EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health
Health Insurance Act 1973
Health Insurance Legislation Amendment (Group Numbers) Determination 2017
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may determine by legislative instrument that a health service not specified in an item in the General Medical Services Table (the GMST), the Pathology Services Table (the PST) or the Diagnostic Imaging Services Table (the DST) shall, in specified circumstances and for the purposes of specified statutory provisions, be treated as if it were specified in the GMST, the PST or the DST, as appropriate. The GMST is set out in the Health Insurance (General Medical Services Table) Regulations, the PST is set out in the Health Insurance (Pathology Services Table) Regulations and the DIST is set out in the Health Insurance (Diagnostic Imaging Services Table) Regulations. Each of these tables is repealed and re-made each year.
Purpose
The purpose of the Health Insurance Legislation Amendment (Group Numbers) Determination 2017 (the Determination) is to amend the Health Insurance (Midwife and Nurse Practitioner) Determination 2015 (the Midwife Determination) and the Health Insurance (Allied Health Services) Determination 2014 (the Allied Health Determination) to group all items specified in each Determination under the relevant group and subgroup, consistent with the Medicare Benefits Schedule (MBS). The MBS is a publically available listing of Medicare-eligible services.
The use of groups and subgroups is in keeping with the structure of the GMST, the PST and the DIST. These amendments will allow the relevant items to be referred to by group and subgroup where appropriate, rather than specifying individual item numbers.
Consultation
No consultation was undertaken for this amendment as it is a minor drafting change for the purpose of specifying groups and subgroups for each item in the Midwife Determination and the Allied Health Determination. This change is consistent with the structure of the GMST, the PST and the DIST and the MBS published on mbsonline.gov.au, which contains a list of all Medicare items categorised by group and subgroup.
Details of the Determination are set out in the Attachment.
The Determination commences on the day after it is registered on the Federal Register of Legislation.
The Determination is legislative instrument for the purposes of the
Legislation Act 2003.
Authority: Subsection 3C(1) of the
Health Insurance Act 1973
ATTACHMENT
Details of the Health Insurance Legislation Amendment (Group Numbers) Determination 2017
Section 1 – Name of Determination
Section 1 provides for the Determination to be referred to as the Health Insurance Legislation Amendment (Group Numbers) Determination 2017.
Section 2 – Commencement
Section 2 provides that the Determination commences on the day after it is registered on the Federal Register of Legislation.
Section 3 – Authority
Section 3 provides that the Determination is made under subsection 3C(1) of the Health Insurance Act 1973.
Section 4 – Schedules
Section 4 provides that the each instrument that is specified in a Schedule to the Determination is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to the Determination has effect according to its terms.
Schedule 1 – Midwifery services
Schedule 1 amends the Health Insurance (Midwife and Nurse Practitioner) Determination 2015 to specify groups and subgroups for midwifery Medicare items.
Schedule 2 – Nurse practitioner services
Schedule 2 amends the Health Insurance (Midwife and Nurse Practitioner) Determination 2015 to specify groups and subgroups for nurse practitioner Medicare items.
Schedule 3 – Allied health services
Schedule 3 amends the Health Insurance (Allied Health Services) Determination 2014 to specify groups and subgroups for allied health Medicare items.
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Health Insurance Legislation Amendment (Group Numbers) Determination 2017
This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.
Overview of the Legislative Instrument
The purpose of the Health Insurance Legislation Amendment (Group Numbers) Determination 2017 (the Determination) is to amend the Health Insurance (Midwife and Nurse Practitioner) Determination 2015 and the Health Insurance (Allied Health Services) Determination 2014 to group all items under the relevant group and subgroup to be consistent with the Medicare Benefits Schedule (MBS) and with the structure of the tables of services prescribed under the Health Insurance Act 1973.
Human rights implications
The Determination engages Articles 9 and 12 of the International Covenant on Economic Social and Cultural Rights (ICESCR), specifically the rights to health and social security.
The Right to Health
The right to the enjoyment of the highest attainable standard of physical and mental health is contained in Article 12(1) of the ICESCR. The UN Committee on Economic Social and Cultural Rights (the Committee) has stated that the right to health is not a right for each individual to be healthy, but is a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health.
The Committee reports that the ‘highest attainable standard of health’ takes into account the country’s available resources. This right may be understood as a right of access to a variety of public health and health care facilities, goods, services, programs, and conditions necessary for the realisation of the highest attainable standard of health.
The Right to Social Security
The right to social security is contained in Article 9 of the ICESCR. It requires that a country must, within its maximum available resources, ensure access to a social security scheme that provides a minimum essential level of benefits to all individuals and families that will enable them to acquire at least essential health care. Countries are obliged to demonstrate that every effort has been made to use all resources that are at their disposal in an effort to satisfy, as a matter of priority, this minimum obligation.
The Committee reports that there is a strong presumption that retrogressive measures taken in relation to the right to social security are prohibited under ICESCR. In this context, a retrogressive measure would be one taken without adequate justification that had the effect of reducing existing levels of social security benefits, or of denying benefits to persons or groups previously entitled to them. However, it is legitimate for a Government to re-direct its limited resources in ways that it considers to be more effective at meeting the general health needs of all society, particularly the needs of the more disadvantaged members of society.
Analysis
This Determination will maintain rights to health and social security as it does not affect existing access to publicly subsidised health services which are clinically effective and
cost-effective.
Conclusion
This Legislative Instrument is compatible with human rights as it has a positive effect on human rights issues.
Jack Quinane
Acting Assistant Secretary
Primary Care Analytics and Pathology Branch
Medical Benefits Division
Department of Health