Health Insurance (Section 3C Pathology Services – Alport Syndrome Testing) Determination 2019 (Cth)
Health Insurance (Section 3C Pathology Services – Alport Syndrome Testing) Determination 2019
__________________________________________________________________
I, CELIA STREET, delegate of the Minister for Health, make the following determination.
Dated 25 March 2019
Celia Street
Assistant Secretary
Diagnostic Imaging and Pathology Branch
Medical Benefits Division
Health Financing Group
Department of Health
Contents
1. Name
2. Commencement
3. Authority
4. Definitions
5. Treatment of relevant services
Schedule 1 – relevant services
Name
This Determination is the Health Insurance (Section 3C Pathology Services – Alport Syndrome Testing) Determination 2019.
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 May 2019 | |
Note: This table relates only to the provisions of this instrument as originally made.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.
Authority
This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.
Definitions
In this Determination:
Act means the Health Insurance Act 1973.
relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under that Act, relating to pathology services, professional services or items.
relevant family history means, for any particular patient, a first degree biological relative with Alport syndrome, or suspected of carrying one or more of the COL4A3, COL4A4 or COL4A5 genes.
relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in the Schedule.
Schedule means the Schedule to this Determination.
Note: The following terms are defined in subsection 3(1) of the Act:
·clinically relevant service
·item
·pathology services table
·professional service
(2) Unless the contrary intention appears, a reference in this Determination 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.
Treatment of relevant services
For subsection 3C(1) of the Act a relevant service, provided in accordance with this Determination 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 pathology service; and
(b)there were an item in Group P7 of the pathology 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.
Schedule 1 – relevant services
| Group P7 – Genetics | ||
| Item | Service | Fee ($) |
| 73298 | Characterisation of germline gene variants in the following genes: (a) COL4A3; and (b) COL4A4; and (c) COL4A5; in a patient for whom clinical and relevant family history criteria have been assessed by a specialist or consultant physician, who requests the service to be strongly suggestive of Alport syndrome | 1200.00 |
| 73299 | Characterisation of germline gene variants: (a) in the following genes: (i) COL4A3; and (ii) COL4A4; and (iii) COL4A5; (b) in a patient who: (i) is a first degree biological relative of a patient who has had a pathogenic mutation identified in one or more of the genes mentioned in subparagraphs (a)(i), (ii) and (iii); and (ii) has not previously received a service which item 73298 applies; requested by a specialist or consultant physician | 400.00 |
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