Health Insurance (1998-99 Pathology Services Table) Amendment Regulations 1999 (No. 1) 1999 No. 19
EXPLANATORY STATEMENT
STATUTORY RULES 1999 No. 19
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 1999 (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, which commence on 1 November 1998, prescribed such a table.
The 1998-99 Pathology Services Table of the Medicare Benefits Schedule incorporated extensive changes as part of its annual renewal. As a result of practical feedback on the application of these changes, a number of further revisions have been made, including changes to the HIV viral load items following a review of more recent evidence in this area.
The changes to the 1998-99 Pathology Services Table have been developed with the cooperation and support of the two peak pathology professional bodies, the Royal College of Pathologists of Australasia and the Australian Association of Pathology Practices, through the Pathology Services Table Committee and the Pathology Consultative Committee.
The changes have no major financial implications and are included within the expenditure targets for 1998199 as set under the current Pathology Agreement.
Details of the Regulations are set out in the Attachment.
The Regulations commence on 1 March 1999.
ATTACHMENT
Regulation 1 cites the regulations as the Health Insurance (1998-99 Pathology Services Table) Amendment Regulations 1999. (No. 1)
Regulation 2 prescribes a commencement date of 1 March 1999.
Regulation 3 prescribes the amendments to the Health Insurance (1998-99 Pathology Services Table) Regulations 1998.
The changes under Regulation 3, Schedule 1 are:
Item 1 amended an existing rule for HIV viral RNA load testing by increasing the test limit claim from 6 to 7 in a 12 month period.
Item 2 inserted a new rule to apply to the two folate items (items 66599 and 66602) which specifies that no more than a maximum of 3 episodes can be claimed in a 12 month period for both items and defines the claiming circumstances should both items occur in the same patient episode.
Item 3 amended two HIV viral RNA load items (items 693 78 and 693 8 1), the two folate items (items 66599 and 66602) and a microbiology item (item 69375).
Item 4 inserted a new item for the measurement of HIV viral RNA load in cerebrospinal fluid for HIV sero-positive patients with nervous system involvement (item 69382).