EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health and Ageing
Health Insurance Act 1973
Health Insurance (Indium-labelled Octreotide Study) Determination 2010
Background
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may, by writing, determine 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 is remade each year.
A determination made under subsection 3C(1) is a legislative instrument (see subsection 3C(4) of the Act and paragraph 6(d) of the Legislative Instruments Act 2003).
In 1999, the Medical Services Advisory Committee (MSAC) undertook a review of Indium-labelled Octreotide Scintigraphy, a diagnostic service used to determine gastro-entero-pancreatic endocrine tumours. MSAC recommended and the Minister for Health and Aged Care approved, public funding for the Indium-labelled Octreotide Study service. Funding for the service was initially introduced under Health Insurance Determination HS/3/1999 due to the high cost of the service and the need to maximise scope to control use of the service should inappropriate billing become apparent. The Medicare fee for the Indium-labelled Octreotide Study service specified in the Health Insurance Determination HS/3/1999 was subsequently revised by the Health Insurance Determination HS/4/2001 and Health Insurance Determination HS/8/2002, in line with general indexations of nuclear medicine imaging items in November 2001 and November 2002 respectively.
The Health Insurance (Indium-labelled Octreotide Study) Determination HS/03/2004 (the 2004 Determination) revoked and replaced the above 3C Determinations. This was done to simplify and update the arrangements for the funding of Indium-labelled Octreotide Study; and to revise the Medicare fee in respect of the service specified in the 2004 Determination to ensure that it was consistent with the fee indexation of all nuclear medicine items in the Health Insurance (Diagnostic Imaging Services Table) Regulations 2004. The Health Insurance (Indium-labelled Octreotide Study) Determination HS/09/2006 (the 2006 Determination) revoked and replaced the 2004 Determination for similar reasons.
The Health Insurance (Indium-labelled Octreotide Study) Determination 2010 revokes the 2006 Determination because the service specified in the 2006 Determination is added to the Table from 1 July 2010. The service is added to the Table because it is no longer necessary to monitor and evaluate the volume of the service and cost to the Medicare outlays. The addition of the Indium-labelled Octreotide Study service to the Table will also ensure that the service is managed in the same way as all other Medicare eligible nuclear medicine services from 1 July 2010.
Consultation
No consultation was undertaken in the making of this Determination as the instrument is machinery in nature and does not substantially alter existing arrangements.
Details of the Determination are set out in the Attachment.
This Determination commence on 1 July 2010.
ATTACHMENT
DETAILS OF THE HEALTH INSURANCE (INDIUM-LABELLED OCTREOTIDE STUDY) DETERMINATION 2010
Section 1 Name of Determination
Section 1 provides that the name of the Determination is the Health Insurance (Indium-labelled Octreotide Study) Determination 2010.
Section 2 Commencement
Section 2 provides that the Determination commences on 1 July 2010.
Section 3 Revocation
Section 3 provides that the Determination revokes the Health Insurance (Indium-labelled Octreotide Study) Determination HS/09/2006.