Health Insurance (Bone Densitometry) Determination HS/02/2006

Administered by Department of Health, Disability and Ageing

Legislation au F2006L03524 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

Health Insurance Act 1973

Health Insurance (Bone Densitometry) Determination HS/02/2006

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 2006 which are remade each year.

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

  • Health Insurance Determination HS/4/1999

On 7 September 1999, the then Minister for Health and Aged Care made Health Insurance Determination HS/4/1999 (the Current Determination) under subsection 3C(1) of the Act, which permits the payment of Medicare benefit in relation to specified bone densitometry services.

Subsection 4(1) of the Current Determination provides that a bone densitometry service specified in the Schedule to the Current Determination shall be treated as if it were a professional service and a medical service for the purposes of the following specific provisions:

(a) Schedule 1 to the National Health Act 1953;

(b) Subsections 3(1) and 19(6) and sections 8, 9, 10, 14, 17, 18, 20, 20A, 20B and 20BA of the Act; and

(c) Regulations 13, 27, 28, 29, 30 and 31 of the Health Insurance Regulations 1975.

Subsection 4(2) of the Current Determination provides that a bone densitometry service specified in the Schedule to the Current Determination is to be treated as if it were related to an item in the Table that specifies the fee mentioned in the Schedule to the Current Determination for that service.

Subsequent amendments have been made to the Current Determination to increase the fees in respect of the bone densitometry services specified in the Schedule to the Current Determination to be in line with general fee increases that were being applied to services in the Table (see Health Insurance (Amendment) Determination HS/08/2002, Health Insurance (Amendment) Determination HS/06/2003, Health Insurance (Amendment) Determination HS/10/2004 and Health Insurance (Amendment) Determination HS/04/2005).

  • Health Insurance (Bone Densitometry) Determination HS/02/2006

Health Insurance (Bone Densitometry) Determination HS/02/2006 (the Determination) remakes the Current Determination, as amended.

The Determination revises the wording of various provisions of the Current Determination to reflect updated drafting practice.

In addition, the Determination provides for an increase of 2.1 percent in the fees in respect of the services covered by the Determination compared to the fees in respect of the same services in the Current Determination, as amended.  This fee increase is in line with the general fee increase that is being applied to most services in the Table from 1 November 2006.

Details of the Determination are set out in the Attachment.

Consultation

No consultation was undertaken in the making of the Determination as the instrument is machinery in nature and does 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 commences on 1 November 2006.

Section 3

Section 3 provides that the Determination revokes Health Insurance Determination HS/4/1999.

Section 4

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

A key term is 'relevant service' which means a service defined in paragraph 3C(8) of the Act that is specified in the Schedule to the Determination.  There are six 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 general medical services 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 service the applicable item number, item descriptor and fee.

 

 

Overview

The Health Insurance (Bone Densitometry) Determination HS/02/2006 was enacted to address the need for updating the provisions governing the payment of Medicare benefits for bone densitometry services, which are essential for the diagnosis and monitoring of osteoporosis. This determination was issued by the Minister for Health and Ageing under the authority of the Health Insurance Act 1973, which allows the Minister to determine that specific health services not listed in the general medical services table should be treated as if they were listed under certain conditions. The primary policy objective of this determination is to ensure that bone densitometry services receive appropriate Medicare benefits and are adequately covered under the national health insurance scheme. The Determination revises the existing Health Insurance Determination HS/4/1999, aligning the language with contemporary drafting practices and increasing the fees by 2.1 percent to reflect the general fee increases applied to other services in the general medical services table as of 1 November 2006.

Scope and Application

The Health Insurance (Bone Densitometry) Determination HS/02/2006 applies to specific bone densitometry services that are not listed in the general medical services table under the Health Insurance Act 1973. By virtue of this determination, these specified bone densitometry services are treated as if they were listed in the table, thereby qualifying for certain statutory provisions and eligibility for Medicare benefits. This applies to the persons and entities providing these services, as well as the patients receiving them, within the Commonwealth of Australia. The geographic and jurisdictional reach is national, as the Act operates across Australia. The determination also specifies fees for these services, which are aligned with general fee increases applied to other services in the table, effective from 1 November 2006. Any exclusions, exemptions, or thresholds are implicitly defined by the specific services listed in the Schedule to the Determination, which outlines the applicable item number, descriptor, and fee for each service. The application of this Act can be further extended or restricted through subordinate instruments, such as amendments to the Current Determination, which have been used to update fees in line with broader changes in the general medical services table.

Key Provisions

The Health Insurance (Bone Densitometry) Determination HS/02/2006 (the Determination) primarily serves to update and revise the existing Health Insurance Determination HS/4/1999, as amended, concerning the provision of Medicare benefits for bone densitometry services. Section 1 of the Determination gives it its official title, while Section 2 specifies its commencement date, 1 November 2006. Section 3 revokes the earlier determination to ensure that only the updated provisions remain in effect. Section 4 defines key terms used within the Determination, with a particular focus on the term 'relevant service', which refers to specific services outlined in the Schedule attached to the Determination. Subsection 4(2) further clarifies that references to provisions of Acts or regulations should be interpreted as they apply from time to time, subject to the authorisation under subsection 3C(3) of the Health Insurance Act 1973. The Determination imposes specific obligations on healthcare providers and Medicare beneficiaries concerning the provision and receipt of bone densitometry services. According to Section 5, relevant services listed in the Schedule are to be treated as both professional and medical services for the purposes of various provisions in the Health Insurance Act 1973, the National Health Act 1953, and related regulations. This means that these services will be eligible for Medicare benefits under the conditions specified in the Determination. Moreover, Paragraph 5(b) stipulates that these services should be considered as if they were included in the general medical services table, with fees specified in the Schedule. This ensures that providers are compensated appropriately for these services. Failure to comply with the provisions of the Determination may result in various consequences, although the text does not explicitly detail offences or penalties. Generally, non-compliance with Medicare regulations can lead to civil or criminal penalties, depending on the nature and severity of the breach. In cases of deliberate or negligent breaches, penalties can include fines, imprisonment, or both. The specific maximum penalties would be governed by the relevant sections of the Health Insurance Act 1973 and associated regulations, which might include provisions under sections 120 to 127 of the Act. It is essential for healthcare providers and beneficiaries to adhere to the Determination to avoid any potential legal repercussions.

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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.