Ref No.
AUSTRALIAN GOVERNMENT
DEPARTMENT OF HEALTH
HEALTH INSURANCE ACT 1973
Health Insurance (Medicare Benefit Payable in Respect of Professional Services—Murrumbidgee Local Health District) Direction 2020
I, Paul McBride, First Assistant Secretary, Medical Benefits Division, Health Resourcing Group, delegate for the Minister for Health, acting under subsection 19(2) of the Health Insurance Act 1973, hereby:
DIRECT that Medicare Benefits shall be payable in respect of:
(a) A professional service (as defined in Section 3 of the Health Insurance Act 1973) which has been agreed to be provided under the Memorandum of Understanding (MOU) between the Department of Health (ABN: 24 004 196 909) and the Murrumbidgee Local Health District (ABN: 71 172 428 618) (MLHD) in relation to the rural generalists innovative employment model trial within the Murrumbidgee region for which;
(i) items specified in Schedule A of this Direction; and
of the general medical services table (means the table prescribed under subsection 4(1) of the Health Insurance Act 1973), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Health Insurance Act 1973) and pathology services table (means the table prescribed under subsection 4A(1) of the Health Insurance Act 1973) relates: and
(b) Where the professional service is provided to:
(i) an eligible person (as defined in Section 3 of the Health Insurance Act 1973); and
(ii) a patient who is not receiving an episode of hospital treatment (as defined in Section 121-5 of the Private Health Insurance Act 2007); and
(c) the professional services referred to in clause (a):
(i) is professional attendance provided in a general practice (as defined in Section 7.1.1 of the general medical services table); and
(ii) is provided at an approved Modified Monash Model 4-7 (as defined in Section 7.1.1 of the general medical services table) practice location specified in Schedule B; and
(iii) is provided by a participating rural generalist trainee (as defined in the MOU mentioned in (a)):
- who is centrally employed, with a salary, by the MLHD for the provision of primary and acute care services: and
- is registered in the rural generalists innovative employment model trial within the Murrumbidgee region.
DECLARED that this Direction shall have effect from the date of signature until
31 December 2024 inclusive unless earlier revoked.
Date this 19th day of October 2020
Paul McBride
First Assistant Secretary
Medical Benefits Division
Health Resourcing Group
Department of Health
SCHEDULE A
MEDICARE BENEFITS SCHEDULE ITEMS AS AGREED IN THE MEMORANDUM OF UNDERSTANDING BETWEEN THE DEPARTMENT OF HEALTH AND THE MURRUMBIDGEE LOCAL HEALTH DISTRICT
For services listed in the below tables, all provisions of the Health Insurance Act 1973 (the Act) and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items apply.
General Medical Services Table
Group | Group Name | Subgroup | Subgroup Name |
A1 | General practitioner attendances to which no other item applies | ||
A2 | Other non-referred attendances to which no other item applies | ||
A5 | Prolonged attendances to which no other item applies | ||
A6 | Group therapy | ||
A7 | Acupuncture and non-specialist practitioner items | All |
|
A11 | Urgent attendances after-hours | ||
A14 | Health assessments | ||
A15 | GP Management plans, team care arrangements and multidisciplinary care plans and case | 1 | GP Management plans, team care arrangements and multidisciplinary care plans |
2 | Case conferences | ||
A17 | Domiciliary and residential medication management reviews | ||
A18 | Attendances associated with Practice Incentive Program payments | All |
|
A19 | Attendances associated with Practice Incentive Program payments | All |
|
A20 | Mental health Care | All |
|
A22 | General practitioner after-hours attendances to which no other item applies | ||
A23 | Other non-referred after-hour attendances to which no other item applies | ||
A27 | Pregnancy support counselling | ||
A29 | Early intervention services for children with autism, pervasive development disorder or disability | ||
A30 | Medical practitioner video conferencing consultation | 1 | Video conferencing consultation attendance at consulting rooms, home visit of other institution |
2 | Video conferencing consultation attendance at a residential aged care facility | ||
3 | Mental health and well-being video conferencing consultation | ||
