Health Insurance Amendment Regulations 2010 (No. 4)

Administered by Department of Health, Disability and Ageing

Legislation au F2010L02797 Regulations Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

Select Legislative Instrument 2010 No. 262

 

Health Insurance Act 1973

 

Health Insurance Amendment Regulations 2010 (No. 4)

 

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.

 

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 currently specified under Schedule 4 to the Health Insurance Regulations 1975 (the Principal Regulations).

 

The purpose of the Regulations is to amend Schedule 4 to the Principal Regulations to implement a 2010-11 Budget measure to recognise Addiction Medicine, Sexual Health Medicine and Sport and Exercise Medicine as medical specialties.  

 

Schedule 5 to the Principal Regulations is made for the purposes of section 3GA of the Act and provides for the establishment of a register of 'approved placements' by Medicare Australia.  Practitioners who are enrolled in or undertaking a course or program of a kind specified in Schedule 5 are eligible for registration on the register of approved placements.  Part 1 of Schedule 5 lists specified bodies and qualifications whilst Part 2 of Schedule 5 lists bodies and programs.  Medicare Australia 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.  Private sector training is a large component of specialist training across all disciplines, and access to Medicare items is essential in order not to impede effective training.  Fee-for-service arrangements involving Medicare-eligible services are vital to the funding of these training placements.

 

Part 1 of Schedule 5 is amended by the Regulations to list the specialties of Addiction Medicine, Sexual Health Medicine and Sport and Exercise Medicine so that specialist trainees are able to provide Medicare-eligible services whilst on private sector placements. 

 

Part 2 of Schedule 5 is amended by the Regulations to omit the Australasian College of Sports Physicians Training Program and the Department of Health and Ageing’s Approved Placements for Sports Physicians Training Program.  As a specialty, Sport and Exercise Medicine is listed in Schedule 4 (as a specialty) and Part 1 of Schedule 5 (as a provider of specialist training), and may therefore be removed from Part 2 of Schedule 5.

 

Details of the Regulations are set out in the Attachment.

 

The Department consulted with the specialist medical colleges, the Australasian College of Sports Physicians and the Royal Australasian College of Physician’s Australasian Chapter of Addiction Medicine and Australasian Chapter of Sexual Health Medicine in relation to recognition as a medical specialty. In addition, the Department consulted with Medicare Australia and the Department of Veterans’ Affairs in relation to administering the amended legislation.

 

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 1 November 2010.

 

 

  


ATTACHMENT

 

Details of the HEALTH INSURANCE AMENDMENT REGULATIONS 2010 (NO. 4)

 

Regulation 1 – Name of Regulations

Regulation 1 provides for the Regulations to be referred to as the Health Insurance Amendment Regulations 2010 (No. 4).

 

Regulation 2 – Commencement

Regulation 2 provides for the Regulations to commence on 1 November 2010.

 

Regulation 3 – Amendment of Health Insurance Regulations 1975

Regulation 3 provides that Schedule 1 amends the Health Insurance Regulations 1975 (the Principal Regulations).

 

Schedule 1 – Amendments

 

Item [1]     Schedule 4, after item 101

This item inserts the speciality of Sport and Exercise Medicine so Medicare Australia, the agency administering the Principal Regulations, is aware that medical practitioners who hold this qualification are specialists and entitled to specialist rebates.

 

Item [2]     Schedule 4, after item 102A

This item inserts the specialties of Addiction Medicine and Sexual Health Medicine so that Medicare Australia is aware that medical practitioners who hold these qualifications are specialists and entitled to specialist rebates.

 

Item [3]     Schedule 5, Parts 1 and 2

This item substitutes the table in Part 1 of Schedule 5 to the Principal Regulations to reflect the inclusion of the Australasian Chapter of Addiction Medicine (item 1), the Australasian Chapter of Sexual Health Medicine (item 3) and the Australasian College of Sports Physicians (item 6) so that specialist trainees in these specialties are able to provide Medicare-eligible services whilst on private sector placements. 

