Health Insurance (Bone Densitometry) Determination 2009

Administered by Department of Health, Disability and Ageing

Legislation au F2009L04633 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

Health Insurance Act 1973

 

Health Insurance (Bone Densitometry) Determination 2009

 

Issued by the Authority of the Minister for Health and Ageing

 

Background

 

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 circumstances and for specified statutory provisions, be treated as if it were so listed.  The Table is set out in the Health Insurance (General Medical Services Table) Regulations which are remade each year.

 

A determination made under subsection 3C(1) of the Act is a legislative instrument (see subsection 3C(4) of the Act and paragraph 6(d) of the Legislative Instruments Act 2003).

 

The Health Insurance (Bone Densitometry) Determination 2009 (‘the Determination’) will revoke and replace the Health Insurance (Bone Densitometry) Determination 2008 (‘the 2008 Determination’). 

 

Health Insurance (Bone Densitometry) Determination 2008

 

The bone densitometry services specified in the Schedule to the 2008 Determination concerned the provision of bone mineral density tests to patients who already had proven low bone mineral density or who were considered to be at high risk because they had had a fracture after minimal trauma, suffered from a condition that is associated with low bone mineral density such as chronic liver disease, or were on a course of treatment that may cause low bone mineral density.

 

Health Insurance (Bone Densitometry) Determination 2009
 

The Determination will replace the 2008 Determination.  The purpose of the Determination is to replace the fees with new fees, due to annual indexation.  These new fees will be taken to have applied from 1 November 2009.

 

Subsection 3C(2) of the Act provides that determinations made under subsection 3C(1) of the Act may be expressed to have taken effect from a day earlier than the day on which the determination is made. This determination is taken to have commenced on 1 November 2009.

 

The effect of the retrospective commencement is to authorise individuals to be paid, from 1 November 2009, Medicare benefits for the specified services with an increased fee, in line with the general fee increase applied to most services in the Table from that date.  This does not adversely affect the rights of any person or impose liabilities on any person (other than the Commonwealth or an authority of the Commonwealth) and the retrospective commencement of the determination does not offend subsection 12(2) of the Legislative Instruments Act 2003.

 

Details of the Determination are set out in the Attachment.

 

Commencement

 

The Determination is taken to have commenced on 1 November 2009.

 

Consultation

 

No consultation was undertaken in the making of the Determination as the changes to the Schedule are minor machinery in nature and do not substantially alter existing arrangements.

 

 

 


ATTACHMENT

Notes on sections

 

Section 1

 

Section 1 provides for the name of the Determination.

 

Section 2

 

Section 2 provides that the Determination is taken to have commenced on 1 November 2009.

 

Section 3

 

Section 3 provides that the Determination revokes the Health Insurance (Bone Densitometry) Determination 2008.

 

Section 4

 

Subsection 4(1) defines terms used in the Determination.

 

A key term is 'relevant service' which means a health service as defined in paragraph 3C(8) of the Act that is specified in the Schedule to the Determination.  There are seven such relevant services in the Schedule.

 

Subsection 4(2) provides that a reference to a provision of an Act or regulations, including the Act, the National Health Act 1953 and the regulations made under these Acts, is a reference to the provision as in force from time to time (as authorised by subsection 3C(3) of the Act).

 

Section 5

 

Paragraph 5(a) provides that a relevant service specified in the Schedule to the Determination shall be treated as if it were both a professional service and a medical service for the purposes of the provisions of the Act, the National Health Act 1953 and regulations made under each Act that make provision for medical services or professional services.

 

Paragraph 5(b) provides that a relevant service specified in the Schedule to the Determination is to be treated as if there were an item in the Table that related to the service and specified a fee in respect of that service, being the fee specified in the Schedule to the Determination in relation to the service.

 

Schedule

 

The Schedule sets out the relevant services and assigns to each relevant service the applicable item number, item descriptor and fee.

 

Overview

The Health Insurance (Bone Densitometry) Determination 2009 was enacted to update the fees for bone densitometry services under the Health Insurance Act 1973. This legislation was introduced by the Minister for Health and Ageing and was designed to address the need for annual indexation of fees for specified bone mineral density tests. The Determination revokes and replaces the Health Insurance (Bone Densitometry) Determination 2008 to reflect the updated fees that took effect from 1 November 2009. The policy objective is to ensure that healthcare providers are compensated appropriately for their services, aligning with the general fee increases applied to most services within the general medical services table. No consultation was deemed necessary as the changes were minor and did not substantially alter existing arrangements.

Scope and Application

The Health Insurance (Bone Densitometry) Determination 2009 applies to health services provided under the Health Insurance Act 1973, specifically bone densitometry services. These services are provided to patients who have proven low bone mineral density or are at high risk due to factors such as fractures, chronic conditions, or certain treatments. The Act allows the Minister for Health and Ageing to determine that these services, not listed in the general medical services table, will be treated as if they were listed under specified circumstances. This Determination replaces the 2008 version, updating fees due to annual indexation, and it is effective from 1 November 2009, with retrospective application to allow for the increased fees from that date. The Act applies across the Commonwealth of Australia and the Determination extends its reach by specifying particular health services and their associated fees, thereby ensuring that eligible patients can receive the necessary bone densitometry services with the appropriate Medicare benefits.

Key Provisions

The Health Insurance (Bone Densitometry) Determination 2009, issued under the authority of the Minister for Health and Ageing, primarily serves to update the fees for specified bone densitometry services listed in the Health Insurance (General Medical Services Table) Regulations (sections 1-5). This Determination replaces the 2008 version to reflect the annual indexation of fees, effective from 1 November 2009. It specifies that these bone densitometry services, which include bone mineral density tests for patients with proven low bone mineral density or those at high risk due to certain conditions or treatments, will be treated as listed services for the purposes of Medicare benefits (section 5(a) and (b)). The Determination imposes specific obligations on the parties involved, primarily concerning the updated fees for these services. Health service providers are required to bill according to the new fees set out in the Schedule, ensuring that patients receive the appropriate Medicare benefits for these specified bone densitometry services. The Commonwealth, through Medicare, is obligated to pay these updated fees in accordance with the Determination, aligning with the general fee increases applied to most services in the Table from 1 November 2009. The Determination does not introduce new offences but relies on the existing framework of the Health Insurance Act 1973 and related regulations for enforcement. Any non-compliance with the specified fees or improper billing practices could result in civil or criminal penalties under the relevant Acts, including fines and potential legal action. The retrospective commencement of the Determination ensures that it does not adversely affect any person's rights or impose liabilities other than on the Commonwealth, thereby adhering to the legislative requirements outlined in the Legislative Instruments Act 2003.

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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.