Health Insurance (Sacral Nerve Stimulation) Determination 2007 (Cth)

Health Insurance (Sacral Nerve Stimulation) Determination 2007

__________________________________________________________________

I, TONY ABBOTT, Minister for Health and Ageing, make this Determination under subsection 3C (1) of the Health Insurance Act 1973.

Dated   20/09/2007

TONY ABBOTT

________________________________

Minister for Health and Ageing

Contents

1.Name of Determination   3

2.Commencement   3

3.Revocation of Health Insurance (Sacral Nerve Stimulation) Determination HS/07/2006 3

4.Interpretation   3

5.Circumstances where this Determination applies   3

6.Treatment of a relevant service   3

Schedule       Specified health services   5

1. Name of Determination

This Determination is the Health Insurance (Sacral Nerve Stimulation) Determination 2007.

1. Commencement

This Determination commences on 1 November 2007. 

1. Revocation of Health Insurance (Sacral Nerve Stimulation) Determination HS/07/2006

This Determination revokes Health Insurance (Sacral Nerve Stimulation) Determination HS/07/2006.

1. Interpretation

1. In this Determination:

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

the Act means the Health Insurance Act 1973.

the Schedule means the Schedule to this Determination.

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.

1. Unless the contrary intention appears, in this Determination a reference 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.

1. Circumstances where this Determination applies

This Determination applies to a relevant service performed in the following circumstances:

(a)the patient has received a sacral nerve stimulation implant for the management of refractory urinary incontinence or urge retention;

(b)the patient requires replacement or removal of the pulse generator and/or leads for the neurostimulator device; and

(c)the service referred to in paragraph (a) was rendered to the patient prior to 30 April 1998 and a Medicare benefit was paid for that service under item 30000, 39134, 39139 or 39140.

1. Treatment of relevant services

A relevant service shall be treated as if:

(a)it were both a professional service and a medical service for the purposes of the provisions of the Act, the National Health Act 1953, the Health Insurance Regulations 1975 and the National Health Regulations 1954 that make provision in respect of professional services or medical services; and

(b)there were an item in the general medical services table that related to the relevant service and specified in respect of the service a fee in relation to a State, being the fee specified in the Schedule in relation to the State specified.

Schedule        Specified health services

Item	Health Service	Fee for all States
36658	Sacral nerve stimulation for refractory urinary incontinence or urge retention, removal of pulse generator and leads.	$475.35
36660	Sacral nerve stimulation for refractory urinary incontinence or urge retention, removal and replacement of pulse generator	$230.75
36662	Sacral nerve stimulation for refractory urinary incontinence or urge retention, removal and replacement of leads	$551.10

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