Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (GENERAL MEDICAL SERVICES TABLE) AMENDMENT REGULATIONS 2004 (NO. 8) 2004 NO. 343

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 2004 (the Principal Regulations) currently prescribe such a table.

The purpose of the Regulations is to allow services provided by eligible non-vocationally recognised medical practitioners, under the After Hours Other Medical Practitioners Program (the Program), to attract the full Medicare rebate. The Program is intended to extend the full Medicare rebate, being the same rate as that for services provided by practitioners who are vocationally registered under section 3F of the Act, to certain medical practitioners providing general practice services through an accredited Medical Deputising Service and accredited general practices that provide after hours services.

The Program replaces the Medical Deputising Service - After Hours Other Medical Practitioners Program (the previous Program), which has the effect of extending the availability of after-hours services to a wider range of locations.

The Regulations amend the definition of "eligible non-vocationally recognised medical practitioner" in Part 2 of Schedule 1 to the Principal Regulations, to expand the current definition to include participants in the Program. The Regulations also replace the definition of the previous Program with a definition of the Program.

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 January 2005.

ATTACHMENT

DETAILS OF THE HEALTH INSURANCE (GENERAL MEDICAL SERVICES TABLE) AMENDMENT REGULATIONS 2004 (NO. 8)

Regulation 1 provides for the Regulations to be referred to as the Health Insurance (General Medical Services Table) Amendment Regulations 2004 (No. 8).

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

Regulation 3 provides for Schedule 1 to amend the Health Insurance (General Medical Services Table) Regulations 2004.

Schedule 1 - Amendments

Item [1] - Schedule 1, Part 2

This item updates the paragraph 3(3)(d) in subrule 3(3) to include in the definition of "eligible non-vocationally recognised medical practitioner" certain medical practitioners registered under the After Hours Other Medical Practitioners Program (the Program).

Item [2] - Schedule 1, Part 2

This item removes the reference to the Medical Deputising Service - After Hours Other Medical Practitioners (OMPs) Program (the previous Program) in paragraph 3(4)(d), and replaces it with a reference to the Program. The effect of listing the Program is to extend access to the higher Medicare rebate for after-hours services provided by other medical practitioners in a wider range of locations.