Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE REGULATIONS (AMENDMENT) 1997 NO. 300

Statutory Rules 1997 No. 300

Issued by authority of the Minister for Health and Family Services

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 regulation's for the purposes of the Act.

Section 4AA of the Act provides that regulations may prescribe a table of diagnostic services. The Health Insurance, (1996-97 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 rendered by the providing practitioner unless the service was requested in writing by a medical practitioner, a dental practitioner, a chiropractor, a physiotherapist or a podiatrist. An R-type service is a service identified with the symbol (R) and comprise the majority of services in the Table.

Subsection 16B(2) of the Act, provides that regulations may prescribe R-type diagnostic imaging services specified in regulations that may be requested by a dental practitioner

Regulation 10 of the Health Insurance Regulations specifies R-type items that may be requested by practitioners who are registered or licensed under relevant State or Territory laws as dental practitioners. Dental practitioners are divided into: dental practitioners; dental practitioners approved by the Minister under paragraph (b) of the definition of a professional service in subsection 3(1) of the Act (that is oral and maxillofacial specialists; and prosthodontists.

The Regulations amend Regulation 10 of the Health Insurance Regulations by deleting three Medicare Benefits Schedule item numbers which, hitherto, oral and maxillofacial surgeons could request, and one Medicare Benefits Schedule item which, hitherto, all types of dental practitioner could request. These items relate to x-rays of the oesophagus, and laryngography (items 58906 and 59742) and pneumoarthrography and arthrography (items 59745 and 59748) in the Health Insurance (1996-97 Diagnostic Imaging Services Table) Regulations. The services covered by the deleted items have been combined With or are covered by other items in the Health Insurance (1997-98 Diagnostic Imaging Services Table) Regulations that are specified in Regulation 10 of the Health Insurance Regulations.

There are no objections. to the proposals by the relevant organisation,

The Regulations came into effect from November 1 997.