Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (PATHOLOGY SERVICES TABLE) AMENDMENT REGULATIONS 2006 (NO. 1) (SLI NO 87 OF 2006)

EXPLANATORY STATEMENT

 

Select Legislative Instrument 2006 No. 87

 

Minute No. 9 of 2006 – Minister for Health and Ageing

 

Subject:            Health Insurance Act 1973

                       
                        Health Insurance (Pathology Services Table) Amendment
                        Regulations 2006 (No. 1)

 

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.

 

The Act provides, in part, for payments 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, including pathology services, set out in prescribed tables.

 

Section 4A of the Act provides that the regulations may prescribe a table of pathology services that sets out items of pathology services, the amount of fees applicable in respect of each item, and rules for interpretation of the table.  The Health Insurance (Pathology Services Table) Regulations 2005 (the Principal Regulations) currently prescribe such a table. 

 

The purpose of the Regulations is to amend the current table of pathology services by making the following changes, as part of the ongoing management of the table:

 

·        amendments to 1 existing rule and 2 existing subrules;

·        amendments to 2 existing items;

·        re-assignment of four existing items from one group to another; and

·        the addition of one new item.

 

The changes have been developed following consultation and with the co-operation and support of the two peak pathology bodies - the Royal College of Pathologists of Australasia (RCPA) and the Australian Association of Pathology Practices (AAPP) - through the Pathology Services Table Committee.

 

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

 

The Regulations commence on 1 May 2006.

 

                                                                                                      Authority:       Subsection 133(1) of the

                                                                                                                            Health Insurance Act 1973


ATTACHMENT

 

DETAILS OF THE PROPOSED HEALTH INSURANCE (PATHOLOGY SERVICES TABLE) AMENDMENT REGULATIONS 2006 (NO. 1)

 

Regulation 1 provides for the Regulations to be referred to as the Health Insurance (Pathology Services Table) Amendment Regulations 2006 (No. 1).

 

Regulation 2 provides for the Regulations to commence on 1 May 2006.

 

Regulation 3 provides for Schedule 1 to amend the Health Insurance (Pathology Services Table) Regulations 2005

 

Schedule 1 – Amendments

Item [1]

The definition of ‘recognised pathologist’ is provided in the rules of interpretation of the table.

The Regulations remove the reference in that definition to section 61 of the Act, as that action was repealed by the Health Insurance Amendment (Medical Specialists) Act 2005.  The Regulations amend the definition to make reference to subsection 3D(1), paragraph 3DB(4)(a) or subsection 3E(1) of the Act.

 

Item [2]

This item separates the existing subrule 4(2) into 2 subrules to avoid the possible interpretation that existing paragraphs (h) to (j) only apply in relation to paragraph (g).

 

Item [3]

This item amends rule 20 to provide that rule 20 does not apply to item 66794 in Group P2 – Chemical but would apply to item 73317 in Group P7 – Genetics, which relates to a certain genetic test and would be added by item [10].  

This change would be made in response to the re-assignment made by items [5-7] and [10].

 

Item [4]

The subrule 25(6) refers to limitation on certain items.  This item amends subrule 25(6) to provide that subrule 25(6) refers to an additional item 73314 if, which relates to a certain genetic test and would be added by item [10], subject to the item only being performed 4 times or less in a 12 month period.   

 

Items [5-7]

These items amend Schedule 1, Part 3, to omit items 65168, 65174, 65200 and 66794 in Group P1 – Haematology, which relate to certain genetic tests. These items are moved to Group P7 – Genetics by item [10].

 .

Item [8]

This item amends item 69486 to allow a subset of women, who have been treated for high grade abnormalities of the cervix where treatment was undertaken more than 2 years ago and who are currently ineligible for the rebated human papillomavirus (HPV) test, and who would have to undergo annual pap tests until the age of 70, to access the rebate. This subset of women would be able, following 2 normal pap tests and negative HPV tests, to return to the recommended 2 yearly cycle of pap tests.

 

This amendment is in line with the National Health and Medical Research Council (NHMRC) Guidelines: Screening to Prevent Cervical Cancer: Guidelines for the Management of Asymptomatic Women with Screen Detected Abnormalities – 2005.

 

Item [9]

This item amends Schedule 1, Part 3, item 71146 (which relates to the collection of stem cells from blood), column 2, after ‘white cell count’ insert ‘on the pheresis collection’.

 

This amendment makes clear that a total white cell count needs to be performed on the blood flowing through the pheresis machine that is collecting stem cells from the donor’s blood.

 

Item [10]

This item amends Schedule 1, Part 3,

·        to insert after item 73305 the new reassigned items:  73308, 73311, 73315, 73317; and

·        to insert a new item 73320 to allow a current test in haematology to also be carried out by genetic analysis. 

 

Item [11]

This item amends Schedule 1, Part 4, to omit items 65168 and 65174 and insert 73308 and 73311. This change would be made in response to the re-assignment made by items [5-7] and [10].

 

Item [12]

This item amends Schedule 1, Part 4, to omit items 66794 and insert 73317.  This change is made in response to the re-assignment made by items [5-7] and [10].

 

Item [13]

This item amends Schedule 1, Part 4, to omit items 65168 and 65174 and insert 73308 and 73311. This change would be made in response to the re-assignment made by items [5-7] and [10].

 

 

 

 

 

 

 


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