Explanatory Statement

Health Insurance Act 1973

Health Insurance (Indium-labelled Octreotide Study) Determination HS/09/2006

Issued by the authority of the Minister for Health and Ageing

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 2006 which are 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).

• Health Insurance (Indium-labelled Octreotide Study) Determination HS/03/2004

On 27 April 2004, the then Minister for Health and Aged Care made Health Insurance Determination HS/03/2004 (the Current Determination) under subsection 3C(1) of the Act.  The Current Determination permits the payment of Medicare benefit in relation to the Indium-labelled Octreotide Study service specified in the Schedule to the Current Determination.

The Current Determination provides that the Indium-labelled Octreotide Study service specified in the Schedule to the Current Determination is to be treated as if it were listed in the Table, for the purposes of the statutory provisions specified in section 5 of the Current Determination.  The statutory provisions specified in section 5 of the Current Determination are those contained in the Act, the National Health Act 1953 and the regulations made under each Act which relate to professional services and medical services generally.

Health Insurance (Amendment) Determination HS/10/2004, effective 1 November 2004, amended the Current Determination to increase the fee in respect of the Indium-labelled Octreotide Study service specified in the Schedule to the Current Determination to be in line with the general fee increase that was being applied to nuclear medicine services in the Table.

• Health Insurance (Indium-labelled Octreotide Study) Determination HS/09/2006

Health Insurance (Indium-labelled Octreotide Study) Determination HS/09/2006 (the Determination) remakes the Current Determination.

The Determination clarifies that rule 27 of Schedule 1, Part 2 of the Health Insurance (Diagnostic Imaging Services Table) Regulations 2006 applies to the service covered by the Determination.

In addition, the Determination provides for an increase of 1 percent in the fee in respect of the service covered by the Determination compared to the fee in respect of the same service in the Current Determination, as amended.  This fee increase is in line with the 1 percent fee increase that is being applied to nuclear medicine services in the Table from 1 November 2006.

Details of the Determination are set out in the Attachment.

Consultation

No consultation was undertaken in the making of the Determination as the instrument is machinery in nature and does not substantially alter existing arrangements.

ATTACHMENT

Notes on sections

Section 1

Section 1 provides for the name of the Determination.

Section 2

This section provides that the Determination is to commence on 1 November 2006. 

Section 3

Section 3 provides that the Determination revokes Health Insurance Determination HS/03/2004.

Section 4

Subsection 4(1) defines terms used in the Determination.

A key term is 'relevant service' which means a service defined in paragraph 3C(8) of the Act which is specified in the Schedule of the Determination.  There is one such relevant service in the Schedule.

Subsection 4(2) provides that a reference to a provision of an Act or regulations, including the Act, the National Health Act 1953 and the regulations made under these Acts, is a reference to  the provision as in force from time to time (as authorised by subsection 3C(3) of the Act).

Section 5

Paragraph 5(a) provides that the relevant service specified in the Schedule to the Determination shall be treated as if it were both a professional service and a medical service for the purposes of the provisions of the Act, the National Health Act 1953 and regulations made under each Act that make provision for medical services or professional services.

Paragraph 5(b) provides that the relevant service shall be treated as if there were an item in the diagnostic imaging services table that related to the service and specified a fee in respect of that service, being the fee specified in the Schedule to the Determination in relation to the service.

Paragraph 5(c) provides that rule 27 of the Health Insurance (Diagnostic Imaging Services Table) Regulations 2006 applies to the relevant service.

Schedule

The Schedule sets out the relevant service and assigns the applicable item number, item descriptor and fee.