a referral given by a participating midwife, the referral is valid for 12 months after the first service given in accordance with the referral and for one pregnancy only.

 

New subreguation 31(1C) provides that in the case of a referral given by a participating nurse practitioner, the referral is valid for 12 months after the first service given in accordance with the referral.