EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health and Ageing
Health Insurance Act 1973
Health Insurance (Allied Health Services) Amendment Determination 2010 (No. 2)
Purpose and operation
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may determine that a health service not listed in the general medical services table shall, or shall in specified circumstances and for specified statutory provisions, be treated as if it were both a professional service and a medical service and as if it were listed in the general medical services table.
The Health Insurance (Allied Health Services) Determination 2009 (No 2) (the Principal Determination), made under subsection 3C(1) of the Act, specifies health services which may be provided by allied health professionals as Medicare eligible services. The Principal Determination also establishes the eligibility requirements, including registration and accreditation, for allied health professionals to provide these Medicare eligible services.
This determination amends the Principal Determination.
The National Registration and Accreditation Scheme (NRAS) for health professions was agreed by the Council of Australian Governments (COAG) at its meeting on 26 March 2008. NRAS provides for the national registration of health professionals and accreditation of health education and training. NRAS is implemented through the Health Practitioner Regulation National Law (the National Law), which commenced in states and territories on
1 July 2010. The 10 health professions regulated from 1 July 2010 are: medical, dental, optometry, podiatry, chiropractic, physiotherapy, nursing and midwifery, pharmacy, osteopathy and psychology.
As part of the move to a single national registration system, from 1 July the current 72 state and territory registration boards covering the regulated professions will be replaced by nine profession-specific national boards under the Australian Health Practitioner Regulation Agency (AHPRA).
At a result of the implementation of NRAS from 1 July 2010, consequential amendments to the eligibility criteria for three allied health professions, podiatry, psychology and mental health nurses, are required. This determination, the Health Insurance (Allied Health Services) Amendment Determination 2010 (No. 2) (the Determination), gives effect to those amendments.
Details of the Determination are set out in the Attachment.
Commencement
The Determination is taken to have commenced from 1 July 2010, the date of commencement of NRAS. This ensures that the changes to the way podiatrists, psychologists and mental health nurses are registered and accredited will be reflected in eligibility requirements for these allied health professions in the Principal Determination from that date, and patients will continue to be able to receive Medicare eligible services from these health professionals.
The retrospective commencement of this Determination does not disadvantage anyone other than the Commonwealth. Further, subsection 3C(2) of the Act provides that determinations made under subsection 3C(1) of the Act may be expressed to have taken effect from a day earlier than the day on which the determination is made. In accordance with subsection 12(3) of the Legislative Instruments Act 2003 (the LIA), the operation of subsection 12(2) of the LIA is subject to any contrary provision for commencement of the Determination in the Act. Therefore, the retrospective commencement of the Determination does not offend subsection 12(2) of the LIA.
Consultation
The Department has consulted with the Australian Psychological Society (APS), the Australian Health Practitioner Regulation Agency (AHPRA), the Australian College of Mental Health Nurses (ACMHN) and Medicare Australia regarding implementation of NRAS for 1 July 2010, and the amendments to the Determination.
ATTACHMENT
DETAILS OF THE HEALTH INSURANCE (ALLIED HEALTH SERVICES) AMENDMENT DETERMINATION 2010 (No. 2)
Part 1 Preliminary
Section 1 Name of Determination
Section 1 provides that the title of this Determination is the Health Insurance (Allied Health Services) Amendment Determination 2010 (No. 2).
Section 2 Commencement
Section 2 provides that the Determination is taken to have commenced on 1 July 2010.
Section 3 Schedule 1 – Amendments of the Health Insurance (Allied Health Services)
Determination 2009 (No. 2)
Section 3 provides that Schedule 1 of the Determination amends the Principal Determination.
Section 4 Schedule 2 – transitional provisions
Section 4 allows for transitional provisions that have effect according to their terms.
Schedule 1 – Amendments
Item 1
This item inserts a definition of ‘National Law’ in subsection 4(1) of the Principal Determination. Schedule 1 to the Health Practitioner Regulation National Law Act 2009 (Qld) sets out the Health Practitioner Regulation National Law. In states and territories other than Western Australia this Health Practitioner Regulation National Law, as applied as a law of that jurisdiction, is the ‘National Law’. In Western Australia, the ‘National Law’ is the legislation enacted by the Health Practitioner Regulation National Law (WA) Act 2010 that corresponds to the Health Practitioner Regulation National Law.
Item 2
This item inserts a definition of ‘Psychology Board of Australia’ in subsection 4(1) of the Principal Determination. The Psychology Board of Australia is the new national board responsible for the registration of psychologists, established under section 31 of the National Law.
