Health Insurance (Section 3C Diagnostic Imaging – Additional Nuclear Medicine Services) Determination 2022 (Cth)

Case

Health Insurance (Section 3C Diagnostic Imaging – Additional Nuclear Medicine Services) Determination 2022

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

Dated       30 March 2022       

Nigel Murray

Assistant Secretary

MBS Policy and Specialist Services Branch

Medical Benefits Division

Health Resourcing Group

Department of Health

Contents

1.  Name 1

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

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

4.  Definitions............................................................................................................................... 1

5.  Treatment of relevant services................................................................................................. 2

6.  Application of provisions of the diagnostic imaging services table......................................... 2

7. Application of items................................................................................................................. 2

Schedule 1 – Relevant Services  3

Schedule 2 – Closed periods of application  4

1.  Name

This instrument is the Health Insurance (Section 3C Diagnostic Imaging – Additional Nuclear Medicine Services) Determination 2022.

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 April 2022.

Note:        This table relates only to the provisions of this instrument as originally made.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.  Definitions

  1. In this instrument:

Act means the Health Insurance Act 1973.

PET means positron emission tomography.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, 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 instrument.

Note:  The following terms are defined in subsection 3(1) of the Act:

·clinically relevant service;

·diagnostic imaging services table;

·item;

·professional service.

(2)   Unless the contrary intention appears, a reference in this instrument 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.

5.  Treatment of relevant services

For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument 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 diagnostic imaging service; and

(b)there were an item in the diagnostic imaging 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.

6.  Application of provisions of the diagnostic imaging services table

  1. Paragraphs 2.4.1(b) and (c) of the diagnostic imaging services table shall have effect as if items in Schedule 1 of this instrument were specified for the purpose of those paragraphs.

  1. Clause 2.4.2 of the diagnostic imaging services table shall have effect as if the items in Schedule 1 of this instrument were specified in subclause 2.4.2(1).

7. Application of items

  1. During the period or periods specified in Schedule 2 of this instrument, items in Schedule 1 of this instrument apply but not otherwise.

Schedule 1 – Relevant Services

Group I4—Nuclear medicine imaging

Column 1

Item

Column 2

Description

Column 3

Fee ($)

Subgroup 2—PET
61644

Single rest myocardial perfusion study for the assessment of the extent and severity of non‑viable myocardium, with PET, if:

a)   the service is performed because the service to which item 61325 applies cannot be performed due to unavailability of thallous chloride 201 (Tl-201); and

b)   the patient has left ventricular systolic dysfunction and probable or confirmed coronary artery disease; and

c)   the service is performed in conjunction with a rest myocardial perfusion study using technetium-99m; and

d)   the service is requested by a specialist or a consultant physician; and

e)   the service is not associated with a service to which item 11704, 11705, 11707, 11714, 11729 or 11730 applies; and

f)    this service and item 61325 are applicable only twice each 24 months (R)

329.00

Schedule 2 – Closed periods of application

Items in Schedule 1 Apply from Items in Schedule 1 Apply until
1 April 2022 30 September 2022
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