Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020

Administered by Department of Health, Disability and Ageing

Legislation au F2020L00748 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

Health Insurance Act 1973

 

Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020

Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may, by legislative instrument, determine that a health service not specified in an item in the general medical services table (the GMST) and the diagnostic imaging services table (the DIST) shall, in specified circumstances and for specified statutory provisions, be treated as if it were specified in one of these tables.

The GMST is set out in the regulations made under subsection 4(1) of the Act.

 

The DIST is set out in the regulations made under subsection 4AA(1) of the Act.

 

Subsection 33(3) of the Acts Interpretation Act 1901 provides that where an Act confers a power to make, grant or issue any instrument of a legislative or administrative character (including rules, regulations or by-laws), the power shall be construed as including a power exercisable in the like manner and subject to the like conditions (if any) to repeal, rescind, revoke, amend, or vary any such instrument.

 

Purpose

The purpose of the Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020 is to amend nine determinations made under subsection 3C(1) of the Act to increase the fees of the health services specified by 1.5 per cent. This reflects the Government’s policy regarding Medicare indexation and means that patients will receive a higher Medicare benefit for these services from 1 July 2020.

Consultation

In the 2017-18 Budget, the Government announced the re-commencement of indexation of Medicare benefits under the Guaranteeing Medicare - Medicare Benefits Schedule - indexation measure.

 

In the 2019-20 Budget, the Government announced that it would index ultrasound and x-ray diagnostic imaging services from 1 July 2020 under the Guaranteeing Medicare – improved patient access to diagnostic imaging measure.

 

This instrument will implement the Government’s policy regarding indexation by indexing the schedule fees of Medicare items which are listed in certain determinations made under subsection 3C(1) of the Act.

 

No consultation was undertaken on this instrument as it continues the business-as-usual implementation of the Government’s policy on Medicare indexation, which is expected by stakeholders to be applied on 1 July of each year. The complete list of all indexed fees is available in the Medicare Benefits Schedule xml data file which is available for anyone to download on MBS Online (www.mbsonline.gov.au).

 

Details of the Determination are set out in the Attachment.

 

The Determination commences on 1 July 2020.

 

The Determination is a 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 (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020

 

Section 1 – Name

 

Section 1 provides for the Determination to be referred to as the Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020.

 

Section 2 – Commencement

 

Section 2 provides that the Determination commences on 1 July 2020.

 

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 each instrument that is specified in a Schedule to this Determination is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Determination has effect according to its terms.

 

Schedule 1 – Amendments

 

The amendments in Schedule 1 index the schedule fee for items which are listed in the specified determinations.

 

 


Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

 

Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020

 

This 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 Determination

The purpose of the Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020 is to amend nine determinations made under subsection 3C(1) of the Act to increase the fees of the health services specified by 1.5 per cent. This reflects the Government’s policy regarding Medicare indexation and means that patients will receive a higher Medicare benefit for these services from 1 July 2020.

Human rights implications

This instrument 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 instrument furthers the right to health and the right to social security because it will increase the Medicare benefit for patients accessing these services. This will assist patients to continue accessing clinically relevant health services, consistent with the rights to health and social security.

Conclusion

This instrument is compatible with human rights.

 

Paul McBride

First Assistant Secretary

Medical Benefits Division

Health Financing Group

Department of Health

 

Overview

The Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020 amends the Health Insurance Act 1973 to increase the fees of certain health services by 1.5 per cent, reflecting the Government's policy regarding Medicare indexation. This means that from 1 July 2020, patients will receive a higher Medicare benefit for these services. The Determination was made under subsection 3C(1) of the Act and commenced on 1 July 2020. The amendments are detailed in Schedule 1 of the Determination. The instrument is compatible with human rights, specifically engaging Articles 9 and 12 of the International Covenant on Economic Social and Cultural Rights, as it furthers the right to health and the right to social security by increasing the Medicare benefit for patients accessing these services. The purpose of this Determination is to implement the Government's policy on Medicare indexation by amending nine determinations made under subsection 3C(1) of the Act. This policy was announced in the 2019-20 Budget and aims to index ultrasound and x-ray diagnostic imaging services from 1 July 2020. The complete list of all indexed fees is available in the Medicare Benefits Schedule xml data file on MBS Online. No consultation was undertaken on this instrument as it is a business-as-usual implementation of the Government's policy on Medicare indexation, which is expected by stakeholders to be applied on 1 July of each year.

Scope and Application

The Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020 applies to health services not explicitly listed in the general medical services table (GMST) and diagnostic imaging services table (DIST) under the Health Insurance Act 1973. This amendment allows for the Minister to determine that such services may be treated as if they were specified in these tables under particular circumstances. The Determination increases the fees of health services specified by 1.5 per cent, reflecting the government's policy on Medicare indexation. This policy ensures that patients receive a higher Medicare benefit for these services, effective from 1 July 2020. The Determination applies nationally across Australia, as it is a legislative instrument under the Health Insurance Act 1973, which operates under the Commonwealth jurisdiction. The Act itself does not explicitly mention exclusions or thresholds but allows for the Minister to specify the conditions under which certain services are indexed. The application of the Determination can be further extended or restricted through subordinate instruments, as provided under the Acts Interpretation Act 1901.

Key Provisions

The Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020 amends nine determinations under subsection 3C(1) of the Health Insurance Act 1973, increasing the fees for specified health services by 1.5%. This increase, effective from 1 July 2020, is intended to align with the Government's policy on Medicare indexation, thereby ensuring patients receive a higher Medicare benefit for these services. These amended fees are reflected in the general medical services table (GMST) and the diagnostic imaging services table (DIST), which are set out in the regulations under the Act. The Determination specifies the particular determinations to be amended and the extent of the fee increases. The Act imposes several obligations on parties and entities it governs. The Minister, under the authority provided by subsection 3C(1) of the Act, is tasked with making determinations that specify circumstances and statutory provisions under which certain health services not listed in the GMST or DIST are to be treated as if they were specified. This Determination amends previous determinations to reflect the increased fees, ensuring that the changes are implemented as per the Government's policy on Medicare indexation. Additionally, the Act requires that the amendments be consistent with the objectives of the Medicare Benefits Schedule (MBS) and that the changes are implemented in a timely manner to benefit patients from the increased benefits. For breaches or non-compliance with the provisions of the Determination, the Act does not specify particular offences or penalties. However, the Determination is a legislative instrument under the Legislation Act 2003, which means that failure to comply with the requirements of the Determination could result in civil or administrative consequences as prescribed by the relevant legislation. The Act does not explicitly state maximum penalties for breaches but implies that non-compliance could lead to actions that enforce the provisions or rectify the non-compliance, ensuring that the increased Medicare benefits are accurately applied to the specified health services.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.