Health Insurance Legislation Amendment Regulation 2012 (No. 1) (Cth)

Health Insurance Legislation Amendment Regulation 2012 (No. 1)¹

Select Legislative Instrument 2012 No. 57

I, QUENTIN BRYCE, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulation under the Health Insurance Act 1973.

Dated 19 April 2012

QUENTIN BRYCE

Governor-General

By Her Excellency’s Command

TANYA PLIBERSEK

Minister for Health

Contents

1Name of regulation                                              2

2Commencement                                                 2

3Amendment of Health Insurance (Diagnostic Imaging Services Table) Regulations 2011                                                                     2

4Amendment of Health Insurance Regulations 1975        2

Schedule 1Amendments of Health Insurance (Diagnostic Imaging Services Table) Regulations 2011                                              3

Schedule 2Amendment of Health Insurance Regulations 1975    7

1. Name of regulation

This regulation is the Health Insurance Legislation Amendment Regulation 2012 (No. 1).

1. Commencement

This regulation commences on 1 May 2012.

1. Amendment of Health Insurance (Diagnostic Imaging Services Table) Regulations 2011

Schedule 1 amends the Health Insurance (Diagnostic Imaging Services Table) Regulations 2011.

1. Amendment of Health Insurance Regulations 1975

Schedule 2 amends the Health Insurance Regulations 1975.

Schedule 1          Amendments of Health Insurance (Diagnostic Imaging Services Table) Regulations 2011

(section 3)

[1]          Schedule 1, paragraph 1.2.5 (1) (a)

omit

Division 2.1 to 2.5

insert

Divisions 2.1 to 2.4

[2]          Schedule 1, subclause 1.2.5 (3)

omit

subsection 10 (2)

insert

paragraph 10 (2) (aa)

[3]          Schedule 1, clause 1.2.5, note

omit

regulation 6EF

insert

subparagraph 6EF (b) (ii)

[4]          Schedule 1, after clause 1.2.5

insert

1.2.5ABulk-billing—magnetic resonance imaging

(1)This clause applies if:

(a)a service that is mentioned in an item in Division 2.5 of this table is provided; and

(b)the service is not provided in a hospital; and

(c)the service is bulk‑billed.

(2)The fee for the service is 100% of the fee mentioned in this table for the service.

(3)For paragraph 10 (2) (aa) of the Act, the benefit payable is the amount calculated under subclause (2).

Note   Under subparagraph 6EF (b) (ii) of the Health Insurance Regulations 1975, the medicare benefit payable is 100% of the amount calculated under subclause (2).

[5]          Schedule 1, clauses 2.5.1 and 2.5.2

substitute

2.5.1MRI and MRA services—eligible services

Items 63001 to 63482 apply to an MRI or MRA service performed:

(a)at the request of a specialist or consultant physician in accordance with clause 2.5.2; and

(b)in a permissible circumstance mentioned in clause 2.5.3; and

(c)using eligible equipment mentioned in clause 2.5.5.

2.5.2MRI and MRA services—request

For paragraph 2.5.1 (a), a request must:

(a)be made in writing; and

(b)identify the clinical indications for the service.

[6]          Schedule 1, Clause 2.5.3

omit

clause 2.5.1,

insert

paragraph 2.5.1 (b),

[7]          Schedule 1, clauses 2.5.4 and 2.5.5

substitute

2.5.4MRI and MRA services—eligible provider

For paragraph 2.5.3 (a), the table sets out eligible providers for an MRI or MRA service.

Item	Person
1	A specialist in diagnostic radiology who satisfies the Chief Executive Medicare that he or she is a participant in the Royal Australian and New Zealand College of Radiologists’ Quality and Accreditation Program

2.5.5MRI and MRA services—eligible equipment

(1)For paragraph 2.5.1 (c), the table sets out eligible equipment for an MRI or MRA service.

Item

Equipment

   1

Equipment that:

   (a)  is located at premises of a comprehensive practice; and

  (b)  is made available to the practice by a person:

        (i)   who is subject to a deed with the Commonwealth that relates to the equipment; and

       (ii)   for whom the deed has not been terminated

(2)For the table in subclause (1), a comprehensive practice is a medical practice, or a radiology department of a hospital, that provides x-ray, ultrasound and computed tomography services (whether or not it provides other services).

[8]          Schedule 1, clause 2.5.6

omit

Schedule 2          Amendment of Health Insurance Regulations 1975

(section 4)

[1]          Subparagraph 6EF (b) (ii)

substitute

(ii)to which clause 1.2.5 or 1.2.5A of Schedule 1 to the Health Insurance (Diagnostic Imaging Services Table) Regulations 2011 applies.

Note

1. All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See