EXPLANATORY STATEMENT

Select Legislative Instrument 2012 No. 295

Health Insurance Act 1973

Health Insurance (Diagnostic Imaging Services Table) Amendment Regulation 2012 (No. 1)

Subsection 133(1) of the Health Insurance Act 1973 (the Act) provides that the

Governor-General may make regulations, not inconsistent with the Act, prescribing all matters required or permitted by the Act to be prescribed, or necessary or convenient to be prescribed for carrying out or giving effect to the Act. 

Part II of the Act provides for the payment of Medicare benefits for professional services rendered to eligible persons.  Section 9 of the Act provides that Medicare benefits shall be calculated by reference to the fees for medical services set out in the table.

Subsection 4AA(1) of the Act provides that the regulations may prescribe a table of diagnostic imaging services that describes the services, the fees applicable for each item, and rules for interpreting the table.  The Health Insurance (Diagnostic Imaging Services Table) Regulation 2012 (the Principal Regulation) currently prescribes such a table.

The purpose of the regulation is to correct a drafting error in the description of item 63513.    The current wording of the item descriptor does not include the annotations which authorise the claiming of Medicare benefits for the anaesthetic and contrast components of the service. Contrast agents, such as Gadolinium, are substances introduced into the body to improve the visibility of internal body structures in magnetic resonance imaging (MRI).  Therefore, this amendment clarifies that the use of anaesthetic and contrast is permissible where a General Practitioner requests an MRI knee scan for a child under the age of 16 years.

The Act specifies no conditions which need to be met before the power to make the regulation may be exercised. 

The regulation is a legislative instrument for the purposes of the Legislative Instruments Act 2003. 

The regulation commences the day after it is registered.

Consultation

Although no consultation was undertaken in relation to this regulation as the change is a minor amendment to correct an omission in the Principal Regulation, following the announcement of the Diagnostic Imaging Reform Package 2010-11 Budget announcements there was significant consultation with the relevant craft groups in the development of the initiative.  The Review involved extensive formal and informal consultation with the diagnostic imaging industry and profession including the establishment of a Diagnostic Imaging Review Consultation Committee (DIRCC).  These items were developed with assistance from an Expert Group of General Practitioners and Radiologists, including representatives from the Royal Australian and New Zealand College of Radiologists (RANZCR), and the Royal Australian College of General Practitioners (RACGP).

 Authority:     Subsection 133(1) of the

                                                                                                Health Insurance Act 1973