Health Insurance (General Medical Services Table) Amendment (2016 Measures No. 1) Regulation 2016 (Cth)

Health Insurance (General Medical Services Table) Amendment (2016 Measures No. 1) Regulation 2016

I, General the Honourable Sir Peter Cosgrove AK MC (Ret’d), Governor‑General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulation.

Dated 24 March 2016

Peter Cosgrove

Governor‑General

By His Excellency’s Command

Sussan Ley

Minister for Health

Contents

1Name

This is the Health Insurance (General Medical Services Table) Amendment (2016 Measures No. 1) Regulation 2016.

2Commencement

1. (1)

   Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information
Column 1	Column 2	Column 3
Provisions	Commencement	Date/Details
1. Sections 1 to 4 and anything in this instrument not elsewhere covered by this table	1 April 2016.	1 April 2016
2. Schedule 1	1 April 2016.	1 April 2016
3. Schedule 2	1 May 2016.	1 May 2016

Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

1. (2)

   Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3Authority

This instrument is made under the Health Insurance Act 1973.

4Schedules

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1Optometry service amendments

Health Insurance (General Medical Services Table) Regulation 2015

1

Subclause 1.2.3(1) of Schedule 1

Omit “10905 to 10929,”.

2

Clause 1.2.7 of Schedule 1

Omit “Items 3 to 10948”, substitute “Items 3 to 10816”.

3

Division 2.1 (heading)

Repeal the heading, substitute:

Division 2.1—Groups A1 to A9

4

Division 2.1 (note to heading)

Repeal the note, substitute:

Note: Groups A1 to A9 include Groups A1, A2, A3, A4, A28, A5, A6, A7, A8, A12, A13, A21, A11, A14, A15, A17, A18, A19, A20, A24, A27, A22, A23, A26 and A9.

1. 5

   Clause 2.5A.1 of Schedule 1 (paragraph (c) of the definition of eligible allied health provider)

Repeal the paragraph, substitute:

1. (c)

   an optometrist;

1. 6

   Clause 2.10.5 of Schedule 1 (paragraph (c) of the definition of eligible allied health provider)

Repeal the paragraph, substitute:

1. (c)

   an optometrist;

7

Division 2.28 of Schedule 1

Repeal the Division.

1. 8

   Part 3 of Schedule 1 (definition of bulk‑billed)

Repeal the definition, substitute:

bulk‑billed, for Division 2.31, has the meaning given by clause 2.31.1.

Schedule 2Other service amendmentsPart 1General amendments

Health Insurance (General Medical Services Table) Regulation 2015

1

Schedule 1 (items 30620 and 30621)

Repeal the items, substitute:

30620	Repair of symptomatic umbilical, epigastric or linea alba hernia requiring mesh or other formal repair of, in a person 10 years of age or over, other than a service to which item 30403 or 30405 applies (G) (H) (Anaes.) (Assist.)	299.45
30621	Repair of symptomatic umbilical, epigastric or linea alba hernia requiring mesh or other formal repair of, in a person 10 years of age or over, other than a service to which item 30403 or 30405 applies (S) (H) (Anaes.) (Assist.)	407.50

2

Schedule 1 (after item 30639)

Insert:

30640 Repair of large and irreducible scrotal hernia, where duration of surgery exceeds 2 hours, in a person 10 years of age or over, other than a service to which item 30403, 30405, 30614, 30615, 30620 or 30621 applies (H) (Anaes.) (Assist.) 914.95

3

Schedule 1 (after item 32087)

Insert:

32088	Fibreoptic colonoscopy—examination of the colon beyond the hepatic flexure, with or without biopsy, following a positive faecal occult blood test for a participant registered on the National Bowel Cancer Screening Program (Anaes.)	334.35
32089	Endoscopic examination of the colon beyond the hepatic flexure by fibreoptic colonoscopy for the removal of one or more polyps by argon plasma coagulation, following a positive faecal occult blood test for a participant registered on the National Bowel Cancer Screening Program (Anaes.)	469.20

4

Schedule 1 (item 34539)

Omit “in the operating theatre of a hospital”.

5

Schedule 1 (item 35306)

After “Transluminal stent insertion”, insert “, one or more stents,”.

6

Schedule 1 (item 35309)

After “Transluminal stent insertion”, insert “, one or more stents,”.

7

Schedule 1 (item 35646)

Omit “, if performed in the operating theatre of a hospital”.

