Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006

Administered by Department of Health, Disability and Ageing

Legislation au F2006L01822 Not in force Legislative Instrument

Legislation content

Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006

as amended

made under subsection 3C (1) of the

Health Insurance Act 1973

Compilation start date:  26 June 2013

Includes amendments up to: Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Amendment Determination 2013 (No. 1)

 

About this compilation

This compilation

 

This is a compilation of the Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006 as in force on 26 June 2013.  It includes any commenced amendment affecting the legislation to that date.

 

This compilation was prepared on 1 November 2013.

 

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of each amended provision.

 

Uncommenced amendments

 

The effect of uncommenced amendments is not reflected in the text of the compiled law but the text of the amendments is included in the endnotes.

 

Application, saving and transitional provisions for provisions and amendments

 

If the operation of a provision or amendment is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

 

Modifications

 

If a provision of the compiled law is affected by a modification that is in force, details are included in the endnotes.

 

Provisions ceasing to have effect

 

If a provision of the compiled law has expired or otherwise ceased to have effect in accordance with a provision of the law, details are included in the endnotes.

 

 

 

 

 

Contents

 

1. Name of Determination        4

2. Commencement        4

3. Cessation         4

4. Revocation of Health Insurance Determination HS/2/2000   4

5. Interpretation         4

6. Circumstances where this Determination applies     5

7. Treatment of a relevant service       5

 

Schedule -  Specified health services      6

 

Endnotes          7

 

1. Name of Determination

This Determination is the Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006.

 

2. Commencement

This Determination is taken to have commenced on 1 January 2006. 

 

3. Cessation

This Determination will cease to have effect at the end of 30 June 2016.

 

4. Revocation of Health Insurance Determination HS/2/2000

This Determination revokes Health Insurance Determination HS/2/2000.

 

5. Interpretation

(1) In this Determination:

the Act means the Health Insurance Act 1973.

item means an item in the Schedule.

QAAMS Program means the program, known as the Quality Assurance in Aboriginal Medical Services Program, funded by the Department of Health and Ageing as a program to provide education, training, quality assurance, quality control and on-going support services for point of care diabetes testing in Aboriginal Community Controlled Health Services and Aboriginal Medical Services.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in the Schedule.

Note Unless the contrary intention appears, expressions used in this Determination have the same meanings as in the Act—see section 13 of the Legislative Instruments Act 2003.

 

(2) Unless the contrary intention appears, in this Determination a reference to a provision of the Act or regulations made under the Act as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

 

6. Circumstances where this Determination applies

(1) This Determination applies to a relevant service only where all of the following circumstances apply:

(a) where a direction made by the First Assistant Secretary of the Office for Aboriginal and Torres Strait Islander Health under section 19(2) of the Act to enable the payment of medicare benefits for professional services provided in Aboriginal and Torres Strait Islander communities applies to the service; and

(b) where the service is rendered by or on behalf of a medical practitioner; and

(c) where the practitioner referred to in paragraph (b) is:

(i) an employee of an organisation that is receiving funding from the Commonwealth, a State or a Territory; or

(ii) an employee of a State or Territory; and

(d) where the practitioner referred to in paragraph (b), or the organisation for which the practitioner works, is participating in the QAAMS Program; and

(e) where the practitioner referred to in paragraph (b) has determined the service to be necessary for his or her patient.

Note   The circumstance in paragraph (d) mirrors the requirement in section 16A(1)(a) of the Act that the treating practitioner requesting a pathology service must determine that the service is necessary.

 

7. Treatment of a relevant service

A relevant service shall be treated as if:

(a) it were both a professional service and a medical service for the purposes of the provisions of the Act, the National Health Act 1953, the Health Insurance Regulations 1975 and the National Health Regulations 1954 that make provision in respect of professional services or medical services, other than provisions that make provision for pathology services specifically; and

(b) there were an item in the pathology services table that related to the relevant service and specified in respect of the service a fee in relation to a State, being the fee specified in the Schedule in relation to the State specified

 

 

Schedule -  Specified health services

 

Item

Health Service

Fee for all States

73840

Quantitation of glycosylated haemoglobin performed in the management of established diabetes – each test to a maximum of 4 tests in a 12 month period.

$17.00

73844

Quantitation of urinary microalbumin as determined by urine albumin excretion on a timed overnight urine sample or urine albumin/creatinine ratio as determined on a first morning urine sample in the management of established diabetes.

$20.35

 

Note Section 3C (7) of the Act deems an internal Territory to form part of the State of  New South Wales.

Endnotes

 

Endnote 1—About the endnotes

The endnotes provide details of the history of this legislation and its provisions. The following endnotes are included in each compilation:

 

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Endnote 5—Uncommenced amendments

Endnote 6—Modifications

Endnote 7—Misdescribed amendments

Endnote 8—Miscellaneous

 

If there is no information under a particular endnote, the word “none” will appear in square brackets after the endnote heading.

 

Abbreviation key—Endnote 2

The abbreviation key in this endnote sets out abbreviations that may be used in the endnotes.

 

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

 

The legislation history in endnote 3 provides information about each law that has amended the compiled law. The information includes commencement information for amending laws and details of application, saving or transitional provisions that are not included in this compilation.

 

The amendment history in endnote 4 provides information about amendments at the provision level. It also includes information about any provisions that have expired or otherwise ceased to have effect in accordance with a provision of the compiled law.

 

Uncommenced amendments—Endnote 5

The effect of uncommenced amendments is not reflected in the text of the compiled law, but the text of the amendments is included in endnote 5.

 

Modifications—Endnote 6

If the compiled law is affected by a modification that is in force, details of the modification are included in endnote 6.

