Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (DIAGNOSTIC IMAGING SERVICES TABLE) AMENDMENT REGULATIONS 2005 (NO. 5) (SLI NO 311 OF 2005)

EXPLANATORY STATEMENT

 

Select Legislative Instrument 2005 No. 311

 

Health Insurance Act 1973

 

Health Insurance (Diagnostic Imaging Services Table) Amendment Regulations 2005 (No. 5)

 

 

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.

 

Subsection 4AA(1) 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 2005 (the Principal Regulations) prescribe such a table.

 

The purpose of the Regulations is to correct an omission from the Principal Regulations and insert a new item in the table of services.

 

Omission from the Principal Regulations

 

The Health Insurance (Diagnostic Imaging Services Table) Amendment Regulations 2005 (No.3) were approved by the Governor-General in Council on 6 October 2005.  This amendment provided Medicare eligibility to a new MRI machine located at the Mater Children’s Hospital, Brisbane.  However, due to a drafting error this provision was not included in the Principal Regulations when they were remade effective from

1 November 2005.

 

Schedule 1 to the Regulations prescribe the MRI machine located at the Mater Children’s Hospital, Brisbane, with effect from 1 November 2005.  The Office of Legislative Drafting and Publishing has advised that the retrospective commencement date would not cause any disadvantage or liability to anyone, and would comply with the requirements of the Legislative Instruments Act 2003.  That advice is attached.

 

New Item for inclusion in the Principal Regulations

 

The Medical Services Advisory Committee (MSAC) produced a report on magnetic resonance cholangiopancreatography (MRCP) in March 2005.  MRCP is a specialised MRI technique that produces images of the bile ducts, pancreas and surrounding tissues.  This procedure has a significant benefit to patients because it is non-invasive and avoids the risk of infection, pancreatitis, perforation and death associated with similar procedures such as endoscopic retrograde cholangiopancreatography (ERCP).  MSAC recommended that on the strength of evidence pertaining to the safety, effectiveness and cost-effectiveness of MRCP, public funding should be supported for this procedure when referred by specialists.  The Minister for Health and Ageing accepted this recommendation on 4 July 2005.    

 

Schedule 2 to the Regulations would provide for MRCP to be included as a Medicare-eligible service from 1 January 2006 by:

-         inserting the new item of service in Subgroup 21 and renumbering the existing Subgroup 21 to Subgroup 22;

-         amending subrule 31(1) and rules 32 and 37 to include the new item of service in the range of items specified; and 

-         amending subrule 39(2) to specify that the maximum number of MRCP services that can be claimed in any 12 month period is three.

 

The Royal Australian and New Zealand College of Radiologists and the Australian Diagnostic Imaging Association have been consulted about the inclusion of MRCP as an item of service in the Regulations from 1 January 2006.  

 

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

 

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

 

The Regulations were taken to have commenced on 1 November 2005 for Regulations 1-3 and Schedule 1, and commence on 1 January 2006 for Schedule 2.

 

 

                                                                             Authority:              Subsection 133(1) of the                                                                                                Health Insurance Act 1973

 

 


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