Health Insurance (Bone Densitometry) Determination 2012

Administered by Department of Health, Disability and Ageing

Legislation au F2012L02098 Not in force Legislative Instrument

Legislation content

EXPLANATORY STATEMENT

 

Health Insurance Act 1973

 

Health Insurance (Bone Densitometry) Determination 2012

 

Issued by the Authority of the Minister for Health and Ageing

 

 

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) Regulation which is remade each year.

 

 

The Health Insurance (Bone Densitometry) Determination 2012 (‘the Determination’) revokes and replaces the Health Insurance (Bone Densitometry) Determination 2011 (‘the 2011 Determination’), increasing the fees for services due to annual indexation. These changes will apply from 1 November 2012. 

 

 

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

 

 

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 Determination commences on 1 November 2012.

 

Consultation

 

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

Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

Health Insurance (Bone Densitometry) Determination 2012

This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the Legislative Instrument

The Health Insurance (Bone Densitometry) Determination 2012 revokes and replaces the Health Insurance (Bone Densitometry) Determination 2011.

The purpose of the Health Insurance (Bone Densitometry) Determination 2012 is to replace the fees in the Health Insurance (Bone Densitometry) Determination 2011 with increased fees, due to the annual indexation typically applied to Medicare services (other than pathology and diagnostic imaging services).

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

Human rights implications

The right to health

The right to health – the right to the enjoyment of the highest attainable standard of physical and mental health – is contained in article 12(1) of the International Covenant on Economic, Social and Cultural Rights (ICESCR).  The UN Committee on Economic, Social and Cultural Rights (the Committee) has stated that health is a ‘fundamental human right indispensable for the exercise of other human rights’, and that the right to health is not to be understood as a right to be healthy, but rather entails a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health.

Right to Social Security

The right to social security is contained in article 9 of the ICESCR.  The right requires that a country must, within its maximum available resources, ensure access to a social security scheme that provides a minimum essential level of benefits to all individuals and families that will enable them to acquire at least essential health care.  Countries are obliged to demonstrate that every effort has been made to use all resources that are at their disposal in an effort to satisfy, as a matter of priority, this minimum obligation. 

The Committee has stated that the notion of ‘the highest attainable standard of health’ takes into account both the conditions of the individual and the country’s available resources.  The right may be understood as a right of access to a variety of public health and health care facilities, goods, services, programs and conditions necessary for the realisation of the highest attainable standard of health.

The Committee has also stated that with respect to the right to social security that the qualifying conditions for benefits must be reasonable, proportionate and transparent.

There is no incompatibility with the right to health or social security because the legislation is for a legitimate objective and reasonable, necessary and proportionate in the circumstances.  

Conclusion

This Legislative Instrument is compatible with human rights as it has a positive effect on human rights issues.

 

Richard Bartlett

First Assistant Secretary

Medical Benefits Division

Overview

The Health Insurance (Bone Densitometry) Determination 2012 was enacted to update the fees for bone mineral density tests covered under Medicare, reflecting annual indexation. This legislative instrument was issued by the Authority of the Minister for Health and Ageing and is a response to Subsection 3C(1) of the Health Insurance Act 1973, which allows the Minister to determine that specific health services not listed in the general medical services table be treated as if they were listed under certain conditions. The 2012 Determination replaces the 2011 version, addressing minor indexation changes without substantive alterations to existing arrangements. The primary focus of this legislation is to ensure that patients who have proven low bone mineral density or are at high risk due to various medical conditions or treatments receive necessary bone density tests, thereby supporting their health and well-being within the framework of Australia’s social security system.

Scope and Application

The Health Insurance (Bone Densitometry) Determination 2012 applies to the provision of bone mineral density tests under the Health Insurance Act 1973, specifically for patients who either have proven low bone mineral density or are considered to be at high risk due to factors such as having a fracture after minimal trauma, suffering from conditions like chronic liver disease, or undergoing treatments that may cause low bone mineral density. The Determination sets the fees for these services, which are indexed annually to account for changes in the cost of providing such services. It applies across Australia and affects both the providers of these medical services and patients who are eligible for Medicare benefits. The Determination extends the application of the Health Insurance Act to include these specified bone densitometry services, ensuring they are treated as if they were listed in the general medical services table. Any exclusions or exemptions from this Determination would need to be specified within the Schedule to the Determination, but the explanatory statement does not indicate any specific exclusions beyond those naturally implied by the eligibility criteria for the services themselves. The application of this Determination is further refined through subordinate instruments as needed, aligning with the annual indexation process for Medicare services.

Key Provisions

The Health Insurance (Bone Densitometry) Determination 2012 amends the Health Insurance (Bone Densitometry) Determination 2011, which lists fees for bone mineral density tests provided to patients who have proven low bone mineral density or who are at high risk due to certain conditions or treatments (section 3C(1) of the Health Insurance Act 1973). The updated fees reflect annual indexation, which is effective from 1 November 2012. This determination applies to patients who have experienced a fracture from minimal trauma, suffer from conditions like chronic liver disease, or are undergoing treatments that may lead to low bone mineral density. The updated fees aim to ensure that the services remain accessible under the Medicare scheme, thereby supporting the health needs of the affected population. The Act imposes specific obligations on healthcare providers and patients regarding the provision and receipt of bone densitometry services. Healthcare providers must adhere to the updated fee schedule as specified in the Determination, ensuring that these services are billed correctly and that patients are informed of any out-of-pocket costs that may apply. Patients, on the other hand, must ensure that they meet the eligibility criteria as outlined in the Determination to qualify for Medicare-subsidised bone mineral density tests. The Act also requires that the services provided align with the clinical guidelines and conditions set out in the Schedule to the Determination, ensuring that the treatments are both necessary and appropriate for the patient's health needs. Failure to comply with the provisions of the Health Insurance (Bone Densitometry) Determination 2012 may result in various civil and criminal consequences. For instance, healthcare providers who overcharge patients or bill for services not covered under the Determination may face penalties under the Health Insurance Act 1973. Such penalties can include fines, repayment of overcharged amounts, and potential legal action. Additionally, patients who knowingly receive services without meeting the eligibility criteria may also face financial repercussions, including the requirement to repay any benefits received in error. The maximum penalties for such breaches are not explicitly stated in the Determination but are governed by the overarching provisions of the Health Insurance Act 1973, which can include substantial fines and other legal penalties as deemed appropriate by the court.

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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.