EXPLANATORY STATEMENT
Select Legislative Instrument 2011 No. 226
Health Insurance Act 1973
Health Insurance (General Medical Services Table) Amendment Regulations 2011 (No. 3)
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. The effect of section 9 of the Act is that Medicare benefits are calculated with reference to the fees for medical services set out in prescribed tables.
Subsection 4(1) of the Act provides that the regulations may prescribe a table of medical services (other than diagnostic imaging services and pathology services), which sets out items of medical services, the fees applicable for each item, and rules for interpreting the table. The Health Insurance (General Medical Services Table) Regulations 2011 (the Principal Regulations) currently prescribe such a table.
The Regulations amend the Principal Regulations to reintroduce the definition of ‘general practitioner’ that existed up to 31 October 2011.
The definition of ‘general practitioner’ was removed, in error, as part of the annual remaking of the Principal Regulations in October 2011. The Regulations also make a consequential amendment to the definition of ‘general practitioner’ in the Dictionary.
The Act specifies no conditions, which need to be met before the power to make the Regulations is exercised.
The Regulations are a legislative instrument for the purposes of the Legislative Instruments Act 2003.
The Regulations are taken to have commenced on 1 November 2011. The retrospective nature of the amendments do not disadvantage any person or impose a liability on any person other than the Commonwealth. Subsection 12(2) of the Legislative Instruments Act 2003 does not therefore operate to prevent the retrospective amendments from taking effect.
Consultation
As this is a change to re-establish the status quo as at 31 October 2011 no consultation with stakeholders was required.
Authority: Subsection 133(1) of the Health Insurance Act 1973
ATTACHMENT
Details of the Health Insurance (General Medical Services Table) Amendment Regulations 2011 (No. 3)
Regulation 1 – Name of Regulations
This regulation provides that the title of the Regulations is the Health Insurance (General Medical Services Table) Amendment Regulations 2011 (No. 3).
Regulation 2 – Commencement
This regulation provides for the Regulations to be taken to have commenced on
1 November 2011.
Regulation 3 – Amendment of Health Insurance (General Medical Services Table) Regulations 2011
This regulation provides that the Health Insurance (General Medical Services Table) Regulations 2011 are amended as set out in Schedule 1.
Schedule 1 – Amendments
Item [1] – Schedule 1, clause 1.1.1A
This item reintroduces the meaning of ‘general practitioner’ that existed up to 31 October 2011.
Item [2] – Dictionary
This item removes the definition of ‘general practitioner’ and substitutes it with a reference to the new clause 1.1.1A for the meaning of ‘general practitioner’.
Overview
The Health Insurance (General Medical Services Table) Amendment Regulations 2011 (No. 3) was enacted to correct an inadvertent omission in the Health Insurance (General Medical Services Table) Regulations 2011, which had removed the definition of 'general practitioner'. The Health Insurance Act 1973, enacted by the Commonwealth Parliament, governs the payment of Medicare benefits for medical services. Subsection 133(1) of the Act authorises the Governor-General to make regulations that are not inconsistent with the Act, provided they are necessary or convenient to carry out or give effect to the Act. The explanatory statement clarifies that the purpose of these Regulations is to rectify an error made in the remaking of the Principal Regulations in October 2011, and no consultation with stakeholders was necessary due to the nature of the amendments. The Regulations were taken to have commenced on 1 November 2011, and the retrospective amendments do not impose any disadvantage or liability on any person other than the Commonwealth.
Scope and Application
The Health Insurance (General Medical Services Table) Amendment Regulations 2011 (No. 3) pertains to the Health Insurance Act 1973, which governs the payment of Medicare benefits for medical services rendered to eligible persons. The Act applies to medical practitioners, patients, and Medicare providers across Australia. The Act provides for the calculation of Medicare benefits based on fees outlined in prescribed tables, with the Health Insurance (General Medical Services Table) Regulations 2011 originally setting out these fees. The current Regulations amend the Principal Regulations to rectify an oversight that resulted in the removal of the definition of ‘general practitioner’, ensuring that the definition in place prior to 31 October 2011 is reinstated. This amendment is retrospective and does not disadvantage any person, thereby complying with the requirements of the Legislative Instruments Act 2003. As the changes are intended to restore the previous state of affairs, no consultation with stakeholders was deemed necessary.
Key Provisions
The main operative sections of the Health Insurance (General Medical Services Table) Amendment Regulations 2011 (No. 3) include Regulation 3, which amends the Health Insurance (General Medical Services Table) Regulations 2011, and Schedule 1, which details the specific amendments. Regulation 3 (3) reinstates the definition of 'general practitioner' that was in place until 31 October 2011, while Schedule 1, clause 1.1.1A (1) and clause 1.1.1A (2) ensure that the definition is correctly referenced throughout the Regulations. These changes were made to correct an oversight from the annual remaking of the Principal Regulations in October 2011.
The Act imposes several obligations and requirements on the parties it governs. Firstly, it mandates that Medicare benefits are calculated according to the fees for medical services outlined in prescribed tables, as specified in section 9 (9) of the Act. The Regulations ensure that the definition of 'general practitioner' is accurately reflected in these tables, thereby maintaining consistency in the application of Medicare benefits. Furthermore, the Regulations require that any amendments to the Principal Regulations are made in accordance with subsection 133(1) (133(1)) of the Act, ensuring that all changes are not inconsistent with the Act and are necessary or convenient for its effective implementation.
The Act outlines several consequences for breaches of its provisions. While the specific offences, penalties, or civil/criminal consequences are not detailed in the Explanatory Statement, the general legislative framework provides for potential enforcement actions. For instance, breaches of regulations made under the Act could lead to administrative penalties, fines, or other sanctions as prescribed by relevant laws. These could include civil penalties for non-compliance, which may vary depending on the severity and nature of the breach. Additionally, more serious violations might attract criminal penalties, with maximum fines and imprisonment terms stipulated under applicable statutes.
Overall, the Regulations aim to correct a previous oversight and ensure that the definition of 'general practitioner' is accurately and consistently applied across the relevant Medicare tables. By doing so, the Regulations support the proper administration of Medicare benefits and maintain the integrity of the healthcare system.