EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health and Ageing
Health Insurance Act 1973
Health Insurance Determination HS/6/05
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 pathology services table or the diagnostic imaging services table shall, in specified circumstances and for specified statutory provisions, be treated as if it were so listed.
A determination made under subsection 3C(1) is a legislative instrument for the purposes of the Legislative Instruments Act 2003 (see subsection 3C(4) of the Act and paragraph 6(d) of the Legislative Instruments Act 2003).
Health Insurance Determination HS/6/01 (Amendment) HS/6/05 (the Determination) amends Health Insurance Determination HS/6/01 (the Existing Determination).
The purpose of the Determination is to amend the Existing Determination by deleting five items relating to solitary pulmonary nodules, non-small cell lung cancer and epilepsy. The Determination also takes the opportunity of making minor technical amendments for clarity and consistency with Health Insurance (Positron Emission Tomography) Determination HS/07/05.
In accordance with section 17 of the Legislative Instruments Act 2003 consultations have been undertaken with the Australian and New Zealand Association of Physicians in Nuclear Medicine and Medicare Australia in relation to the making of the Determination.
Details of the Determination are set out in the Attachment.
The Determination commences on the day after it is registered on the Federal Register of Legislative Instruments.
ATTACHMENT
NOTES ON SECTIONS TO THE DETERMINATION
Section 1 provides that the Determination may be cited as the Health Insurance Determination HS/6/01 (Amendment) HS/6/05.
Section 2 provides that the Determination commences on the day after registration.
Section 3 provides that this Determination amends Health Insurance Determination HS/6/01.
Schedule 1 - Amendments
Item [1] – Section 2 - Note
This amendment inserts a reference to section 13 of the Legislative Instruments Act 2003.
Item [2] – Section 5
This amendment clarifies that those items listed in the Schedule to the Existing Determination are R-type diagnostic imaging services and must be rendered pursuant to a written request by a specialist or a consultant physician.
Item [3] – Subsection 6 (b)
This amendment inserts a reference to medical services.
Item [4] – Subsection 6 (c)
This amendment clarifies that the positron emission tomography services specified in the Schedule to the Existing Determination are to be treated as an R-type diagnostic imaging service in the diagnostic imaging services table.
Item [5] – Section 7
This deletes section 7. The referral requirements will now be found in paragraph 5(b).
Item [6] – Subsection 8 (1)
This amendment corrects the reference to clause 5(c) to paragraph 6(c).
Item [7] – Paragraph 8 (1) (a)
This amendment updates the reference to Health Insurance (Diagnostic Imaging Services Table) Regulations 2000 to refer to the most current regulations or the regulations that replace them.
Item [8] – Schedule - Item
This amendment deletes items 61523, 61526, 61529, 61532 and 61559 from the Schedule.
Item [9] – Schedule – Health service (PET Service)
This amendment inserts (R) for each item listed in the Schedule to signify them as R-type diagnostic imaging services.