Health Insurance (Optical Coherence Tomography) Determination 2016 (Cth)
Health Insurance (Optical Coherence Tomography) Determination 2016
made under section 3C(1) of the
Health Insurance Act 1973
Compilation No. 1
Compilation date: 1 December 2016
Includes amendments up to: F2016L01691
Registered: 13 January 2017
About this compilation
This compilation
This is a compilation of the Health Insurance (Optical Coherence Tomography) Determination 2016 that shows the text of the law as amended and in force on 1 December 2016 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register ( The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
Modifications
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.
Self-repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
Contents
Part 1 1
1Name of Determination................................................................................................. 1
3Authority....................................................................................................................... 1
4Schedules...................................................................................................................... 1
5Definitions..................................................................................................................... 1
6Treatment of relevant services....................................................................................... 2
Schedule 2—relevant services 3
Endnotes4
Endnote 1—About the endnotes 4
Endnote 2—Abbreviation key 5
Endnote 3—Legislation history 6
Endnote 4—Amendment history 7
Part 1
Name of Determination
This Determination is the Health Insurance (Optical Coherence Tomography) Determination 2016.
Authority
This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.
Schedules
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.
Definitions
(1) In this Determination:
Act means the Health Insurance Act 1973.
pharmaceutical benefits scheme means the scheme for the supply of pharmaceutical benefits established under Part VII of the National Health Act 1953.
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 a Schedule.
Schedule means a Schedule to this Determination.
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.
Treatment of relevant services
For subsection 3C(1) of the Act 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:
(a) it were both a professional service and a medical service; and
(b) there were an item in 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.
Schedule 2—relevant services
| Group D1—Miscellaneous diagnostic procedures and investigations | ||
| Item | Service | Fee ($) |
| Subgroup 2—Ophthalmology | ||
| 11219 | Optical coherence tomography to determine if the requirements relating to: a) age related macular degeneration for access to initial treatment with ranibizumab or aflibercept; or b) diabetic macular oedema for access to initial treatment with ranibizumab, aflibercept or dexamethasone; or c) central or branch retinal vein occlusion for access to initial treatment with ranibizumab or aflibercept; or d) vitreomacular traction for access to initial treatment with ocriplasmin; under the pharmaceutical benefits scheme are fulfilled. Maximum of one service in a 12 month period | 40.00 |
| 11220 | Optical coherence tomography for the assessment of the need for treatment following provision of pharmaceutical benefits scheme‑subsidised ocriplasmin. Maximum of one service per eye per lifetime. | 40.00 |
Endnotes
Endnote 1—About the endnotes
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Abbreviation key—Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.
If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.
Endnote 2—Abbreviation key
| ad = added or inserted | o = order(s) |
| am = amended | Ord = Ordinance |
| amdt = amendment | orig = original |
| c = clause(s) | par = paragraph(s)/subparagraph(s) |
| C[x] = Compilation No. x | /sub‑subparagraph(s) |
| Ch = Chapter(s) | pres = present |
| def = definition(s) | prev = previous |
| Dict = Dictionary | (prev…) = previously |
| disallowed = disallowed by Parliament | Pt = Part(s) |
| Div = Division(s) | r = regulation(s)/rule(s) |
| ed = editorial change | reloc = relocated |
| exp = expires/expired or ceases/ceased to have | renum = renumbered |
| effect | rep = repealed |
| F = Federal Register of Legislation | rs = repealed and substituted |
| gaz = gazette | s = section(s)/subsection(s) |
| LA = Legislation Act 2003 | Sch = Schedule(s) |
| LIA = Legislative Instruments Act 2003 | Sdiv = Subdivision(s) |
| (md) = misdescribed amendment can be given | SLI = Select Legislative Instrument |
| effect | SR = Statutory Rules |
| (md not incorp) = misdescribed amendment | Sub‑Ch = Sub‑Chapter(s) |
| cannot be given effect | SubPt = Subpart(s) |
| mod = modified/modification | underlining = whole or part not |
| No. = Number(s) | commenced or to be commenced |
Endnote 3—Legislation history
| Name | Registration | Commencement | Application, saving and transitional provisions |
| Health Insurance (Optical Coherence Tomography) Determination 2016 | 31 Oct 2016 (F2016L01691) | s 1–6 and Sch 1: 1 Nov 2016 (s 2(1)) Sch 2 and 3: 1 Dec 2016 (s 2(2)) | — |
Endnote 4—Amendment history
| Provision affected | How affected |
| s 2............................................. | rep LA s 48D |
| Schedule 1 | |
| Schedule 1................................ | rep F2016L01691 |
| Schedule 3 | |
| Schedule 3................................ ................................................. | rep F2016L01691 |
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