Item 3
This item amends the requirements for eligibility as an allied health professional for the provision of focussed psychological strategies health services in item 7 of Schedule 1 of the Principal Determination. New paragraph (a) provides that a person who is a psychologist registered without limitation as a person who may provide the relevant services under the applicable law in force in the state or territory in which the service is provided is an allied health professional for the provision of focussed psychological strategies health services.
This amendment reflects the greater mobility that NRAS will afford regulated health professions, as health professionals no longer need to be registered separately in each state or territory in which they practice. Registration under a law of one state or territory will enable the health professional to practice in any other state or territory without further registration.
The amendment also updates the requirements for eligibility by deleting the reference to the Psychologists Registration Board.
These are technical amendments consequential on the implementation of NRAS.
Item 4
This item amends the requirements for eligibility as an allied health professional for the provision of mental health services in item 8 of Schedule 1 of the Principal Determination. New paragraph (b) provides that a person who has been certified as a credentialled mental health nurse by the Australian College of Mental Health Nurses meets the requirements for eligibility.
Under the nationally consistent registration standards implemented by NRAS, ‘mental health nurse’ is no longer a category of registration. New paragraph (b) therefore omits reference to persons registered as mental health nurses in Tasmania or the Australian Capital Territory. Item 11 of Schedule 2 of the Determination provides a transitional provision for persons affected by the removal of this path of recognition as an allied health professional for the provision of mental health services.
Items 5 and 6
Item 5 amends the requirements for eligibility as an allied health professional for the provision of mental health services in item 8 of Schedule 1 of the Principal Determination by substituting a new paragraph (d).
Item 6 amends the requirements for eligibility as an allied health professional for the provision of non-directive pregnancy support counselling health services in item 9 of Schedule 1 of the Principal Determination by substituting a new paragraph (b).
Both are technical consequential amendments and reflect the new national registration arrangements for psychologists.
Item 7
This item amends the requirements for eligibility for an allied health professional for the provision of a podiatry health service in item 13 of Schedule 1 of the Principal Determination. Previously, where a podiatry health service was provided in the Northern Territory an eligible allied health professional was a person:
- registered to provide podiatry health services in a state or territory other than the Northern Territory; or
- holding full membership of the Australian Podiatry Association in a state or territory other than the Northern Territory.
With the implementation of a national registration for podiatrists under NRAS, registration is available for podiatrists in the Northern Territory. The opportunity has therefore been taken to standardise the eligibility requirements for allied health professionals for the provision of a podiatry health service. Under the new definition, the requirement is that the person is registered to provide that type of service under the relevant law in force in the state or territory in which the service is provided.
Item 10 of the Schedule to the Determination provides a transitional provision for persons affected by the removal of membership of the Australian Podiatry Association in a state or territory other than the Northern Territory as a pathway to recognition as an allied health professional for the provision of a podiatry health service.
Item 8
This item amends the requirements for eligibility for an allied health professional for the provision of a psychological therapy health service in item 14 of Schedule 1 to the Principal Determination. The change to paragraph (a) is a technical change to reflect the new national registration arrangements for psychologists. A new subparagraph (b)(iii) has been added, which reflects that the new Psychology Board of Australia may endorse registered psychologists to practice in clinical psychology.
Item 9
This item amends the requirements for eligibility for an allied health professional for the provision of a psychology health service in item 15 of Schedule 1 to the Principal Determination. This is a technical consequential amendment to reflect the new national registration arrangements for psychologists.
Schedule 2 – Transitional provisions
Item 10
This item provides that a person who was an allied health professional for the provision of a podiatry health service provided in the Northern Territory because they were a full member of the Australian Podiatry Association in a state or territory other than the Northern Territory will continue to be taken to be such an allied health professional for a period of six months.
This will give members of the Australian Podiatry Association who wish to continue to provide Medicare eligible podiatry health services, but who have not yet registered with the Podiatry Board of Australia, a period of six months to arrange for registration.
Item 11
This item provides that a person who was an allied health professional for the provision of a mental health service in the Australian Capital Territory or Tasmania because they were registered in the relevant jurisdiction as a mental health nurse will be taken to be such an allied health professional for a period of six months.
Some nurses may no longer meet the requirements for an allied health professional for the provision of a mental health service because registration as a mental health nurse is not available under NRAS. This provision gives these people a period of six months to arrange for certification by the Australian College of Mental Health Nurses.