 

This item also substitutes the table in Part 2 of Schedule 5 to omit the Australasian College of Sports Physicians Training Program (item 13) and the Commonwealth Department of Health and Ageing’s Approved Placements for Sports Physicians Training Program (item 21) from the table.  As a specialist organisation and qualification that is recognised in Schedule 4, it is unnecessary to list item 13 in Part 2 of Schedule 5.  As a specialist training course that is  recognised in Part 1 of Schedule 5, it is unnecessary to list item 13 in Part 2 of Schedule 5.

 

A number of Rural Workforce Agencies have changed their names since they were established in 1998.  Items 6,7,8,9 and 10 in Part 2 of Schedule 5 are amended to reflect these changes.

 

Items in the table are now listed alphabetically and renumbered.

 

Overview

The Health Insurance Amendment Regulations 2010 (No. 4) were enacted to address the need for updating the recognition of medical specialties under the Health Insurance Act 1973. This Act was established to provide for the administration of the Medicare system in Australia and, over time, amendments have been necessary to keep pace with advancements in medical fields and training programs. These regulations, introduced by the Governor-General in accordance with the authority granted under the Act, aim to recognise new medical specialties and streamline the process for specialist trainees to access Medicare benefits during their training. The policy objective of these amendments is to ensure that the Medicare system remains effective and relevant by recognising emerging medical fields and supporting the training of specialists in these areas. The amendments also seek to remove redundancies in the administrative framework, thereby improving efficiency and clarity in the recognition process for both practitioners and trainees.

Scope and Application

The Health Insurance Amendment Regulations 2010 (No. 4) amend the Health Insurance Regulations 1975 to implement a measure introduced in the 2010-11 Budget aimed at recognising new medical specialties. The Regulations apply to medical practitioners and specialist training programs in Australia, with a specific focus on Addiction Medicine, Sexual Health Medicine, and Sport and Exercise Medicine. These specialties are recognised under Schedule 4 to the Health Insurance Regulations 1975, thereby entitling qualified medical practitioners to specialist rebates through Medicare Australia. Additionally, the Regulations modify Schedule 5 to the Principal Regulations to include these new specialties in the register of approved placements, ensuring that specialist trainees can provide Medicare-eligible services during their training in the private sector. The changes streamline the recognition of these specialties and remove redundant entries, reflecting the current organisational structures and training programs. These Regulations, which commenced on 1 November 2010, ensure that the recognition and funding of specialist training are aligned with the latest developments in medical practice.

Key Provisions

The Health Insurance Amendment Regulations 2010 (No. 4) primarily focus on updating the Health Insurance Regulations 1975 to recognise three new medical specialties: Addiction Medicine, Sexual Health Medicine, and Sport and Exercise Medicine. Under Section 133(1) of the Health Insurance Act 1973, these regulations are made to ensure the Act's objectives are effectively met, without inconsistency. Specifically, Section 3D of the Act is updated to include these new specialties, allowing specialists in these areas to attract Medicare rebates at the specialist level (Regulation 3, Schedule 1, Item [1] and Item [2]). The regulations also amend Schedule 5 to ensure that specialist trainees in these new specialties can provide Medicare-eligible services during their private sector placements (Regulation 3, Schedule 1, Item [3]). The obligations imposed by these regulations on the relevant parties primarily revolve around the recognition and administration of these new medical specialties. Medicare Australia must now be aware of these new specialties and ensure that practitioners qualified in these areas are entitled to specialist rebates. Additionally, the new specialties must be reflected in the register of 'approved placements' by Medicare Australia. This involves listing the Australasian Chapter of Addiction Medicine, the Australasian Chapter of Sexual Health Medicine, and the Australasian College of Sports Physicians in Schedule 5, Part 1, while removing certain training programs from Part 2 of Schedule 5 (Regulation 3, Schedule 1, Item [3]). These changes aim to streamline the process and ensure that specialist trainees can access Medicare benefits without impediment. Failure to comply with these regulations can result in legal consequences. While the Act does not specify particular offences, non-compliance could potentially lead to civil or administrative penalties. For instance, if Medicare Australia fails to recognise and issue provider numbers to specialists in the newly recognised fields, this could be considered a breach of their obligations under the Act. The specific penalties for such breaches would depend on the nature and severity of the non-compliance, but they could include fines or other enforcement actions under the relevant administrative laws. The regulations themselves do not specify maximum penalties, but these would be determined in the context of broader administrative and legislative frameworks.

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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.