Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (GENERAL MEDICAL SERVICES TABLE) AMENDMENT REGULATIONS 2008 (NO. 4) (SLI NO 268 OF 2008)

 

 

EXPLANATORY STATEMENT

 

 

Select Legislative Instrument 2008 No. 268

 

Health Insurance Act 1973

 

Health Insurance (General Medical Services Table) Amendment Regulations 2008 (No. 4)

 

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.

 

Part II of the Act provides for the payment of Medicare benefits for professional services rendered to eligible persons. Section 9 of the Act provides that Medicare benefits are 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 2008 (the Principal Regulations) currently prescribe such a table.

 

Items 603 and 696 in Schedule 1, Part 3 of the Principal Regulations provide increased Medicare benefits for medical services provided between (a) 6 pm and 8 pm on any day other than a Saturday, Sunday or public holiday; and (b) 12 pm and 1 pm on a Saturday.

 

The purpose of the regulations is to include items 603 and 696 in the list of items for services rendered out-of-surgery and out-of-normal-hours, and for which medical practitioners may also claim an extra bulk billing incentive of $9.80 (item 10992 in Schedule 1, Part 3 of the Principal Regulations).

 

The amendment is part of the on-going management of the GMST. Consultation was undertaken in 2007 with the Practice Incentive Payments and Enhanced Primary Care Review Advisory Group (PERAG) which is convened by the Department of Health and Ageing to advise on the implementation and use of specific primary health care programs and Medicare items. PERAG comprises representatives from each of the four major general practice groups: the Australian Medical Association, the Royal Australian College of General Practitioners, the Rural Doctors Association of Australia and the Australian General Practice Network. The Group provided comment when the items were being developed but did not provide specific comment on their inclusion in the list of items for which the bulk-billing incentive payment may be claimed.

 

The Act specifies no conditions which need to be met before the power to make the Regulations is exercised.

 

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

The Regulations commence on 1 January 2009.

 

 


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