EXPLANATORY STATEMENT

Issued by the Authority of the Minister for Health and Ageing

Select Legislative Instrument 2005 No. 9

Health Insurance Act 1973

Health Insurance Amendment Regulations 2005 (No. 1)

Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides that the

Governor-General may make regulations, not inconsistent with the Act, prescribing all matters required or permitted by the Act to be prescribed, or necessary or convenient to be prescribed for carrying out or giving effect to the Act.

The Act provides, in part, for payments of Medicare benefits in respect of professional services rendered to eligible persons.  Section 3D of the Act provides for the recognition of members of certain organisations as specialists on advice from the relevant organisation for the purpose of attracting Medicare rebates at the specialist level. 

Subsection 3D(1) of the Act provides that a medical practitioner is recognised as a specialist in a particular specialty if the Managing Director of the Health Insurance Commission receives written notice from the “relevant organisation” that the medical practitioner meets the criteria for the specialty.  Subsection 3D(2) of the Act specifies these criteria and includes the requirement that the medical practitioner has obtained a “relevant qualification”. 

Subsection 3D(5) of the Act defines relevant organisation and relevant qualification as being those organisations and qualifications declared by the Health Insurance Regulations 1975 (the Principal Regulations).

Schedule 4 to the Principal Regulations lists the names of the specialities, relevant organisations and relevant qualifications that are recognised for the purposes of section 3D of the Act.  For each specialty, the relevant organisation is a specialist medical college and the relevant qualification is fellowship of that college. 

The purpose of the Regulations is to update Schedule 4 to the Principal Regulations to accurately reflect the current names of organisations, specialties and qualifications. Over time, various administrative changes within the specialist medical colleges have resulted in changes to several of the names of colleges and specialties, and thus their recognised qualifications. To ensure that no medical practitioners are disadvantaged by this update, the revision of Schedule 4 incorporates transitional and retrospective arrangements. 

The specialties currently listed in Schedule 4 were recognised by the National Specialist Qualification Advisory Committee of Australia.  That body was disbanded in 1997, and its functions taken over by the Australian Medical Council’s Recognition of Medical Specialties Advisory Committee.  The amendments update the names of the organisations and qualifications pertaining to specialties which had been recognised by the former body (as no new specialties have been endorsed since 1997), each with effect from the date on which the name change occurred.  The Regulations also re-make Schedule 4 to consolidate and renumber these changes.

The Act specifies no conditions that need to be met before the power to make the Regulations may be exercised.

Details of the Regulations are set out in the Attachment.

The Regulations are a legislative instrument for the purposes of the Legislative Instruments Act 2003.

Most elements of the Regulations have a retrospective effect, from the dates on which the organisations affected by the various provisions changed their names.  The following Regulations are taken to have commenced as follows:

• regulations 1 and 2, subregulation 3(1) and Schedule 1, on 30 April 1997;
• subregulation 3(2) and Schedule 2, on 31 May 1997;
• subregulation 4(1) and Schedule 3, on 23 October 1998;
• subregulation 4(2) and Schedule 4, on 27 October 1998;
• subregulation 4(3) and Schedule 5, on 21 December 2000;  and
• subregulation 4(4) and Schedule 6, on 22 February 2002

Subregulation 4(5) and Schedule 7 to the Regulations commence on the day on which the Regulations are registered on the Federal Register of Legislative Instruments. 

The Office of Legislative Drafting and Publication has advised that the amendments which have retrospective effect are not contrary to subsection 12(2) of the Legislative Instruments Act 2003 as the changes are beneficial in nature, and do not affect the rights of any person so as to disadvantage that person.  Nor do they impose liabilities on any person in respect of anything done, or omitted to be done, before the date of notification.

ATTACHMENT

DETAILS OF THE HEALTH INSURANCE AMENDMENT REGULATIONS

2005 (No. 1 )

Regulation 1 provides for the Regulations to be referred to as the Health Insurance Amendment Regulations 2005 (No. 1).

Regulation 2 provides for regulations 1 and 2, subregulation 3(1) and Schedule 1 to the Regulations to be taken to have commenced on 30 April 1997;  subregulation 3(2) and Schedule 2 to the Regulations to be taken to have commenced on 31 May 1997;  Subregulation 4(1) and Schedule 3 to the Regulations to be taken to have commenced on 23 October 1998; subregulation 4(2) and Schedule 4 to the Regulations to be taken to have commenced on 27 October 1998; subregulation 4(3) and Schedule 5 to the Regulations to be taken to have commenced on 21 December 2000; subregulation 4(4) and Schedule 6 to the Regulations to be taken to have commenced on 22 February 2002; and subregulation 4(5) and Schedule 7 to the Regulations to commence on the day on which the Regulations are registered on the Federal Register of Legislative Instruments.

Regulations 3 and 4 provide for Schedules 1 to 7 to amend the Health Insurance Regulations 1975 (the Principal Regulations), as in force immediately before the respective commencement dates of the amendments.  Regulation 3 uses the citation of the Principal Regulations as it existed on the dates that Schedules 1 and 2 are taken to have commenced.

Amendments to Schedule 4 to the Principal Regulations

Schedule 1 – Amendment taken to have commenced on 30 April 1997

All the amendments are to existing Schedule 4 to the Principal Regulations.

