Health Insurance (Vertebroplasty) Determination HS/05/2005 (Cth)

Health Insurance (Vertebroplasty) Determination HS/05/2005

_______________________________________________________

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

Dated             16/10/2005

                           Tony Abbott

Minister for Health and Ageing

_______________________________________________________

1.             Citation

This determination is the Health Insurance (Vertebroplasty) Determination HS/05/2005.

2.             Interpretation

  (1)   In this Determination:

relevant service means a health service that is specified in the Schedule.

theAct means the Health Insurance Act 1973.

Note 1: general medical services table and professional service are defined in subsection 3 (1) of the Act.

Note 2:health service is defined in subsection 3C (8) of the Act.

Note 3: day hospital facility is defined in subsection 4(1) of the National Health Act 1953, which is incorporated into the Act by subsection 3(1A) of the Act.

(2)For the avoidance of doubt, in this Determination:

(a) a reference to the Act includes a reference to regulations made under the Act; and

(b)   a reference to the National Health Act 1953 includes a reference to regulations made under that Act.

3.  Commencement

This Determination commences on 1 November 2005.

4.Cessation

This Determination ceases to have effect at the end of 30 April 2006.

5.             Treatment of a relevant service (Act s. 3C (1))

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 and the National Health Act 1953 that relate to professional and medical services; and

(b)   there were an item in the general medical services table relating to the relevant service that specified a fee for the service, being the fee specified in the Schedule for that service.

Schedule         Specified health services

Item	Health Service	Fee
35400	Vertebroplasty, for the treatment of a painful osteoporotic vertebral compression fracture, where: (a)    the patient to whom the service is provided has not had the pain arising from the vertebral compression fracture controlled by conservative medical therapy; and (b)   diagnostic imaging has confirmed that vertebroplasty will be of benefit; in association with item 61109, 57341 or 57345, performed on an admitted patient in a hospital or day hospital facility.	$571.90
35402	Vertebroplasty, for the treatment of a painful metastatic deposit or multiple myeloma in a vertebral body, in association with item 61109, 57341 or 57345, performed on an admitted patient in a hospital or day hospital facility.	$571.90