 

Misdescribed amendments—Endnote 7

An amendment is a misdescribed amendment if the effect of the amendment cannot be incorporated into the text of the compilation. Any misdescribed amendment is included in endnote 7.

 

Miscellaneous—Endnote 8

 

Endnote 2—Abbreviation key

 

ad = added or inserted

pres = present

am = amended

prev = previous

c = clause(s)

(prev) = previously

Ch = Chapter(s)

Pt = Part(s)

def = definition(s)

r = regulation(s)/rule(s)

Dict = Dictionary

Reg = Regulation/Regulations

disallowed = disallowed by Parliament

reloc = relocated

Div = Division(s)

renum = renumbered

exp = expired or ceased to have effect

rep = repealed

hdg = heading(s)

rs = repealed and substituted

LI = legislative instrument

s = section(s)

LIA = Legislative Instruments Act 2003

Sch = Schedule(s)

mod = modified/modification

Sdiv = Subdivision(s)

No = Number(s)

SLI = Select Legislative Instrument

o = order(s)

SR = Statutory Rules

Ord = Ordinance

Sub-Ch = Sub-Chapter(s)

orig = original

SubPt = Subpart(s)

par = paragraph(s)/subparagraph(s)

 

 /sub-subparagraph(s)

 

 

 

 

Endnote 3—Legislation history

 

Name

FRLI registration or gazettal

Commencement

Application, saving and transitional provisions

Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006

16 June 2006 (see F2006L01822)

1 January 2006

 

Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites)  Amendment Determination 2009 (No.1)

22 June 2009 (see F2009L02468)

30 June 2009

__

Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites)  Amendment Determination 2012 (No.1)

18 December 2012 (see F2012L02513)

1 January 2013

__

Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites)  Amendment Determination 2013 (No.1)

25 June 2013 (see F2013L01158)

26 June 2013

__

 

 

Endnote 4—Amendment history

 

Provision affected

How affected

s.3………………………………………..

am. F2009L02468; F2013L01158

Sch……………………………………….

am. F2012L02513

Endnote 5—Uncommenced amendments [none]

Endnote 6—Modifications [none]

Endnote 7Misdescribed amendments [none]

Endnote 8—Miscellaneous [none]

 

 

 

 

Overview

The Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006 was introduced to address the gap in Medicare benefits for diabetes testing services provided in Aboriginal and Torres Strait Islander primary health care sites. This legislative instrument, enacted under subsection 3C(1) of the Health Insurance Act 1973 by the Australian Parliament, was designed to ensure that necessary diabetes testing services are covered under Medicare for patients in these specific health care settings. The primary policy objective was to improve health outcomes for Aboriginal and Torres Strait Islander people by facilitating access to essential diabetes management services. The determination specifies particular health services related to diabetes testing that are eligible for Medicare benefits, thereby encouraging the provision of these services in primary health care sites. The legislation was scheduled to cease on 30 June 2016, reflecting a targeted approach to address the identified health care needs within the specified timeframe.

Scope and Application

The Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006 applies specifically to health services related to diabetes testing provided in Aboriginal and Torres Strait Islander primary health care sites. This legislation applies to relevant services that meet certain criteria, including where a direction under section 19(2) of the Health Insurance Act 1973 applies to the service, where the service is rendered by or on behalf of a medical practitioner, and where the practitioner or the organisation for which the practitioner works is participating in the Quality Assurance in Aboriginal Medical Services Program. The services must also be deemed necessary by the practitioner for their patient. The determination specifies the treatment of a relevant service, treating it as both a professional service and a medical service for the purposes of the Act and related regulations, except for provisions that specifically make provision for pathology services. The determination includes a schedule of specified health services and their corresponding fees. The legislation has a national reach, as it is made under the Health Insurance Act 1973, a Commonwealth Act. The determination ceased to have effect at the end of 30 June 2016. The application and scope of the legislation can be extended or restricted through subordinate instruments, such as amendments to the determination.

Key Provisions

The Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006 (the Determination) is a legislative instrument made under subsection 3C(1) of the Health Insurance Act 1973. It provides that certain health services related to diabetes testing in Aboriginal and Torres Strait Islander primary health care sites are eligible for Medicare benefits. Section 6 of the Determination specifies the circumstances where it applies, namely when a direction made by the First Assistant Secretary of the Office for Aboriginal and Torres Strait Islander Health applies to the service, the service is rendered by a medical practitioner, the practitioner is employed by an organisation receiving Commonwealth, State or Territory funding or by a State or Territory, the practitioner or organisation is participating in the Quality Assurance in Aboriginal Medical Services Program, and the practitioner has determined the service to be necessary for the patient. Section 7 of the Determination treats the relevant services as both professional services and medical services for the purposes of the Act and other specified Acts and regulations. The Determination imposes several obligations on the parties it governs. Firstly, medical practitioners who render the relevant services must be employees of an organisation that receives funding from the Commonwealth, a State or a Territory, or employees of a State or Territory. Secondly, the practitioner or the organisation for which the practitioner works must be participating in the Quality Assurance in Aboriginal Medical Services Program. Thirdly, the practitioner must determine that the service is necessary for the patient. Failure to comply with these obligations may result in the services not being eligible for Medicare benefits. There are no explicit offences or penalties stated in the Determination for breach of its provisions. However, the failure to comply with the obligations outlined in the Determination may result in the services not being eligible for Medicare benefits, which could have financial consequences for the practitioner or organisation rendering the services. Additionally, if the Determination is found to be in breach of other legislation, such as the Legislative Instruments Act 2003, there may be consequences under that legislation.

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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.