Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations (Amendment) 1995 No. 154
EXPLANATORY STATEMENT STATUTORY RULES 1995 No. 154
Issued by authority of the Minister of Human Services and Health
Health Insurance Act 1973
Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations (Amendment)
The Health Insurance Act 1973 (the Act) provides for payments by way of Medicare benefits, payments for hospital services and payments for matters concerning related committees and tribunals.
Section 133 of the Act provides that the Governor-General may make regulations for the purposes of the Act.
Section 4AA of the Act provides that the regulations may prescribe a table of diagnostic imaging services (the table). The Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations, Statutory Rules 1994 No. 363 (the Principal Regulations) currently prescribe such a table.
Rules of Interpretation
The amendment to the Rules of Interpretation in the table provides that items for the preparation of patients for radiological procedures apply only to diagnostic radiology services.
Services and Fees
The amendments also insert a new item dealing with ultrasound services for the measurement of umbilical artery blood flow in respect of intrauterine growth retardation and insert an anaesthetic value for another ultrasound item.
The amendments also delete two outdated items and, as a consequence, amend one item for the preparation of patients for a radiological procedure.
The Regulations commence on 1 July 1995.
Overview
The Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations (Amendment) 1995 No. 154 were enacted to amend the Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations under the authority of the Minister of Human Services and Health. The Health Insurance Act 1973 established a framework for Medicare benefits, hospital services, and related committees and tribunals. The purpose of these amendments was to update and refine the diagnostic imaging services table to reflect the latest medical practices and technologies. The policy objective was to ensure that the diagnostic imaging services covered under Medicare remain relevant and effective in meeting the health needs of the population. These regulations were designed to address any gaps or outdated services in the existing table, ensuring that patients have access to the most current and necessary diagnostic procedures.
Scope and Application
The Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations (Amendment) 1995 No. 154 amends the Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations, Statutory Rules 1994 No. 363, under the authority of the Health Insurance Act 1973. The Act governs the provision of Medicare benefits, hospital services, and related administrative functions, and its regulations can be extended through the Governor-General's powers under Section 133 of the Act. These particular regulations are focused on updating the table of diagnostic imaging services, as outlined in Section 4AA, to ensure it reflects current medical practices and requirements. The amendment applies to diagnostic radiology services, including the addition of new services such as ultrasound for measuring umbilical artery blood flow in cases of intrauterine growth retardation and the assignment of an anaesthetic value to another ultrasound service. The amendment also removes outdated items and adjusts associated services accordingly. These changes are designed to align the diagnostic imaging services table with contemporary medical needs and technological advancements, ensuring that the services covered under Medicare remain relevant and effective. The regulations took effect on 1 July 1995, indicating their immediate applicability to the relevant entities and services within the scope of the Health Insurance Act.
Key Provisions
The main operative sections of these regulations are section 4AA of the Health Insurance Act 1973, which empowers the Governor-General to make regulations for the purposes of the Act, and section 3 of the Health Insurance (1994-1995 Diagnostic Imaging Services Table) Regulations, which provides for the table of diagnostic imaging services. These sections set the foundation for the amendments made by Statutory Rules 1995 No. 154, which include adjustments to the Rules of Interpretation, the addition of new services, and the removal of outdated items.
The Regulations impose specific obligations on the parties and entities governed by them. Firstly, they require the inclusion of a new item for ultrasound services related to the measurement of umbilical artery blood flow for intrauterine growth retardation and the addition of an anaesthetic value to another ultrasound item. Secondly, they mandate the deletion of two outdated items from the table and subsequently adjust another item concerning the preparation of patients for radiological procedures. These amendments ensure the table remains relevant and reflective of current medical practices.
Failure to comply with these regulations can result in various civil and criminal consequences. Although the specific penalties are not detailed in the Explanatory Statement, breaches of health insurance regulations generally can attract fines under the Health Insurance Act 1973. For example, individuals or entities found guilty of non-compliance could face penalties that could include significant monetary fines. Furthermore, ongoing non-compliance might lead to further legal actions, including court proceedings, which could result in additional penalties and legal costs.
The regulations also stipulate that they come into effect on 1 July 1995. This commencement date ensures that all relevant parties are aware of the changes and can adjust their practices accordingly. By setting a clear start date, the Regulations provide certainty and allow sufficient time for healthcare providers and insurers to adapt to the new requirements.