Health Insurance (1992-1993 General Medical Services Table) Regulations

Legislation au C2004L04885 Regulations Not in force Legislative Instrument

Legislation content

Health Insurance (1992-1993 General Medical Services Table) Regulations 1992
No. 338
 

EXPLANATORY STATEMENT

STATUTORY RULES 1992 No. 338

Issued by the authority of the Minister for Health, Housing and Community Services

Health Insurance Act 1973

Health Insurance (1992-1993 General Medical Services Table) Regulations

Section 133 of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make regulations for the purposes of the Act.

Section 4 of the Act provides that the regulations may prescribe a table of medical services The table), (other than pathology services) in accordance with the form of table set out in Schedule 1 and that, upon commencement of a regulation prescribing the table, it has effect as if it were set out in Schedule 1 in place of the table in that Schedule. The table may be varied and must be remade each specified twelve month period. The Health Insurance (1992-1993 General medical Services Table) Regulations (the Regulations) prescribe such a table for the purposes of section 4.

Section 9 of the Act provides that medicare benefits shall be calculated by reference to the fees for general medical services set out in the table.

The Regulations replace the 1991-1992 Regulations (Statutory Rules 1991 No. 351) and incorporate the provisions of Statutory Rules 1992 No. 70 - Health Insurance (1991-1992 General Medical Services Table) Regulations (Amendment) - and Statutory Rules 1992 No. 191 - Health Insurance (1991-1992 General Medical Services Table) Regulations (Amendment) - all of which are due to lapse within the next 12 months. They amend the existing table of general medical services and its rules of interpretation by:

•       revising item descriptions

•        including or deleting new/obsolete items

•       revising schedule fees

•       including items determined under section 3C of the Act

•       expanding consultant psychiatrist attendance items

•       expanding and amending the rules of interpretation, and

•       making miscellaneous and consequential amendments to remove errors, anomalies and ambiguities.

Details of the changes to the table, which result from the ongoing review of items to ensure that they reflect current medical practice, are set out below:

(1)       The Medicare Benefits Consultative Committee (MBCC) undertook reviews of endocrine surgery, breast surgery, upper castrointestinal surgery and colo-rectal surgery. Agreement was reached with the Australian Medical Association (AMA) and the relevant professional craft groups on revised item descriptions and the inclusion or deletion of new or obsolete items. The Minister approved the revision of these items in the table on 11 August 1992.

(2)       The MBCC also completed its review of adult cardiothoracic surgery in consultation with the AKA and the Australasian Society of Cardiac and Thoracic Surgeons. Agreement was reached on revised Schedule descriptors and the relative value of the Schedule fees for items in this group and Ministerial approval to the changes was received on 11 August 1992.

(3)       MBCC also reviewed dental anaesthesia and gynaecological services and Ministerial approval was given to recommendations on 19 August 1992.

(4)       The Department of Health, Housing and Community Services and the Australian and New Zealand Association of oral and Maxillofacial Surgeons reviewed oral and maxillofacial services and recommendations received Ministerial approval on 19 August 1992.

(5)       The MBCC, in consultation with the Royal Australian and New Zealand College of Psychiatrists, also agreed to changes to attendances by consultant psychiatrists. The proposed amendment removes the location restriction from the descriptions of Items 157 and 158. It also creates a new item to cover up to two interviews in any twelve month period of a person other than the patient in the course of the continuing management of the patient. Previously such interviews only attracted benefits when they occurred during the initial diagnostic evaluation of the patient. The Minister approved these changes on 20 August 1992.

As announced in the 1992-1993 Budget, an increase of 2.31 per cent in the fees for all general medical services, with the exception of professional attendances provided by nonvocationally registered general practitioners (Items 52-96), has been incorporated in the table. The Government approved this increase in fees, with effect from 1 November 1992.

The fee increase of 2.31 per cent was a Government decision based on consideration of movements in the Average Award Rates of Pay Index and the Consumer Price Index and taking into account overall economic policy.

