EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health and Ageing
Health Insurance Act 1973
Health Insurance (Allied Health and Dental Services)
Amendment Determination 2007 (No. 1)
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may, by writing, determine that a health service not listed in the general medical services table (the Table) shall, in specified circumstances and for specified statutory provisions, be treated as if it were so listed. This Table is set out in the Health Insurance (General Medical Services Table) Regulations.
A determination made under subsection 3C(1) is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
Subsection 3C(8) provides that the health services that may be subject to a determination made under subsection 3C(1) include dental services and any other prescribed service that relates to health. Regulation 3A of the Health Insurance Regulations 1975 prescribes 16 classes of allied health services as “health services” for the purposes of section 3C of the Act.
The purpose of this Determination is to amend the Health Insurance (Allied Health and Dental Services) Determination 2006. It adds new items to the Medicare Benefits Schedule, which will allow a rebate to be paid for allied health group services provided by eligible diabetes educators, exercise physiologists and dietitians on referral from a GP. The Determination also makes some minor amendments to clarify existing arrangements for allied health services already payable under Medicare.
Details of this Determination are set out in the Attachment.
The Determination commences on 1 May 2007.
Consultation
The Department of Health and Ageing consulted with the relevant allied health peak bodies (the Dietitians Association of Australia, the Australian Diabetes Educators Association, and the Australian Association for Exercise and Sports Science) and representatives from the Australian General Practice Network, the Australian Medical Association, the Royal Australian College of General Practitioners, and the Rural Doctors Association of Australia.
ATTACHMENT
DETAILS OF THE HEALTH INSURANCE (ALLIED HEALTH AND DENTAL SERVICES) AMENDMENT DETERMINATION 2007 (No. 1)
Preliminary
Section 1 provides for the Determination to be referred to as the Health Insurance (Allied Health and Dental Services) Amendment Determination 2007 (No. 1).
Section 2 provides for the Determination to commence on 1 May 2007.
Section 3 indicates that Schedule 1 of this Determination amends the Health Insurance (Allied Health and Dental Services) Determination 2006.
Schedule 1 – Amendments
Item 1 adds a definition of “course of treatment” for the psychological therapy and focussed psychological strategies items.
Item 2 changes a full stop to a semi colon.
Item 3 adds “narrative therapy for Aboriginal and Torres Strait Islander people” to the list of evidence based psychological therapies included under focussed psychological strategies.
Items 4 and 5 add definitions of a “GP management plan” and “multidisciplinary care plan” for the allied health group items created under Part 4 of this Determination.
Items 6 and 7 clarify the item numbers applicable for referrals by consultant physicians specialising in paediatrics and psychiatry under the allied mental health items.
Items 8 and 9 amends the name of the professional college credentialing mental health nurses following a name change for the organisation.
Item 10 clarifies the wording used to describe patient eligibility for the allied health services under items 10950 to 10970.
Item 11 clarifies the requirements for the medical practitioner to review the need for a further course of treatment under the items listed.
Item 12 sets out the service requirements and schedule fees for new allied health group services for patients with type 2 diabetes (items 81100 to 81125).
Item 13 clarifies the wording used to describe patient eligibility for dental care services under items 10975 to 10977.
Item 14 clarifies that a specialist or consultant physician may refer patients to a clinical psychologist under the items listed.
Item 15 deletes now redundant references to “day-hospital facility” in the allied health and dental items listed.