Health Insurance Commission Amendment Regulations 2001 (No. 2)

Overview

The Health Insurance Commission Amendment Regulations 2001 (No. 2) were introduced to address the need for the formal registration of sonographers in Australia, ensuring that diagnostic ultrasound services performed on behalf of reporting physicians could be claimed for Medicare rebates. Enacted under the authority of the Minister for Health and Aged Care, these regulations amend the Health Insurance Commission Regulations 1975 by conferring an additional function on the Health Insurance Commission, specifically to establish and maintain a Register of Sonographers. Effective from 1 November 2001, the legislation mandates that a sonographer must be registered to enable Medicare rebate claims for services performed on their behalf. The Register will be maintained by the Australasian Sonographer Accreditation Registry in conjunction with the Commission, with detailed provisions covering registration processes, eligibility criteria, and the administration of the Register. The policy objective is to ensure that only qualified and accredited sonographers are recognised for Medicare purposes, thereby maintaining the integrity and quality of diagnostic services.

Scope and Application

The Health Insurance Commission Amendment Regulations 2001 (No. 2) amend the Health Insurance Commission Regulations 1975 to extend the functions of the Health Insurance Commission to include the establishment and maintenance of a Register of Sonographers. This is pursuant to section 44 of the Health Insurance Commission Act 1973, which allows for regulations to be made to prescribe matters for the purposes of the Act, and subsection 8AA(2), which provides that the Commission is to perform functions prescribed by the regulations. The Regulations are applicable to individuals who perform diagnostic ultrasound services on behalf of reporting physicians in order to claim Medicare rebates, where the sonographer must be registered on the newly established Register. The Register is to be administered by the Australasian Sonographer Accreditation Registry in conjunction with the Commission. The Regulations include provisions for the registration of eligible sonographers, the form and method of maintaining the Register, and the eligibility criteria for registration. The Regulations also provide for the removal of names from the Register and the notification requirements associated with such removals. The Regulations apply nationally, and there are no stated exclusions or exemptions. The Regulations extend the application of the Act through the establishment of the Register and the associated administrative framework.

Key Provisions

The Health Insurance Commission Amendment Regulations 2001 (No. 2) establish a new function for the Health Insurance Commission (the Commission), as provided for under section 44 of the Health Insurance Commission Act 1973. Specifically, the Regulations confer an additional function on the Commission, namely, to establish and maintain a Register of Sonographers (the Register) (regulation 3S). This function is to ensure that for reporting physicians to be able to claim for Medicare rebateable diagnostic ultrasound services performed on their behalf, the sonographer must be Registered, that is, a person whose name is entered on the Register. The Regulations also detail the processes for registration and maintenance of the Register, including the form for an application for registration (regulation 3S(4)), the time limits within which an eligible sonographer must be registered by the Commission (regulation 3S(5)), and the circumstances in which the Commission is required to remove a person's name from the Register (regulation 3S(7)). The Regulations impose several obligations on the Commission in relation to the Register. Firstly, the Commission is required to register eligible sonographers (regulation 3S(3)). The eligibility requirements for registration are set out in regulation 3S(10) and include possession of an accredited postgraduate qualification in medical ultrasound, current participation in an accredited course of study or a Diploma of Medical Ultrasound, or five years or greater clinical experience before 1 November 2001 working as a sonographer in Australia or New Zealand under the supervision, or direction, of a medical practitioner. Secondly, where the eligible sonographer is a student, the Commission must record that fact in the Register (regulation 3S(6)). Thirdly, the Commission must notify a person before removing their name from the Register and give at least 28 days notice before doing so (regulations 3S(8) and 3S(9)). The Regulations also allow for the Register to be maintained in any form, including a computer record (regulation 3S(2)). The Register will be administered by the Australasian Sonographer Accreditation Registry (ASAR) in conjunction with the Commission. The Regulations do not expressly provide for offences, penalties, or civil or criminal consequences for breach. However, the failure to comply with the requirements of the Regulations, such as the obligation to register eligible sonographers or to provide notice before removing a person's name from the Register, could potentially give rise to legal action by affected parties. For example, a sonographer who is not registered and who is therefore unable to claim for Medicare rebateable diagnostic ultrasound services performed on their behalf may have grounds for legal action against the Commission. Similarly, a sonographer who is removed from the Register without notice may also have grounds for legal action against the Commission. The consequences of such legal action would depend on the specific circumstances of the case and the applicable law.