EXPLANATORY STATEMENT
Select Legislative Instrument 2007 No. 311
Subject: Health Insurance Act 1973
Health Insurance Amendment Regulations 2007 (No. 5)
Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides, in part, 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.
Section 3D of the Act provides for the recognition of members of certain organisations as specialists for the purpose of attracting Medicare rebates at the specialist level. These organisations are specified under Schedule 4 to the Health Insurance Regulations 1975 (the Principal Regulations).
Private sector training is becoming a larger component of specialist training across all disciplines, and access to Medicare items is essential in order not to impede effective training. The Department of Health and Ageing (the Department) has been working with the specialist medical colleges to diversify specialist training with placements in the private sector. Fee-for-service arrangements involving Medicare eligible services are vital to the funding of these training placements.
Part 1 of Schedule 5 to the Principal Regulations lists bodies and qualifications so that specialist trainees may be added to the Register of Approved Placements maintained by Medicare Australia, in order to enable those trainees to access Medicare rebates. Medicare will issue a medical practitioner in an approved placement whose name is on the Register with a provider number in order to access Medicare benefits from the location at which the placement has been approved.
The purpose of the Regulations is to amend Part 1 of Schedule 5 to the Principal Regulations so that anaesthetic, intensive care, pain medicine, and palliative medicine specialist trainees will be able to provide Medicare-eligible services whilst on private sector placements. The Regulations also correct one minor typographical error in Schedule 4 to the Principal Regulations.
Details of the Regulations are set out in the Attachment.
The Department advised the specialist colleges listed in Part 1 of Schedule 5 that it intended updating the Schedule and sought feedback on whether their listing required updating. It also sought feedback from the Australian and New Zealand College of Anaesthetists regarding the accuracy of its proposed listing. In addition, the Department consulted with Medicare Australia and the Office of Best Practice Regulation.
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 commence on the day after they are registered on the Federal Register of Legislative Instruments.
ATTACHMENT
Details of the Health Insurance Amendment Regulations 2007 (No. 5)
Regulation 1 provides for the Regulations to be referred to as the Health Insurance Amendment Regulations 2007 (No. 5).
Regulation 2 provides for the Regulations to commence the day after they are registered on the Federal Register of Legislative Instruments.
Regulation 3 provides that Schedule 1 amends the Health Insurance Regulations 1975 (the Principal Regulations).
Schedule 1 – Amendments
Item [1]
Schedule 4, item 109, columns 2 and 4
This item amends a typographic error by omitting the word Australasian and inserting Australian to reflect the correct name of the Royal Australian and New Zealand College of Radiologists.
Item [2]
Schedule 5, Part 1
This item substitutes the list of specified bodies to add four new bodies and qualifications. Anaesthetic medicine, intensive care medicine, pain medicine, and palliative medicine have previously been recognised as medical specialties, and added to Schedule 4. Their addition to Schedule 5, Part 1 allows specialist trainees in those disciplines to access Medicare items whilst on approved private sector training places.
This item also updates the listings for a number of bodies and courses to reflect changes in their names since their last entry, to rectify an incorrect listing, or to remove a defunct qualification.
Overview
The Health Insurance Amendment Regulations 2007 (No. 5) were enacted to address the growing role of private sector training in specialist medical education, ensuring that such training is adequately funded through Medicare rebates. These regulations amend the Health Insurance Regulations 1975 under the authority provided by Subsection 133(1) of the Health Insurance Act 1973. The primary objective is to enable specialist trainees in anaesthetics, intensive care, pain medicine, and palliative medicine to access Medicare rebates during their placements in the private sector, thereby facilitating their training without financial impediment. The Department of Health and Ageing, in collaboration with relevant specialist medical colleges, Medicare Australia, and the Office of Best Practice Regulation, developed these regulations to reflect the evolving landscape of specialist training and to correct a minor typographical error in the Principal Regulations. The Regulations commence on the day after they are registered on the Federal Register of Legislative Instruments, as required by the Legislative Instruments Act 2003.
Scope and Application
The Health Insurance Amendment Regulations 2007 (No. 5) amend the Health Insurance Regulations 1975 to update the list of recognised specialist medical colleges and qualifications, thereby allowing specialist trainees in certain disciplines to access Medicare rebates while completing approved placements in the private sector. These regulations apply to medical practitioners, specialist trainees, and other relevant parties involved in specialist medical training and placements, particularly those in the fields of anaesthetic, intensive care, pain medicine, and palliative medicine. The amendments aim to ensure that private sector training placements do not face funding impediments by enabling access to Medicare rebates. The regulations extend to the entire Commonwealth of Australia, and there are no stated exclusions or exemptions within the provided text. The regulations are subordinate instruments that extend the application of the Health Insurance Act 1973 by detailing specific bodies and qualifications that qualify for Medicare rebates during specialist training placements in the private sector. The Regulations commence on the day after they are registered on the Federal Register of Legislative Instruments.
Key Provisions
The main operative sections of the Health Insurance Amendment Regulations 2007 (No. 5) include several key provisions under Schedule 1 (paragraphs 2 and 3). Regulation 1 names the Regulations as the Health Insurance Amendment Regulations 2007 (No. 5), while Regulation 2 specifies that the Regulations commence on the day after they are registered on the Federal Register of Legislative Instruments. Regulation 3 indicates that Schedule 1 amends the Health Insurance Regulations 1975 (the Principal Regulations). Under Schedule 4, item [1] corrects a typographical error by replacing "Australasian" with "Australian" to accurately reflect the name of the Royal Australian and New Zealand College of Radiologists. Under Schedule 5, Part 1, item [2] amends the list of specified bodies and qualifications to include four new bodies and qualifications: anaesthetic medicine, intensive care medicine, pain medicine, and palliative medicine. This update allows specialist trainees in these disciplines to access Medicare items while on approved private sector training placements. It also updates the listings for a number of bodies and courses to reflect changes in their names since their last entry, to correct an incorrect listing, or to remove a defunct qualification.
The Act imposes several obligations and requirements on the parties it governs. Firstly, the Regulations require the Department of Health and Ageing to consult with specialist medical colleges, Medicare Australia, and the Office of Best Practice Regulation when updating the list of specified bodies and qualifications under Schedule 5, Part 1 of the Principal Regulations (paragraph 7). The Department must also notify the specialist colleges listed in Schedule 5, Part 1 of any intended updates to the Schedule and seek their feedback on whether their listing requires updating (paragraph 7). Secondly, the Regulations mandate that specialist trainees in anaesthetic medicine, intensive care medicine, pain medicine, and palliative medicine must be added to the Register of Approved Placements maintained by Medicare Australia in order to access Medicare rebates (paragraph 4). This requirement ensures that these trainees can access Medicare-eligible services while on approved private sector training placements. Lastly, the Regulations require the specialist colleges listed in Schedule 5, Part 1 to ensure that their bodies and qualifications are accurately represented in the Schedule (paragraph 5).
Any breach of the Act or the Regulations may result in civil or criminal consequences. The Act does not specify any offences or penalties for breach, however, the Regulations may be subject to penalties under the Administrative Penalties Act 1998 (Cth) or other relevant legislation. The maximum penalty for a civil penalty notice under the Administrative Penalties Act 1998 (Cth) is 20 penalty units (currently $4,200) for individuals and 100 penalty units (currently $21,000) for bodies corporate (section 11). For criminal offences, the maximum penalty depends on the specific offence and may range from fines to imprisonment. It is important to note that the penalties for breach may vary depending on the specific circumstances of the case and the relevant legislation.