Health Insurance (Pathology Services Table) Amendment Regulations 2006 (No. 1) (Cth)

Case

Health Insurance (Pathology Services Table) Amendment Regulations 2006 (No. 1)1

Select Legislative Instrument 2006 No. 87

I, PROFESSOR MARIE BASHIR, AC, CVO, Administrator of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.

Dated 26 April 2006

MARIE BASHIR

Administrator

By Her Excellency’s Command

TONY ABBOTT

Minister for Health and Ageing

  1. Name of Regulations

These Regulations are the Health Insurance (Pathology Services Table) Amendment Regulations 2006 (No. 1).

  1. Commencement

These Regulations commence on 1 May 2006.

  1. Amendment of Health Insurance (Pathology Services Table) Regulations 2005

Schedule 1 amends the Health Insurance (Pathology Services Table) Regulations 2005.

Schedule 1          Amendments

(regulation 3)

[1]          Schedule 1, Part 2, subrule 1 (1), definition of recognised pathologist

substitute

recognised pathologist means:

(a)a medical practitioner recognised as a specialist in pathology under subsection 3D (1) of the Act; or

(b)a medical practitioner in relation to whom there is in force a determination under paragraph 3DB (4) (a) or subsection 3E (1) of the Act that the practitioner is recognised as a specialist in pathology.

[2]          Schedule 1, Part 2, subrule 4 (2)

substitute

(2)Rule 3 does not apply to a pathology service described in subrule (3) if:

(a)under a request for a service, other than a request for a service described in paragraph (3) (a), no more than 6 tests are requested; and

(b)the tests are performed within 6 months of the request; and

(c)the account for the service is endorsed ‘Rule 3 Exemption’.

(3)For subrule (2), the pathology services are:

(a)estimation of prothrombin time (INR) for a patient undergoing anticoagulant therapy; and

(b)quantitative estimation of lithium for a patient undergoing lithium therapy; and

(c)a service described in item 65070 in relation to a patient undergoing chemotherapy for neoplastic disease or immunosuppressant therapy; and

(d)a service described in item 65070 in relation to clozaril, ticlopidine hydrochloride, methotrexate, gold, sulphasalazine or penicillamine therapy of a patient; and

(e)a service described in any of items 66500 to 66515, in relation to methotrexate or leflunomide therapy of a patient; and

(f)quantitative estimation of urea, creatinine and electrolytes in relation to:

(i)cis‑platinum or cyclosporin therapy of a patient; or

(ii)chronic renal failure of a patient being treated in a dialysis program conducted by a recognised hospital; and

(g)quantitative estimation of albumin and calcium in relation to therapy of a patient with vitamin D, its metabolites or analogues; and

(h)quantitative estimation of calcium, phosphate, magnesium, potassium, urea, creatinine and electrolytes for a cancer patient receiving bisphosphonate infusions.

[3]          Schedule 1, Part 2, rule 20

omit

For item 66794:

insert

For item 73317:

[4]          Schedule 1, Part 2, subrule 25 (6)

omit

items 69445, 71079 and 73523

insert

items 69445, 71079, 73314 and 73523

[5]          Schedule 1, Part 3, item 65168

omit

[6]          Schedule 1, Part 3, items 65174 and 65200

omit

[7]          Schedule 1, Part 3, item 66794

omit

[8]          Schedule 1, Part 3, item 69486, column 2

substitute

A test for high risk human papillomaviruses (HPV) in a patient who:

   (a)  within the 2 year period before the test, has received excisional or ablative treatment for high grade squamous intraepithelial lesions (HSIL) of the cervix; or

  (b)  within the 2 year period before the test, has had a positive HPV test after excisional or ablative treatment for HSIL of the cervix; or

   (c)  is undergoing annual cytological review following treatment for HSIL of the cervix

(Item is subject to rule 25)

[9]          Schedule 1, Part 3, item 71146, column 2

after

white cell count

insert

on the pheresis collection

[10]        Schedule 1, Part 3, after item 73305

insert in Group P7

73308 Characterisation of the genotype of a patient for Factor V Leiden gene mutation, or detection of other relevant mutations in the investigation of proven venous thrombosis or pulmonary embolism — 1 or more tests 37.10
73311 Characterisation of the genotype of a person who is a first degree relative of a person who has been proven to have 1 or more abnormal genotypes under item 73308 — 1 or more tests 37.10
73314

Characterisation of gene rearrangement by nucleic acid amplification in the diagnosis and monitoring of patients with laboratory evidence of:

   (a)  acute myeloid leukaemia; or

  (b)  acute promyelocytic leukaemia; or

   (c)  acute lymphoid leukaemia; or

  (d)  chronic myeloid leukaemia

(Item is subject to rule 25)

235.00
73317

Detection of the C282Y genetic mutation of the HFE gene and, if performed, detection of other mutations for haemochromatosis where:

   (a)  the patient has an elevated transferrin saturation or elevated serum ferritin on testing of repeated specimens; or

  (b)  the patient has a first degree relative with haemochromatosis; or

   (c)  the patient has a first degree relative with homozygosity for the C282Y genetic mutation, or with compound heterozygosity for recognised genetic mutations for haemochromatosis

(Item is subject to rule 20)

37.10
73320 Detection of HLA‑B27 by nucleic acid amplification 41.25

[11]        Schedule 1, Part 4

omit

Factor V Leiden mutation FVLM 65168, 65174

insert

Factor V Leiden mutation FVLM 73308, 73311

[12]        Schedule 1, Part 4

omit

Haemochromatosis FEUP 66794

insert

Haemochromatosis FEUP 73317

[13]        Schedule 1, Part 4

omit

Prothrombin gene mutation PGM 65168, 65174

insert

Prothrombin gene mutation PGM 73308, 73311

Note

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

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