Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Amendment Determination (No. 2) 2011

Administered by Department of Health, Disability and Ageing

Legislation au F2011L02757 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

Issued by the Authority of the Minister for Health and Ageing

 

Health Insurance Act 1973

Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Amendment Determination (No.2) 2011

 

Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides, in part, that the Minister may determine in writing that a health service not listed in the Diagnostic Imaging Services Table (the Table) shall, in specified circumstances and for specified statutory provisions, be treated as if it were so listed.  The Table is set out in the Health Insurance (Diagnostic Imaging Services Table) Regulations which are remade each year.  

 

The purpose of this amending determination is to amend the Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI) Service Determination 2009 (the Determination) to enable Medicare-eligible Magnetic Resonance Imaging (MRI) services to continue under the Determination after 31 December 2011. It also requires Regional Imaging Pty Limited (RIL) to provide these services to patients in accordance with a new funding agreement.  Both the Determination and funding agreement will now cease on 30 June 2013

 

The Determination  and the Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Amendment Determination 2011 enabled patients in Gippsland and South Eastern NSW to have access to Medicare-eligible MRI services while a new funding agreement was being negotiated.  Regional Imaging Pty Limited and the Commonwealth as represented by the Department of Health Ageing have now negotiated a new funding agreement which has been signed by both parties.

 

A determination made under subsection 3C(1) of the Act is a legislative instrument for the purposes of the Legislative Instruments Act 2003.

 

Details of the Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service Amendment Determination (No. 2) 2011 (the Amending Determination) are set out in the Attachment.

 

This Amending Determination incorporates the funding agreement between the Department of Health and Ageing and Regional Imaging Pty Limited as in force on 1 January 2012. It also incorporates the Health Insurance (Diagnostic Imaging Services Table) Regulations which are remade every year.

 

 

Consultation

 

The Department of Health and Ageing has consulted with Regional Imaging Pty Limited about the continuation of the mobile MRI service.  No consultation was undertaken in the making of the Amending Determination as the instrument is machinery in nature and does not substantially alter existing arrangements.

 

The Amending Determination commences on 31 December 2011 and ceases to have effect at the end of 30 June 2013.

 

 

DIAGNOSTIC SERVICES BRANCH

DEPARTMENT OF HEALTH AND AGEING

November 2011

 


ATTACHMENT

DETAILS OF THE HEALTH INSURANCE (GIPPSLAND AND SOUTH EASTERN NEW SOUTH WALES MOBILE MRI SERVICE) AMENDMENT DETERMINATION (No.2) 2011

Section 1  Name of Determination

This section provides that the name of the Amending Determination is the Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Amending Determination (No.2) 2011.

 

Section 2  Commencement

This section provides that the Amending Determination commences on 31 December 2011. 

 

Section 3 Amendment of the Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Determination 2009

This section provides that the Schedule of the Amending Determination amends the Determination.

 

Schedule  Amendments

 

Item 1 deletes the previous date of cessation and inserts a new date of cessation

Item 2 inserts a definition of ‘diagnostic imaging services table.’  This is a minor technical amendment which streamlines the definitions used in the Determination.

Item 3 deletes the definition of ‘eligible equipment.’ This definition is no longer required as there is a new funding agreement with Regional Imaging Pty Limited and the Department of Health and Ageing.

Item 4 deletes the definition of ‘eligible location.’ This definition is no longer required as there is a new funding agreement with Regional Imaging Pty Limited and the Department of Health and Ageing.

Item 5 inserts a definition of ‘funding agreement.’ Paragraph 5(1)(b) now requires the services to be performed in accordance with the new funding agreement.

Item 6 deletes paragraph 4(2)(d) which states that a reference to the Health Insurance (Diagnostic Imaging Services Table) Regulations is a reference to regulations made under the Health Insurance Act 1973. This is no longer required as paragraph 4(2)(c) makes it clear that any legislation (and this would include regulations) such as the Health Insurance (Diagnostic Imaging Services Table) Regulations shall be interpreted as a reference to legislation that is in force from time to time.

Item 7 inserts a requirement for the services to be performed in accordance with the new funding agreement.

Item 8  inserts a reference to ‘diagnostic imaging services table.’ It also refers to Part 2 of the diagnostic imaging services table. These are minor technical amendments which streamline terms used in the Determination.

Item 9 inserts a reference to ‘diagnostic imaging services table.’ It also refers to Part 2 of the diagnostic imaging services table. These are minor technical amendments which streamline terms used in the Determination.

