Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (GENERAL MEDICAL SERVICES TABLE) AMENDMENT REGULATIONS 2004 (NO. 3) 2004 NO. 126

EXPLANATORY STATEMENT

STATUTORY RULES 2004 No. 126

Issued by the Authority of the Minister for Health and Ageing

Health Insurance Act 1973

Health Insurance (General Medical Services Table) Amendment Regulations 2004 (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, 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 the 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 a new item, and rules for determining its application, to give effect to changes announced by the Australian Government on 18 November 2003 to strengthen and protect Medicare. The new item allow a Medicare benefit to be paid when a medical practitioner undertakes a comprehensive medical assessment for a permanent resident of a Residential Aged Care Facility. The new item will not be able to be claimed more than once in a twelve month period in respect of the same person.

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 Regulations may be exercised.

The Regulations commence on 1 July 2004.

ATTACHMENT

DETAILS OF THE HEALTH INSURANCE (GENERAL MEDICAL SERVICES TABLE) AMENDMENT REGULATIONS 2004 (No. 3)

Regulation 1 provides for the Regulations to be referred to as the Health Insurance (General Medical Services Table) Amendment Regulations 2004 (No. 3).

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

Regulation 3 provides for Schedule 1 to amend the Health Insurance (General Medical Services Table) Regulations 2003 (the Principal Regulations).

Schedule 1 - Amendments

Item [1] Definition of 'Comprehensive Medical Assessment' in rule 43B

This item inserts a new rule 43B into Part 2 of Schedule 1 to the Principal Regulations to define the term 'Comprehensive Medical Assessment' for the purposes of new item 712 (see item [2] below).

Item [2] New item 712

This item introduces a new item 712 into Part 3 of Schedule 1 to the Principal Regulations to allow for attendance by a medical practitioner at a residential aged care facility or at consulting rooms for a comprehensive medical assessment of a permanent resident of a residential aged care facility. This also stipulates patient eligibility (including that the item could not be claimed more than once in a twelve month period in respect of the same person) and the fee payable for this item.


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