8

Schedule 1 (after item 37038)

Insert:

37040 Bladder stress incontinence, sling procedure for, using a non‑adjustable synthetic male sling system, with or without mesh, other than a service associated with a service to which item 30405, 35599 or 37042 applies (H) (Anaes.) (Assist.) 911.30

9

Schedule 1 (after item 37336)

Insert:

37338 Urethral synthetic male sling system, division or removal of, for urethral obstruction or erosion, following previous surgery for urinary incontinence, other than a service associated with a service to which item 37340 or 37341 applies (H) (Anaes.) (Assist.) 911.30

10

Schedule 1 (items 47300 to 47345)

Repeal the items, substitute:

47301	Phalanx, middle or proximal, treatment of fracture of, by closed reduction, requiring anaesthesia, not provided on the same occasion as a service described in item 47304, 47307, 47310, 47313, 47316 or 47319 (Anaes.)	86.80
47304	Metacarpal, treatment of fracture of, by closed reduction, requiring anaesthesia, not provided on the same occasion as a service described in item 47301, 47307, 47310, 47313, 47316 or 47319 (H) (Anaes.)	98.90
47307	Phalanx or metacarpal, treatment of fracture of, by closed reduction with percutaneous K‑wire fixation (H) (Anaes.) (Assist.)	200.00
47310	Phalanx or metacarpal, treatment of fracture of, by open reduction with fixation (H) (Anaes.) (Assist.)	330.00
47313	Phalanx or metacarpal, treatment of intra‑articular fracture of, by closed reduction with percutaneous K‑wire fixation (H) (Anaes.) (Assist.)	320.00
47316	Phalanx or metacarpal, treatment of intra‑articular fracture of, by open reduction with fixation, not provided on the same occasion as a service to which item 47319 applies (H) (Anaes.) (Assist.)	635.00
47319	Middle phalanx, proximal end, treatment of intra‑articular fracture of, by open reduction with fixation, not provided on the same occasion as a service to which item 47316 applies (H) (Anaes.) (Assist.)	650.00

11

Schedule 1 (items 47360 to 47375)

Repeal the items, substitute:

47361	Radius or ulna, or radius and ulna, distal end of, treatment of fracture of, by cast immobilisation, other than a service associated with a service to which item 47362, 47364, 47367, 47370 or 47373 applies	131.85
47362	Radius or ulna, or radius and ulna, distal end of, treatment of fracture of, by closed reduction, requiring general or major regional anaesthesia, but excluding local infiltration, other than a service associated with a service to which item 47361, 47364, 47367, 47370 or 47373 applies (Anaes.)	197.60
47364	Radius or ulna, distal end of, not involving joint surface, treatment of fracture of, by open reduction with fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.)	280.00
47367	Radius, distal end of, treatment of fracture of, by closed reduction with percutaneous fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.)	223.60
47370	Radius, distal end of, treatment of intra‑articular fracture of, by open reduction with fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.)	406.00
47373	Ulna, distal end of, treatment of intra‑articular fracture of, by open reduction with fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.)	290.00

Part 2Restricting services to in‑hospital services

Health Insurance (General Medical Services Table) Regulation 2015

12

Schedule 1 (item 31551)

After “after‑care”, insert “(H)”.

13

Schedule 1 (item 32145)

After “hospital”, insert “(H)”.

14

Schedule 1 (item 32212)

After “after‑care”, insert “(H)”.

15

Schedule 1 (item 35103)

After “only”, insert “(H)”.

16

Schedule 1 (item 35630)

After “applies”, insert “(H)”.

17

Schedule 1 (item 39135)

After “hospital”, insert “(H)”.

18

Schedule 1 (item 45020)

After “period”, insert “(H)”.

19

Schedule 1 (item 45823)

After “hospital”, insert “(H)”.

20

Schedule 1 (item 45851)

After “applies”, insert “(H)”.

21

Schedule 1 (item 46486)

After “hospital”, insert “(H)”.

22

Schedule 1 (item 46489)

After “hospital”, insert “(H)”.

23

Schedule 1 (item 46516)

After “hospital”, insert “(H)”.

24

Schedule 1 (item 47381)

After “hospital”, insert “(H)”.

25

Schedule 1 (item 47385)

After “hospital”, insert “(H)”.

26

Schedule 1 (item 47426)

After “hospital”, insert “(H)”.

27

Schedule 1 (item 47456)

After “hospital”, insert “(H)”.

28

Schedule 1 (item 47696)

After “hospital”, insert “(H)”.

29

Schedule 1 (item 47906)

After “hospital”, insert “(H)”.

30

Schedule 1 (item 48603)

After “applies”, insert “(H)”.

31

Schedule 1 (item 50115)

After “applies”, insert “(H)”.

32

Schedule 1 (item 50330)

After “applies”, insert “(H)”.

33

Schedule 1 (item 50348)

After “hospital”, insert “(H)”.

34

Schedule 1 (item 50390)

After “hospital”, insert “(H)”.

35

Schedule 1 (item 50516)

After “hospital”, insert “(H)”.

36

Schedule 1 (item 50524)

After “hospital”, insert “(H)”.

37

Schedule 1 (item 50552)

After “hospital”, insert “(H)”.

38

Schedule 1 (item 50568)

After “hospital”, insert “(H)”.

39

Schedule 1 (item 50600)

After “hospital”, insert “(H)”.

40

Schedule 1 (item 52097)

After “hospital”, insert “(H)”.

41

Schedule 1 (item 52106)

After “hospital”, insert “(H)”.

42

Schedule 1 (item 52135)

After “hospital”, insert “(H)”.

43

Schedule 1 (item 53206)

After “applies”, insert “(H)”.