The Regulations also introduce a new rule of interpretation to specify "prescribed locations" for the purposes of a new item inserted into the table to cover anaesthesia in connection with magnetic resonance imaging (MRI) services.

The Regulations commence on 1 November 1992.

 

Overview

The Health Insurance (1992-1993 General Medical Services Table) Regulations 1992 were enacted to update the table of medical services under the Health Insurance Act 1973. This legislation was introduced to address the need for periodic revision of the table of general medical services to reflect current medical practices and to ensure that the fees for these services remain aligned with economic indicators such as the Average Award Rates of Pay Index and the Consumer Price Index. Issued under the authority of the Minister for Health, Housing and Community Services, the Regulations aim to provide a transparent and equitable framework for calculating Medicare benefits by updating the fees and descriptions of medical services, as well as by clarifying and expanding certain items. The Regulations also incorporate amendments and corrections to previous regulations, ensuring the table remains accurate and relevant. These changes are intended to streamline the administration of Medicare benefits and to support the ongoing review process to keep the medical services table reflective of contemporary medical practice.

Scope and Application

The Health Insurance (1992-1993 General Medical Services Table) Regulations 1992 No. 338 applies to the medical services provided under the Health Insurance Act 1973, excluding pathology services. These Regulations are issued under the authority of the Minister for Health, Housing and Community Services and are applicable nationally, as they are a Commonwealth regulation. The Act and its Regulations apply to all medical practitioners, patients, and health insurance providers who are part of the Medicare system in Australia. The Regulations serve to update and amend the table of medical services, including item descriptions, inclusion or deletion of items, revision of fees, and other consequential amendments to ensure the table reflects current medical practices and resolves any errors or ambiguities. The scope of the Regulations is extended through subordinate instruments to include amendments and updates as necessary, with the table required to be remade every twelve months to incorporate any changes in medical practices and fee adjustments.

Key Provisions

The Health Insurance (1992-1993 General Medical Services Table) Regulations (the Regulations) provide a comprehensive framework for the calculation of Medicare benefits for general medical services, other than pathology services, for the specified period. Section 133 of the Health Insurance Act 1973 (the Act) allows the Governor-General to make regulations for the purposes of the Act, and section 4 of the Act specifies that these regulations may prescribe a table of medical services (the table) that outlines the fees for various general medical services. Section 9 of the Act mandates that Medicare benefits are calculated by reference to the fees set out in this table. The Regulations, therefore, prescribe the table of fees for general medical services for the period of 1 November 1992 to 31 October 1993, replacing the previous year's regulations and incorporating amendments made throughout the preceding year. The Regulations impose specific obligations on various parties, including medical practitioners, patients, and the government. Medical practitioners are required to adhere to the fees and item descriptions outlined in the table when providing services to patients who are eligible for Medicare benefits. Patients, in turn, must be aware of these fees and descriptions when seeking medical services and claiming benefits. The government, through the Minister for Health, Housing and Community Services, is responsible for the ongoing review and approval of the table's contents, ensuring that the fees and descriptions reflect current medical practices and economic conditions. The Regulations also require the Minister to approve any changes to the table, as evidenced by the various Ministerial approvals mentioned in the Explanatory Statement. Breach of the provisions outlined in the Regulations may result in civil or criminal consequences. While the Explanatory Statement does not explicitly outline penalties for non-compliance, it is reasonable to infer that such breaches could lead to legal action under the Health Insurance Act 1973 or other relevant legislation. For example, medical practitioners who do not adhere to the fees and descriptions in the table may face civil penalties for overcharging patients or undercharging the government. Similarly, patients who knowingly submit false claims or information may also face civil or criminal penalties. The specific penalties for such breaches would depend on the nature and severity of the offence, as well as any relevant case law or statutory provisions.

Legal classification tags

Area of Law
Health Law
Instrument
Regulation
Concepts
Definitions & Interpretation
Regulatory Standards
Fees Adjustment

Interactions

Authorises

All Versions

Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.