Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (DIAGNOSTIC IMAGING SERVICES TABLE) AMENDMENT REGULATIONS 2004 (NO. 6) 2004 NO. 384

Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides 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, in part, for payments of Medicare benefits in respect of professional services rendered to eligible persons. 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.

Section 4AA of the Act provides that the regulations may prescribe a table of diagnostic imaging services, the amount of fees applicable in respect of each item and the rules for interpretation of the table. The Health Insurance (Diagnostic Imaging Services Table) Regulations 2004 (the Principal Regulations) currently prescribe such a table.

The Minister for Health and Ageing announced on 9 June 2004 that the Government would extend MBS eligibility to additional Magnetic Resonance Imaging (MRI) units. The Department of Health and Ageing has undertaken a MRI Invitation to Apply (ITA) to select around twenty additional MRI units for Medicare eligibility. The ITA was widely distributed through the print media. The MRI units selected through the ITA will be invited to register under the `2004 MRI Additional Units Eligibility Scheme' (the 2004 Scheme). The 2004 Scheme was published in the Gazette on 29 November 2004.

The purpose of the Regulations is to enable the MRI units registered under the 2004 Scheme to provide Medicare eligible services.

The Regulations also amend the definition of `eligible provider'. This clarifies that `eligible provider' includes providers who use either of the two MRI units in children's hospitals that are already recognised as eligible equipment in rule 36 of the Principal Regulations, and providers of Medicare eligible MRI or Magnetic Resonance Angiography (MRA) services under the 2004 Scheme. MRA is a form of MRI which uses the same unit, but examines the cardiovascular system rather than a particular region of the body.

Details of the Regulations are provided in the Attachment.

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 January 2005.

ATTACHMENT

DETAILS OF THE HEALTH INSURANCE (DIAGNOSTIC IMAGING SERVICES TABLE) AMENDMENT REGULATIONS 2004 (NO. 6)

Regulation 1 provides for the Regulations to be referred to as the Health Insurance (Diagnostic Imaging Services Table) Amendment Regulations 2004 (No. 6).

Regulation 2 provides for the Regulations to commence on 1 January 2005.

Regulation 3 provides for Schedule 1 to amend the Health Insurance (Diagnostic Imaging Services Table) Regulations 2004 (the Principal Regulations).

Schedule 1 - Amendments

Part 2 of Schedule 1 to the Principal Regulations - Rules of interpretation

Item [1]

This item amends subrule 31(2) to replace the reference to paragraph 36(b) with a reference to paragraph 36(c). This consequential amendment is needed because item [3] (below) renumbers paragraph 36(b) as paragraph 36(c).

Item [2]

This item amends rule of interpretation 34 (MRI and MRA services - eligible provider). The current rule 34 is renumbered as new subrule 34(1), and is amended to specify that the subrule applies to services performed with equipment to which rule 35 or paragraph 36(a) applies.

This item inserts new subrule 34(2) which specifies that the requirements that a provider of MRI services must satisfy in order to be an `eligible provider' for the purposes of providing a service on the equipment specified in new paragraphs 36(b) and (c). New paragraphs 36(b) and (c) specify, respectively, the MRI units registered under the `2004 MRI Additional Units Eligibility Scheme' (the 2004 Scheme) and the MRI units at two children's hospitals (see item [3], below).

Item [3]

This item amends rule of interpretation 36 (MRI and MRA services - eligible equipment) by renumbering existing paragraph 36(b) as 36(c), and adding new paragraph 36(b).

New paragraph 36(b) provides that the MRI units that are registered under the 2004 MRI Additional Units Eligibility Scheme (the 2004 Scheme) are eligible equipment.

New Note 2 to this item clarifies that the 2004 Scheme is the scheme that was published in the Gazette on 29 November 2004.