Item 10  inserts a reference to ‘diagnostic imaging services table.’ It also refers to Part 2 of the diagnostic imaging services table. These are minor technical amendments which streamline terms used in the Determination.

Item 11 inserts a reference to ‘diagnostic imaging services table.’ It also refers to Part 2 of the diagnostic imaging services table. These are minor technical amendments which streamline terms used in the Determination.

Item 12 inserts a reference to ‘diagnostic imaging services table.’ It also refers to Part 2 of the diagnostic imaging services table. These are minor technical amendments which streamline terms used in the Determination.

 

 

 

 

Overview

The Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Amendment Determination (No.2) 2011, enacted by the Commonwealth of Australia, was introduced to address a gap in the availability of Medicare-eligible Magnetic Resonance Imaging (MRI) services in the Gippsland and South Eastern New South Wales regions. This legislation amends the Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Determination 2009 to allow for the continuation of these services beyond their original cessation date of 31 December 2011, and until 30 June 2013. The objective of this determination is to facilitate the negotiation of a new funding agreement between Regional Imaging Pty Limited and the Commonwealth, represented by the Department of Health and Ageing, thereby ensuring that patients in these regions have continued access to essential diagnostic imaging services. The determination is a legislative instrument under the Legislative Instruments Act 2003 and it incorporates the new funding agreement between the Department and Regional Imaging Pty Limited.

Scope and Application

The Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Amendment Determination (No.2) 2011, issued under the Health Insurance Act 1973, extends the availability of Medicare-eligible Magnetic Resonance Imaging (MRI) services in Gippsland and South Eastern New South Wales by Regional Imaging Pty Limited until 30 June 2013. The Act applies to the specified persons and entities involved in the provision of these services, primarily Regional Imaging Pty Limited and the Commonwealth as represented by the Department of Health and Ageing. The jurisdictional reach of this amendment is national, reflecting the Commonwealth's legislative power over health insurance. The determination incorporates the new funding agreement between the Department of Health and Ageing and Regional Imaging Pty Limited, which supersedes the previous arrangements under the Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Determination 2009. The amendments primarily serve to update the terms of the service provision and the cessation date, ensuring continuity of service while the new agreement is in effect. This instrument does not introduce new substantive changes but rather technical amendments to align the Determination with the new funding agreement and regulatory requirements.

Key Provisions

The Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Amendment Determination (No.2) 2011 (the Amending Determination) amends the Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service) Determination 2009 (the Determination). It achieves this by extending the cessation date of the Determination from 31 December 2011 to 30 June 2013, thereby allowing the provision of Medicare-eligible Magnetic Resonance Imaging (MRI) services to continue until the later date (Section 1 and Schedule Item 1). The Amending Determination also streamlines the definitions used in the Determination by inserting a definition of ‘diagnostic imaging services table’ and removing the definitions of ‘eligible equipment’ and ‘eligible location’ (Schedule Items 2, 3 and 4). Additionally, it introduces a definition of ‘funding agreement’ and requires the services to be performed in accordance with the new funding agreement between Regional Imaging Pty Limited and the Department of Health and Ageing (Schedule Items 5 and 7). The Amending Determination also makes minor technical amendments to streamline terms used in the Determination (Schedule Items 6 to 12). The Amending Determination imposes obligations on Regional Imaging Pty Limited to provide MRI services to patients in Gippsland and South Eastern New South Wales in accordance with the new funding agreement. The new funding agreement is incorporated into the Amending Determination and sets out the terms and conditions under which Regional Imaging Pty Limited will provide the services. This includes requirements such as the provision of timely and accurate reports, the maintenance of equipment, and the adherence to relevant standards and guidelines. Additionally, the Amending Determination requires Regional Imaging Pty Limited to comply with any relevant legislation, including the Health Insurance Act 1973 and the Health Insurance (Diagnostic Imaging Services Table) Regulations. There are no specific offences, penalties, or civil/criminal consequences outlined in the Amending Determination. However, failure to comply with the obligations and requirements imposed by the Determination and the funding agreement may result in consequences under other relevant legislation or contractual agreements. For example, if Regional Imaging Pty Limited fails to provide services in accordance with the funding agreement, the Commonwealth may have the right to terminate the agreement and seek damages. Additionally, failure to comply with the Health Insurance Act 1973 or the Health Insurance (Diagnostic Imaging Services Table) Regulations may result in penalties or other consequences under those Acts.

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