Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium-201 Nuclear Medicine Imaging Service) Determination 2023 (Cth)

Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium-201 Nuclear Medicine Imaging Service) Determination 2023

I, Daniel McCabe, delegate of the Minister for Health and Aged Care, make the following Determination.

Dated               25 May 2023              

Daniel McCabe

First Assistant Secretary

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  Definitions................................................................................................................................ 1

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

6  Schedules................................................................................................................................. 2

Schedule 1—Relevant Services  3

1  Name

This instrument is the Health Insurance (Section 3C Diagnostic Imaging – Conjunctive Thallium-201 Nuclear Medicine Imaging Service) 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 July 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Note:          This table relates only to the provisions of this instrument as originally made.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  Definitions

(1)In this instrument:

Act means the Health Insurance Act 1973.

bulk-billed means:

(a)  a medicare benefit is payable to a person in relation to the service; and

(b)  under an agreement entered into under section 20A of the Act:

(i)  the person assigns to the practitioner, by whom the service is provided, the person’s right to the payment of the medicare benefit; and

      (ii) the practitioner accepts the assignment in full payment of the

practitioner’s fee for the service provided.

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 of 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  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—Relevant Services

Group I4—Nuclear medicine imaging
Column 1 Item	Column 2 Description	Column 3 Fee ($)
Subgroup 1—Non PET
61470	Whole body or localised study using thallium-201, or single rest myocardial perfusion study using thallium-201, if all of the following apply: a)    the service is bulk billed; and b)    the service is performed in conjunction with a service described in item 61438, 61461 or 61325	1,126.00