Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE REGULATIONS (AMENDMENT) 1993 NO. 130

STATUTORY RULES 1993 No. 130

Issued by the authority of the Minister for Health

Health Insurance Act 1973

Health Insurance Regulations (Amendment)

The Health Insurance Act 1973 (the Act) provides in part for the payment of Medicare benefits for professional services rendered by medical practitioners and for certain professional services rendered by dental practitioners and optometrists.

Section 133 of the Act provides that the Governor-General may make regulations for the purposes of the Act.

Section 4AA of the Act provides that regulations may prescribe a table of diagnostic imaging services. The Health Insurance (Diagnostic Imaging Services Table) Regulations prescribe such a table.

Subsection 16B(1) of the Act provides in part that Medicare benefits are not payable for an R-type diagnostic imaging service unless the service was requested by a medical practitioner, a dental practitioner or by certain other practitioners.

Subsection 16B(2) of the Act provides that regulations may prescribe R-type diagnostic imaging services that may be requested by dental practitioners. Regulation 10 of the Health Insurance Regulations specifies items 57900 to 57945 inclusive in the Diagnostic Imaging Services Table.

The Regulations amend the Health Insurance Regulations replacing Regulation 10. New Regulation 10 specifies items for any dental practitioner, items for oral and maxillofacial surgeons and items for prosthodontists. Dental practitioners are defined in subsection 3(1) of the Act and oral and maxillofacial surgeons are dental practitioners approved by the Minister under paragraph (b) of the definition of "professional service,, in subsection 3(1) of the Act. Prosthodontists are described in new subregulation 10(2).

The effect of the Regulation is to provide Medicare benefits for additional R-type diagnostic imaging services that any dental practitioner may request and an expanded list of Rtype diagnostic imaging services that may be requested by oral and maxillofacial surgeons and prosthodontists.

The need for these amendments to the Regulations arises following amendments to the Act from 1 May 1991 when Medicare benefits were restricted to specific diagnostic imaging services requested by dental practitioners. Prior to that amendment to the Act, Medicare benefits had been payable for any diagnostic imaging service provided on referral by a dental practitioner, an oral and maxillofacial surgeon or a prosthodontist.

The amended range of diagnostic imaging services provided for in new Regulation 10 has been agreed with representatives of the dental profession.

The Regulations commence on the date of Gazettal.