Health Insurance Amendment Regulations 2006 (No. 3)

Administered by Department of Health, Disability and Ageing

Legislation au F2006L03311 Regulations Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

Select Legislative Instrument 2006 No. 269

 

Issued by the Authority of the Minister for Health and Ageing

 

Health Insurance Act 1973

 

Heath Insurance Amendment Regulations 2006 (No. 3)

 

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.

 

Subsection 3C(1) of the Act enables the Minister to make a written determination in respect of a health service, or a health service in a specified class of health services, for the purposes of payment of Medicare benefits.  Subsection 3C(8) defines the health services that may be subject to a determination under subsection 3C(1), and paragraph 3C(8)(b) enables other types of health services to be prescribed by regulations.

 

The Regulations will amend the Health Insurance Regulations 1975 (the Principal Regulations) to prescribe three additional classes of allied health services as health services for the purposes of section 3C of the Act.  The Regulations are necessary to give effect to changes to Medicare announced by the Australian Government in March and April 2006, which enable Medicare benefits to be payable for these allied health services in specified circumstances.

 

Paragraph 10(2)(aa) of the Act enables a Medicare benefit equal to 100% of the Medicare schedule fee to be paid for certain services, as prescribed in regulations.  Schedule 6 to the Principal Regulations currently lists those services that attract a Medicare benefit equal to 100% of the Medicare schedule fee.  These services comprise non-referred consultations provided by vocationally and non-vocationally registered general practitioners, and services provided by a practice nurse on behalf of a general practitioner.

 

The Regulations will also list several new services in Schedule 6 to the Principal Regulations, as a consequence of amendments being made to other regulations.

 

Among the amendments included in the Health Insurance (General Medical Services Table) Regulations 2006, seven new items for General Practitioner (GP) over 45 health checks, GP mental health care, pregnancy counselling and practice nurse preventive checks will be introduced into the General Medical Services Table.  The Regulations will prescribe these seven items as items that attract a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Details of the Regulations are set out in the Attachment.

 

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

 

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

 

The Regulations take effect on 1 November 2006, in line with the amendments to the General Medical Services Table.

 

 

Authority: Subsection 133(1) of the

Health Insurance Act 1973


ATTACHMENT

 

DETAILS OF THE HEALTH INSURANCE AMENDMENT REGULATIONS 2006 (No 3)

 

Regulation 1 provides for the Regulations to be referred to as the Health Insurance Amendment Regulations 2006 (No. 3).

 

Regulation 2 provides for the Regulations to commence on 1 November 2006.

 

Regulation 3 provides for Schedule 1 to amend the Health Insurance Regulations 1975 (the Principal Regulations).

 

Schedule 1 – Amendment

 

Item [1]

This item amends regulation 3A by substituting it with a new regulation 3A.  The new regulation 3A prescribes three additional classes of allied health services as “health services” for the purposes of section 3C of the Act.  These are:

  • focussed psychological strategies;
  • non-directive pregnancy support counselling; and
  • psychological therapy.

 

Item [2]

This item amends item 7 of Schedule 6 to the Principal Regulations to include item 717 as a service that attracts a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Item 717 is a new GP item for a health check for people 45-49 years of age who may be at risk of developing a chronic disease.

 

Item [3]

This item amends item 12 of Schedule 6 to the Principal Regulations to include items 2710, 2712 and 2713 as services that attract a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Items 2710, 2712 and 2713 improve access to and encourage a multidisciplinary approach to the care of people with mental disorders.  More specifically, these items aim to encourage more GPs to undertake early intervention, assessment and management of patients with mental disorders and to streamline access to appropriate psychological interventions in primary care.

 

Item [4]

This item inserts item 14AA of Schedule 6 to the Principal Regulations to include item 4001 as a service that attracts a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Item 4001 is for the provision of non-directive pregnancy support counselling services by eligible medical practitioners, including a general practitioner, but not including a specialist or consultant physician.

 


Item [5]

This item amends item 14A of Schedule 6 to the Principal Regulations to include items 10994 and 10995 as services that attract a Medicare benefit equal to 100% of the Medicare schedule fee.

 

Items 10994 and 10995 provide for more practice nurses to undertake a wider range of procedures including pap smears and other preventive checks.

 

 

Overview

The Health Insurance Amendment Regulations 2006 (No. 3) were enacted to address the gaps and problems identified in the provision of allied health services and other health services under the Health Insurance Act 1973. The Act allows the Governor-General to make regulations necessary or convenient for carrying out or giving effect to the Act, and these Regulations were made under that authority to implement changes announced by the Australian Government in March and April 2006. The policy objective is to enhance the accessibility and affordability of healthcare services by expanding the range of services for which Medicare benefits can be paid. The Regulations, which took effect on 1 November 2006, prescribe additional classes of allied health services eligible for Medicare benefits and introduce new services that attract a 100% Medicare benefit, thereby improving the scope of healthcare coverage and encouraging a multidisciplinary approach to patient care.

Scope and Application

The Health Insurance Amendment Regulations 2006 (No. 3) pertain to the Health Insurance Act 1973 and affect the provision of health services within Australia. These regulations apply to entities and individuals involved in the delivery and reimbursement of healthcare services, specifically targeting allied health services and general practitioner services. The regulations specify additional classes of allied health services eligible for Medicare benefits and introduce new general practitioner services that qualify for a 100% Medicare benefit. Geographically, these regulations apply nationally across Australia, aligning with the federal nature of the Health Insurance Act. There are no exclusions or exemptions stipulated within these regulations, but they do extend the application of the Act through the prescription of new health services and the amendment of existing regulatory schedules. The regulations came into effect on 1 November 2006, in accordance with the changes to the General Medical Services Table, and are instrumental in implementing policy changes announced by the Australian Government in early 2006.

Key Provisions

The Health Insurance Amendment Regulations 2006 (No. 3) amend the Health Insurance Regulations 1975 to expand the classes of health services that can attract a 100% Medicare benefit. Regulation 3A in Schedule 1 of the Regulations introduces three new classes of allied health services as "health services" for the purposes of section 3C of the Health Insurance Act 1973. These new classes include focussed psychological strategies, non-directive pregnancy support counselling, and psychological therapy. Additionally, the Regulations amend Schedule 6 to include specific services that attract a 100% Medicare benefit. For instance, item 717, a new GP health check item for people aged 45-49, is added. Similarly, items 2710, 2712, and 2713, which improve access to mental health care services, are now eligible for a 100% Medicare benefit. Furthermore, non-directive pregnancy support counselling by eligible medical practitioners is included, and practice nurse preventive checks, such as pap smears, are also added to the list of services eligible for this benefit. The Act imposes several obligations on the parties it governs. The Minister is required to make written determinations regarding health services to enable the payment of Medicare benefits. Additionally, the Regulations mandate that specific health services be prescribed to attract a 100% Medicare benefit. The Regulations also require the Health Insurance Regulations 1975 to be amended to include new classes of health services and specific items eligible for the 100% Medicare benefit. These changes necessitate updates to the General Medical Services Table, ensuring that the new services and items are correctly listed and eligible for the specified Medicare benefits. The Regulations provide for civil and criminal consequences for breaches. While the Act does not specify particular offences or penalties for non-compliance with the Regulations, general provisions under the Health Insurance Act 1973 may apply. For example, penalties for fraudulent claims or misrepresentation of facts to obtain Medicare benefits could include fines and imprisonment. The penalties for breaching these provisions can be severe, with fines up to $22,200 for individuals and $111,000 for bodies corporate, along with potential imprisonment terms. The exact penalties depend on the specific nature and severity of the breach, as well as any relevant case law and statutory provisions.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.