Health Insurance (RET Gene Testing) Determination 2014 (Cth)

Health Insurance (RET Gene Testing) Determination 2014

I, KIRSTY FAICHNEY, delegate of the Minister for Health, make this Determination under subsection 3C(1) of the Health Insurance Act 1973.

Dated    24    October 2014

__________________________

KIRSTY FAICHNEY

ACTING FIRST ASSISTANT SECRETARY

MEDICAL BENEFITS DIVISION

Contents

1.Name of Determination  3

2.Commencement  3

3.Authority  3

4.Interpretation  3

5.Treatment of a relevant service   3

6.Limitation on items 73339 and 73340    4

SCHEDULE –   SPECIFIED HEALTH SERVICES  5

Part 1  Preliminary

1. Name of Determination

This Determination is the Health Insurance (RET Gene Testing) Determination 2014.

1. Commencement

This Determination commences on 1 November 2014.

3.           Authority

This Determination is made under the Health Insurance Act 1973.

4.           Interpretation

(1)    In this Determination:

Act means the Health Insurance Act 1973.

relevant provision means a provision of the Act or of regulations made under the Act, or a provision of the National Health Act 1953 or of regulations made under that Act, that relates to professional services, medical services or items.

relevant service means a health service, as defined in subsection 3C(8)

of the Act, that is specified the Schedule to this Determination.

NoteUnless 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.

(2)    Unless the contrary intention appears, in this Determination a reference to a provision of the Act or regulations made under the Act or the National Health Act 1953 or regulations made 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.

5.           Treatment of a relevant service

A relevant service specified in the Schedule shall, for the purposes of each relevant provision, be treated as if:

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

(b)there was an item in Group P7 of the pathology services table that:

i.     related to the service; and

ii.specified in respect of the service a fee in relation to each State being the fee specified in the Schedule.

6.           Limitation on items 73339 and 73340

For any particular patient, items 73339 and 73340 apply only once. 

SCHEDULE –         SPECIFIED HEALTH SERVICES

Item	Health Service	Fee for all States ($)
73339	Detection of germline mutations in the RET gene in patients with a suspected clinical diagnosis of multiple endocrine neoplasia type 2 (MEN2) requested by a specialist or consultant physician who manages the treatment of the patient. one test.	400.00
73340	Detection of a known mutation in the RET gene in an asymptomatic relative of a patient with a documented pathogenic germline RET mutation requested by a specialist or consultant physician who manages the treatment of the patient. one test.	200.00

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