Explanatory Statement
Issued by the Authority of the Minister for Health and Ageing
Health Insurance Act 1973
Health Insurance (Allied Health Services) Determination 2008
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 circumstance 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 2007.
A determination made under subsection 3C(1) of the Act is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
Subsection 3C(8) of the Act provides that the health services that may be subject to a determination made under subsection 3C(1) of the Act 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.
This Determination revokes the Health Insurance (Allied Health Services) Determination 2007 and re-makes it as the Health Insurance (Allied Health Services) Determination 2008 (the Determination).
This Determination makes the following changes to the Health Insurance (Allied Health Services) Determination 2007:
- identifies that Medicare benefits can be paid, from 1 November 2008, for new follow-up allied health services for people of Aboriginal and Torres Strait Islander descent;
- indexes the fees for all of the existing allied health services in the Determination.
This Determination continues to set out the Medicare items and associated eligibility rules for the provision of allied health services, consistent with the previous Health Insurance (Allied Health Services) Determination 2007.
Details of this Determination are set out in the Attachment.
This Determination commences on 1 November 2008.
Consultation
The relevant professional groups representing allied health providers and general practitioners (Australian Medical Association, Australian General Practice Network, Royal Australian College of General Practitioners, Rural Doctors Association of Australia) are aware of and support the arrangements for the new follow-up allied health items for people of Aboriginal and Torres Strait Islander descent.
The Department has also advised the relevant professional groups and practitioners about the indexation of fees from 1 November 2008.
Attachment
Details of the health insurance (allied health SERVICES) determination 2008
This Explanatory Statement sets out the amendments made by revoking the Health Insurance (Allied Health Services) Determination 2007 and remaking it as the Health Insurance (Allied Health Services) Determination 2008.
Preliminary
Section 1 provides for the Determination to be referred to as the Health Insurance (Allied Health Services) Determination 2008.
Section 2 provides for the Determination to commence on 1 November 2008.
Section 3 revokes the previous Health Insurance (Allied Health Services)
Determination 2007.
Section 4 defines specific terms used in this Determination.
Section 5 confirms that the Medicare items set out in Schedule 2 of the Determination are to be treated for the purposes of the relevant acts and regulations as if they were both professional services and medical services, and as if they were items in the general medical services table.
Section 6 sets out limitations on certain items in Part 2 of Schedule 2.
Sections 7 and 8 set out the referral arrangements that apply to certain items in Part 2 of Schedule 2.
Section 9 indicates that Medicare benefits are payable for items in Schedule 2 only if a private health insurance benefit has not been claimed for the service.
Schedule 1
This Schedule sets out the qualification requirements for allied health professionals providing services under the Medicare items in Schedule 2.
Schedule 2
This Schedule sets out the relevant Medicare items (including the item numbers, service descriptors and fees) for services provided by eligible allied health professionals.
− Part 1 applies to individual allied health services (items 10950 to 10970).
− Part 2 applies to psychological therapy and focussed psychological strategies services (items 80000 to 80170).
− Part 3 applies to pregnancy support counselling services (items 81000 to 81010).
− Part 4 applies to group allied health services for patients with type 2 diabetes
(items 81100 to 81125).
− Part 5 applies to allied health services for children with autism or any other Pervasive Developmental Disorder (items 82000 to 82025)
− Part 6 applies to follow-up allied health services for people of Aboriginal and Torres Strait Islander descent (items 81300 to 81360)
Fees for all items in Parts 1, 2, 3, 4 and 5 of Schedule 2 have been indexed from 1 November 2008.