EXPLANATORY STATEMENT

Select Legislative Instrument No. 214, 2014

Health Insurance Act 1973

Health Insurance (General Medical Services Table) Amendment (Duration of Attendance) Regulation 2014 (No.2)

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 be calculated by reference to the fees for medical services set out in prescribed tables.

Subsections 4(1) of the Act provides that the regulations may prescribe a table of medical services which set out items of medical services, the fees applicable for each item, and rules for interpreting the table.  The Health Insurance (General Medical Services Table) Regulation 2014 (GMST) currently prescribes such a table.

The Health Insurance (General Medical Services Table) Amendment (Duration of Attendance No.2) Regulation 2014 (the proposed Regulation) amends the GMST to align certain Non-Vocationally Registered (VR) General Practice (GP) items with the Government’s decision to set a time limitation on certain GP attendance items through the Health Insurance (General Medical Services Table) Amendment (Duration of Attendance) Regulation 2014.

These amendments ensure that non-VR GP items 52, 53, 5200, and 5203 have the same time structure as do VR GP items 3, 23, 5000 and 5020. Specifically, the amendments ensure that Level A non-VR GP attendance items (52 and 5200) are amended to require an attendance lasting less than 10 minutes, and Level B non-VR GP attendance items (53 and 5203) are amended to require an attendance lasting at least 10 minutes and no more than 25 minutes. These amendments ultimately ensure that MBS rebates are up-to-date, representative of best medical practice, and reflective of Government commitments.

Consultation

In accordance with Section 18 of the Legislative Instruments Act 2003, the nature of the Regulation is such that it was inappropriate to consult. The decision to alter entitlement to Medicare benefits was taken as part of Government’s Mid-Year Economic and Financial Outlook 2014-15.

Details of the Regulation are set out in the Attachment.

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 on 19 January 2015.

 Authority:     Subsection 133(1) of the

                                                                                                Health Insurance Act 1973 

ATTACHMENT

Details of the Health Insurance (General Medical Services Table) Amendment (Duration of Attendance Regulation 2014 (No.2)

Section 1 – Name

This section provides for the Regulation to be referred to as the Health Insurance (General Medical Services Table) Amendment (Duration of Attendance) Regulation 2014 (No.2).

Section 2 – Commencement

This section provides for the Regulation to commence on 19 January 2015.

Section 3 – Authority

This section provides that the Regulation is made under the Health Insurance Act 1973.

Section 4 – Schedules

This section provides that each instrument specified in a Schedule to the instrument is amended or repealed as set out in the applicable items in the Schedule concerned.

Schedule 1 – Amendments

Health Insurance (General Medical Services Table) Regulation 2014

Item [1] –Schedule 1 (item 52, column headed “Description”)

This item amends item 52 so that it is limited to professional attendances lasting less than 10 minutes.

Item [2] – Schedule 1 (item 53, column headed “Description”)

Item 2 amends item 53 so that is limited to professional attendances lasting at least 10 minutes and not more than 25 minutes.

Item [3] – Schedule 1 (item 5200, column headed “Description”)

Item 3 amends item 5200 so that it applies to a professional attendance after-hours lasting less than 10 minutes.

Item [4] – Schedule 1 (item 5203, column headed “Description”)

Item 4 amends item 5203 so that it applies to a professional attendance after-hours lasting at least 10 minutes and not more than 25 minutes.