Item [1] 

This item inserts a new item 7A, which prescribes the Royal Australasian College of Surgeons as a professional organisation, vascular surgery as a specialty and Fellowship of the Royal Australasian College of Surgeons (FRACS) as a qualification.  Vascular surgery was recognised by the National Specialist Qualification Advisory Committee (NSQAC) on 30 April 1997 as a specialty, but was not inserted into Schedule 4 to the Principal Regulations. 

Schedule 2 – Amendments taken to have commenced on 31 May 1997

Item [1]

This item inserts a new item 9A, which prescribes the Royal Australasian College of Physicians as a professional organisation, clinical genetics as a specialty and Fellowship of the Royal Australasian College of Physicians (FRACP) as a qualification.  Clinical genetics was recognised by the NSQAC as a specialty on 31 May 1997, but was not inserted into Schedule 4 to the Principal Regulations. 

Item [2]

This item inserts a new item 10A, which prescribes the Royal Australasian College of Radiologists as a professional organisation, nuclear medicine as a specialty and Fellowship of the Royal Australasian College of Radiologists (FRACR) as a qualification.  This specialty was recognised by the NSQAC on 31 May 1997 but was not inserted into Schedule 4 to the Principal Regulations. 

Item [3]

This item inserts a new item 12A, which prescribes the Royal Australian College of Obstetricians and Gynaecologists as a professional organisation, gynaecological oncology, maternal-fetal medicine, obstetrics and gynaecological ultrasound, reproductive endocrinology and infertility and urogynaecology as specialties, and Fellowship of the Royal Australian College of Obstetricians and Gynaecologists (FRACOG) as a qualification.  These specialties were recognised by the NSQAC on 31 May 1997 but were not inserted into Schedule 4 to the Principal Regulations. 

Schedule 3 – Amendment taken to have commenced on 23 October 1998

Item [1]

This item inserts a new item 12B, which prescribes the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as a professional organisation.  The College included New Zealand in the name of the organisation and the qualification became the Fellowship of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (FRANZCOG) on 23 October 1998.  Obstetrics and gynaecology, gynaecological oncology, maternal-fetal medicine, obstetrics and gynaecological ultrasound, reproductive endocrinology and infertility and urogynaecology as specialties were recognised by the NSQAC on 23 October 1998 but were not inserted into Schedule 4 to the Principal Regulations. 

Schedule 4 – Amendment taken to have commenced on 27 October 1998

Item [1]

On 27 October 1998, the Royal Australasian College of Radiologists changed its name to the Royal Australasian and New Zealand College of Radiologists.  The qualification issued by the organisation changed accordingly, from Fellowship of the Royal Australasian College of Radiologists (FRACR) to Fellowship of the Royal Australasian and New Zealand College of Radiologists (FRANZCR).   The specialties offered by the college did not change.

This item inserts a new item 10B, which prescribes the Royal Australasian and New Zealand College of Radiologists as a professional organisation, diagnostic radiology, diagnostic ultrasound, nuclear medicine and radiation oncology as specialties and Fellowship of the Royal Australasian and New Zealand College of Radiologists (FRANZCR) as a qualification. 

Schedule 5 – Amendment taken to have commenced on 21 December 2000

Item [1]

On 21 December 2000, the Royal Australasian College of Ophthalmologists changed its name to the Royal Australian and New Zealand College of Ophthalmologists.  The qualification issued by the organisation changed accordingly, from Fellowship of the Royal Australasian College of Ophthalmologists (FRACO) to Fellowship of the Royal Australian and New Zealand College of Ophthalmologists (FRANZCO).   The specialty offered by the college did not change.

This item inserts a new item 13A, which prescribes the Royal Australian and New Zealand College of Ophthalmologists as a professional organisation, ophthalmology as a specialty and Fellowship of the Royal Australian and New Zealand College of Ophthalmologists (FRANZCO) as a qualification. 

Schedule 6 – Amendment taken to have commenced on 22 February 2002

Item [1]

On 22 February 2002, the Royal Australasian College of Physicians and the Australian and New Zealand College of Anaesthetists formed the Joint Faculty of Intensive Care Medicine.  This faculty replaces the Faculty of Intensive Care, Australian and New Zealand College of Anaesthetists.  

This item inserts a new item 17, which prescribes the Australian and New Zealand College of Anaesthetists and Royal Australasian College of Physicians, Joint Faculty of Intensive Care Medicine as a professional organisation, intensive care medicine as a specialty and Fellowship of the Joint Faculty of Intensive Care Medicine (FJFICM) as a qualification.

Schedule 7 - Amendments commencing on registration

Item [1]

Subsection 3D(5) of the Act defines relevant organisation and relevant qualification as being those organisations and qualifications declared by the Principal Regulations.   Regulation 4 of the Principal Regulations provides that relevant organisations and relevant qualifications, for the purposes of subsection 3D(1) of the Act, are declared in Schedule 4 to the Principal Regulations. 

This item amends regulation 4, so that it correctly refers to subsection 3D(5) of the Act.

Item [2]

This item replaces Schedule 4 to the Regulations, with the revised Schedule divided into two parts.  In each part, the existing two-digit and three-digit item numbers are replaced by sequential three-digit numbers. 

The fifteen current organisations and qualifications are listed in Part 1 of Schedule 4, together with their relevant specialities.  Notes to the relevant items indicate which organisations were formerly called by another name, and the dates from which the current qualifications have been awarded. 

The seven former organisations and qualifications are listed in Part 2 of Schedule 4.   Notes to the relevant items indicate the current name of organisations, and the last dates on which the former qualifications were awarded.