Health Insurance (Anaesthesia service) Determination 2016 (Cth)

Health Insurance (Anaesthesia service) Determination 2016

I, MARIA JOLLY, delegate of the Minister for Health, make this Determination under subsection 3C(1) of the Health Insurance Act 1973. 

Dated           5 May 2016

MARIA JOLLY
FIRST ASSISTANT SECRETARY
MEDICAL BENEFITS DIVISION
DEPARTMENT OF HEALTH

Contents

1.           Name of Determination

2.           Commencement

3.           Authority

4.           Definitions

5.           Treatment of relevant services

6.           Effect of specified provisions

Schedule – relevant services

Part 1

1. Name of Determination

This Determination is the Health Insurance (Anaesthesia service) Determination 2016.

1. Commencement

This Determination commences on the day after this instrument is registered.

1. Authority

This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.

1. Definitions

1. In this Determination:

   Act means the Health Insurance Act 1973.

   anaesthesia has the same meaning as in clause 2.43.7 of the general medical services table.

   assistance has the same meaning as in clause 2.43.7 of the general medical services table.

   perfusion has the same meaning as in clause 2.43.7 of the general medical services table.

   relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under that Act, relating to medical services, professional services or items.

   relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in the Schedule.

   Schedule means the Schedule to this Determination.

   service time has the same meaning as in clause 2.43.4 of the general medical services table

   Note:       The following terms are defined in subsection 3(1) of the Act:

   ·clinically relevant

   ·general medical services table

(2)    Unless the contrary intention appears, a reference in this Determination to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

1. Treatment of relevant services

For subsection 3C(1) of the Act:

(a)          a relevant service, provided in accordance with this Determination and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(i)it were both a professional service and a medical service; and

(ii)there were an item in the general medical services table that:

(A)related to the service; and

(B)specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

1. Effect of specified provisions

1. Each of the following provisions of the general medical services table shall have effect as if it included a reference to item 23990:

(a)subclause 1.2.4(1);

(b)subclause 1.2.5(1);

(c)paragraphs 2.43.1(1)(b), 2.43.1(2)(b) and 2.43.1(3)(b);

(d)paragraph 2.43.2(b);

(e)subclause 2.43.6(1).

1. Subclauses 2.43.5(2) and 2.43.6(2) of the general medical services table shall have effect as if a reference to items 23010 to 24136 included a reference to item 23990.

1. Subclauses 2.43.5(1) and 2.43.5(4) of the general medical services table shall have effect as if a reference to an item in Group T10 included a reference to item 23990. 

1. Paragraph 3(2)(d) of the Health Insurance Regulations 1975 shall have effect as if item 23990 were also specified in the paragraph.

1. Subregulation 13(20) of the Health Insurance Regulations 1975 shall have effect as if the reference to items 23010 to 24136 included a reference to item 23990.

Schedule – relevant services

Group T10 – Anaesthesia performed in connection with certain services (Relative Value Guide)
Item	Service	Fee ($)
Subgroup 21 – Anaesthesia, perfusion and assistance at anaesthesia (time component)
23990	Anaesthesia, perfusion or assistance, if the service time is more than 17:40 hours but not more than 17:50 hours	2 039.40