Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (GENERAL MEDICAL SERVICES TABLE) AMENDMENT REGULATIONS 2003 (NO. 2) 2003 NO. 318

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 payment 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 set out in prescribed Tables.

Subsection 4 (1) of the Act provides that regulations may prescribe a table of medical services (other than diagnostic imaging services and pathology services) that sets out items of medical services, the amount of fees applicable in respect of each item and rules for interpretation of the table. The Health Insurance (General Medical Services Table) Regulations 2003 currently prescribe such a table.

The purpose of the Regulations is to amend the current table of medical services by introducing three new items, to give effect to changes proposed in the Australian Government's MedicarePlus package:

•       allow an additional amount of Medicare benefit to be paid for bulk billed services under certain circumstances;

•       enable a practice nurse to administer immunisations under specified conditions; and

•       enable a practice nurse to provide wound management under specified conditions.

Details of the Regulations are set out in the Attachment.

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

The Regulations commence on 1 February 2004.

ATTACHMENT

DETAILS OF THE HEALTH INSURANCE (GENERAL MEDICAL SERVICES TABLE) AMENDMENT REGULATIONS 2003 (NO. 2)

Regulation 1 provides for the Regulations to be referred to as the Health Insurance (General Medical Services Table) Amendment Regulations 2003 (No. 2).

Regulation 2 provides for the Regulations to commence on 1 February 2004.

Regulation 3 provides that Schedule 1 amends the Health Insurance (General Medical Services Table) Regulations 2003 (the Principal Regulations).

Schedule 1 - Amendments

Item [1] amends rules contained in Part 2 of Schedule 1 to the Principal Regulations.

Item [2] introduces three new services, and prescribe fees for them, in Part 3 of Schedule 1 to the Principal Regulations.

Part 2 - Rules of interpretation

Item 1 inserts three new rules 77, 78 and 79 on the application of items 10990, 10993 and 10996, respectively. These new items are described at 'Part 3 -- Services and Fees', below.

Rule 77 explains the application of item 10990 in relation to other services, and the circumstances in which a fee under item 10990 is be payable, and defines the terms "bulk-billed", "Commonwealth concession card holder" and "unreferred service" for the purposes of item 10990.

Rule 78 explains the application of item 10993 and defines the terms "enrolled nurse", "general practice", "immunisation", "practice nurse" and "registered vaccine" for the purposes of item 10993. It also describes the circumstances in which item 10993 applies to an immunisation provided to a: person by a practice nurse.

Rule 79 explains the application of item 10996 and defines the terms "enrolled nurse", "general practice" and "practice nurse" by reference to the definitions in Rule 78, for the purposes of item 10996. It also describes the circumstances in which only item 10996 applies to the treatment of a person's wound by a practice nurse.

Part 3 - Services and Fees

Item 2 introduces three new miscellaneous services items numbered 10990, 10993 and 10996.

Item 10990 allows an additional amount to be payable when any unreferred service is bulk billed and provided to a person under the age of 16 or a Commonwealth concession card holder (where that person is not an admitted patient at a hospital or day-hospital facility).

Item 10993 enables a practice nurse to administer immunisations on behalf of a supervising medical practitioner under specified conditions.

Item 10996 enables a practice nurse to provide wound management on behalf of a supervising medical practitioner under specified conditions.