Health Insurance (Section 3C Cleft Lip and Cleft Palate Services) Amendment Determination 2023 (Cth)

Health Insurance (Section 3C Cleft Lip and Cleft Palate Services) Amendment Determination 2023

I, Nigel Murray, delegate of the Minister for Health and Aged Care, make the following determination.

Dated         12  September 2023  

Nigel Murray

Assistant Secretary

MBS Policy and Specialist Programs Branch

Medicare Benefits and Digital Health Division

Health Resourcing Group

Department of Health and Aged Care

Contents

1  Name........................................................................................................................................ 1

2  Commencement........................................................................................................................ 1

3  Authority.................................................................................................................................. 1

4  Schedules................................................................................................................................. 1

Schedule 1—Amendments  2

Health Insurance (Section 3C Cleft Lip and Cleft Palate Services) Determination 2020      2

1  Name

This instrument is the Health Insurance (Section 3C Cleft Lip and Cleft Palate Services) Amendment Determination 2023.

2  Commencement

(1)  Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information
Column 1	Column 2	Column 3
Provisions	Commencement	Date/Details
1.  The whole of this instrument	1 November 2023.

Note:          This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2)  Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3  Authority

This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4  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Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1—Amendments

Health Insurance (Section 3C Cleft Lip and Cleft Palate Services) Determination 2020

1  Subsection 7(1)

Repeal the subsection, substitute:

1. An item specified in the Schedule to this Determination only applies to a service provided to a patient diagnosed with an eligible cleft and craniofacial condition as specified in the table at section 9.

2  Subsection 8(1)

Repeal the subsection, substitute:

1. At the start of 1 November 2023 (the indexation day), each amount covered by subsection (2) is replaced by the amount worked out using the following formula:

3  After section 8

Insert:

9.         Eligible cleft and craniofacial conditions

Table 9– Eligible cleft and craniofacial conditions

1. Oral and/or facial clefting

Limited to

Cleft lip, alveolus and/or palate

Tessier facial cleft

2. Congenital or hereditary craniofacial malformation, deformation or disruption

Limited to

Achondroplasia

Branchial arch disorders including:

Hemifacial/craniofacial microsomia, Goldenhar syndrome, DiGeorge syndrome, Velocardiofacial syndrome

CHARGE syndrome

Congenital hemifacial hyperplasia

Congenital lymphatic and/or vascular malformations of the head & neck, cystic hygroma, Sturge-Weber syndrome, excluding haemangiomas, birthmarks, and naevi.

Craniofacial Neurofibromatosis Type 1

Craniometaphyseal dysplasia

Ectodermal dysplasia

Hemifacial atrophy (Parry Romberg syndrome)

Mandibulofacial dysostosis (Treacher Collins syndrome)

Maxillonasal dysplasia (Binder syndrome)

Oral-facial digital syndrome Type 1

Pierre Robin sequence

Rubinstein-Taybi syndrome

Shprintzen-Goldberg syndrome

Solitary median maxillary central incisor syndrome

Stickler syndrome

Syndromic craniosynostoses including:

Apert, Crouzon, Pfeiffer, Saethre Chotzen, and Muenke syndromes

Trichorhinophalangeal syndrome Type 1

3. Hereditary conditions presenting with the absence of 6 (six) or more permanent teeth, excluding 3^rd molars

4. Hereditary conditions where the presence of supernumerary teeth is a major feature

Limited to

Cleidocranial dysplasia

Gardner’s syndrome

5. Hereditary conditions affecting the formation of enamel and/or dentine of all teeth

Limited to

Amelogenesis imperfecta

Dentinogenesis imperfecta

Regional odontodysplasia