Health Insurance (Management of Bulk-Billed After Hours and Unsociable Hours Services) Determination 2010 (Cth)

Health Insurance (Management of Bulk-Billed After Hours and Unsociable Hours Services) Determination 2010

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I, RICHARD BARTLETT, First Assistant Secretary, Medical Benefits Division, Department of Health and Ageing, make this Determination under subsection 3C (1) of the Health Insurance Act 1973.

Dated  23 April 2010

RICHARD BARTLETT

First Assistant Secretary (Acting)

Medical Benefits Division

Department of Health and Ageing

Contents

1.Name of Determination   3

2.Commencement and Cessation   3

3.Interpretation   3

4.Treatment of a relevant service   4

5.           Application of relevant service   4

6.           Specification of relevant service   4

Schedule 1             Services and fees   5

1. Name of Determination

This Determination is the Health Insurance (Management of Bulk-Billed After Hours and Unsociable Hours Services) Determination 2010.

1. Commencement and Cessation

1. This Determination commences on 1 May 2010.

1. This Determination ceases at midnight on 30 June 2010.

1. Interpretation

1. In this Determination:

Act means the Health Insurance Act 1973.

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

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

Note          Unless the contrary intention appears, expressions used in this Determination have the same meanings as in the Act—see section 13 of the Legislative Instruments Act 2003.

Schedule means the Schedule to this Determination.

1. 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 that provision 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 a relevant service

A relevant service is to be treated, for the relevant provisions, as if:

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

(b)there were an item in Group M1 – Management of bulk-billed services, of the general medical services table that:

i.        related to the service; and

ii.specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

1. Application of relevant service

1. If the medical service described in item 10985 is provided to a person, either that item or item 10990 of the general medical services table, but not both those items, applies to the service.

1. Specification of relevant service

1. Subrules 67(3), 67(4) and 67(5) of the general medical services table shall have effect as if item 10985 were also specified in those subrules.

1. Subrule 93(3) of the general medical services table shall have effect as if the reference to “items 10990, 10991 or 10992” in that subrule was a reference to “items 10985, 10990, 10991 or 10992”.

Schedule 1         Services and fees

Item	Health Service	Fee for all States
10985	A medical service to which item 597, 598, 599 or 600 applies if: (a)     the service is an unreferred service; and (b)     the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and (c)     the person is not an admitted patient of a hospital; and (d)     the service is not provided in consulting rooms; and (e)     the service is provided in an eligible area; and (f)      the service is provided by, or on behalf of, a medical practitioner whose practice location is not in an eligible area; and (g)     the service is bulk billed in respect of the fees for: (i) this item; and (ii) the other item in this table applying to the service.	$10.05

Note: Section 3C(7) of the Act deems an internal territory to form part of the State of New South Wales.