EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health and Ageing
Health Insurance Act 1973
Health Insurance (Cataract Surgery) Determination 2010
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may determine in writing that a health service not listed in an item 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 2009 which are re-made 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 (Cataract Surgery) Determination 2010 (the Determination) will permit the payment of Medicare benefits for cataract surgery.
The Determination provides for fee changes to three items (item 42698, 42701 and 42702). Item 42698 will enable a Medicare benefit to be payable where a service for lens extraction is rendered. Item 42701 will enable a Medicare benefit to be payable where a service for the insertion of an artificial lens is rendered. Item 42702 will enable a Medicare benefit to be payable where a service for a lens extraction and insertion of an artificial lens is rendered.
The purpose of this Determination is to ensure that patients can receive medicare benefits for the cataract surgery services specified in the Schedule to the Determination.
This Determination commences on 1 February 2010 and revokes the Health Insurance (Cataract Surgery) Determination 2009 (No. 2).
Consultation
The Royal Australian and New Zealand College of Ophthalmologists and the Australian Society of Ophthalmologists were consulted and are supportive of fee relativities for the cataract item structure.
Details of the Determination are set out in the Attachment.
ATTACHMENT
Notes on sections in the Determination
Section 1
Section 1 provides the name of the Determination.
Section 2
Subsection 2(1) provides that the Determination commences on 1 February 2010.
The Determination enables the continued payment of medicare benefits for certain cataract surgery services.
Subsection 2(2) provides that the Determination ceases at midnight on 31 October 2010 unless sooner terminated.
Section 3
Section 3 defines terms used in this Determination. These terms are referred to in section 4 of the Determination.
Subsection 3(2) provides that a reference to a provision of an Act or regulations, is a reference to the provision as in force from time to time.
Section 4
Section 4 provides that a relevant service specified in the Schedule to the Determination will be treated from 1 February 2010 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 which provide for medical services or professional services.
Schedule
The Schedule to the Determination sets out the relevant services, assigns the applicable item number, item descriptor and fee for each service.