Health Insurance (1998-99 Pathology Services Table) Amendment Regulations 1998 (No. 1) 1998 No. 373
EXPLANATORY STATEMENT
STATUTORY RULES 1998 No. 373
Issued by the Authority of the Minister for Health and Aged Care
Health Insurance Act 1973
Health Insurance (1998-99 Pathology Services Table) Amendment Regulations 1998 (No. 1)
Section 133 of the Act provides that the Governor-General may make regulations prescribing matters for the purposes of the Act.
Section 9 of the Act provides that Medicare benefits shall be calculated by reference to the fees for medical services (including pathology services) set out in the table.
Section 4A of the Act provides that a table of pathology services may be prescribed. The Health Insurance (199899 Pathology Services Table) Regulations 1998 prescribe such a table.
The regulations make an amendment to the Health Insurance (1998-99 Pathology Services Table) Regulations 1998 by restoring reference to two cytology item numbers for Pap smear testing (items 73053 and 73055) which were inadvertently omitted from Rule 19(1)(d)(i) of Part 1 - Rules of Interpretation. The Health Insurance (1998-99 Pathology Services Table) Regulations 1998 came into effect on 1 November 1998.
Rule 19(1)(d)(i) exempts certain items from the application of the episode cone. The episode cone is brought into effect by Rule 19 which places an upper Emit on the number of items for which Medicare benefits are payable in a patient episode. Under this arrangement, where four or more items of pathology testing services are ordered for a particular patient on the same day, the Medicare benefits payable will be equivalent to those for the three items with the highest schedule fees.
The episode cone applies to services requested by general practitioners for their non-hospitalised patients. Pathology services requested for hospital in-patients, or ordered by specialists are not subject to these arrangements. A number of services are exempt from the episode cone, including the two Pap smear items 73053 and 73055.
The Regulations commenced on 1 November 1998. The earlier commencement date for the Regulations does not disadvantage any person in respect of their rights or create a liability which would be imposed on a person (other than the Commonwealth or an authority of the Commonwealth) and does not contravene subsection 48(2) of the Acts Interpretation Act 1901.