5 | General practitioner video conferencing consultation attendance for patients in rural and remote areas | ||
6 | Other non-referred video conferencing consultation attendance for patients in rural and remote areas | ||
7 | Non-specialist practitioner video conferencing consultation for patients in rural and remote areas | ||
A35 | Non-referred attendance at a residential aged care facility | ||
A36 | Eating Disorder Services | 1 | GP and Medical Practitioner eating disorder treatment and management plans |
3 | Review of eating disorder treatment and management plan | ||
4 | GP and medical practitioner eating disorder s psychological treatment services | ||
A39 | Bushfire Recovery Access Initiative – GP and Medical Practitioner Focussed Psychological Strategies | ||
A40 | COVID-19 Services | 1 | COVID-19 general practice - telehealth services |
2 | COVID-19 general practice - phone services | ||
3 | COVID-19 Focussed psychological strategies - telehealth services | ||
10 | COVID-19 Focussed psychological strategies - phone services | ||
11 | Health assessments for Aboriginal and Torres Strait Islander People - telehealth services | ||
12 | Health assessments for Aboriginal and Torres Strait Islander People - phone Services | ||
13 | GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance | ||
14 | GP management plans, team care arrangements and multidisciplinary care plans via phone attendance | ||
15 | GP pregnancy support counselling - telehealth services | ||
16 | GP pregnancy support counselling - phone services | ||
17 | GP, Specialist and Consultant Physician autism service - telehealth services | ||
18 | GP, Specialist and Consultant Physician autism service - phone services | ||
19 | GP mental health treatment plan - telehealth services | ||
20 | GP mental health treatment plan - phone services | ||
21 | GP Eating Disorder Treatment and Management Plan – telehealth services | ||
22 | GP Eating Disorder Treatment and Management Plans - phone services | ||
25 | Review of an eating disorder Plan - telehealth services | ||
26 | Review of an Eating Disorder Plan – phone services | ||
27 | GP - Eating Disorder Focussed Psychological Strategies – telehealth services | ||
28 | GP - Eating Disorder Focussed Psychological Strategies – phone services | ||
29 | GP and Other Medical Practitioner - urgent after hours service in unsociable hours - telehealth services | ||
30 | GP and Other Medical Practitioner - urgent after hours service in unsociable hours - phone services | ||
M1 | Management of bulk billed services | ||
M12 | Services provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner | 1 | Video conferencing consultation support service provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner |
2 | Video conferencing consultation support service provided at a residential aged care facility on behalf of a medical practitioner | ||
3 | Services provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner | ||
D1 | Miscellaneous diagnostic procedures and investigations | 2 | Ophthalmology |
3 | Otolaryngology | ||
4 | Respiratory | ||
5 | Vascular | ||
6 | Cardiovascular | ||
8 | Genito-urinary physiological investigations | ||
9 | Allergy testing | ||
10 | Other diagnostic procedures and investigations | ||
D2 | Nuclear Medicine (non-imaging) | ||
T1 | Miscellaneous therapeutic procedures | 2 | Dialysis |
4 | Paediatric and neonatal | ||
5 | Cardiovascular | ||
8 | Haematology | ||
9 | Procedures associated with intensive care and cardiopulmonary support | ||
11 | Chemotherapeutic procedures | ||
13 | Miscellaneous therapeutic procedures | ||
T2 | Radiation oncology | 1 | Superficial |
T3 | Therapeutic nuclear medicine | ||
T4 | Obstetrics | ||
T6 | Examination by anaesthetist | ||
T7 | Regional or field nerve blocks | ||
T8 | Surgical Operations | 1 | General |
2 | Colorectal | ||
3 | Vascular | ||
4 | Ear, nose and throat | ||
5 | Urological | ||
6 | Cardio-thoracic | ||
7 | Neurosurgical | ||
8 | Ear, nose and throat | ||
9 | Ophthalmology | ||
11 | Paediatric | ||
12 | Amputations | ||
13 | Plastic and reconstructive surgery | ||
14 | Hand surgery | ||
15 | Orthopaedic | ||
T9 | Assistance at operations | ||
T10 | Anaesthesia performed in connect with certain services (relative value guide) | All
|
|
Diagnostic Imaging Services Table
Group | Group Name | Subgroup | Subgroup Name |
I1 | Ultrasound | 6 | Musculoskeletal ultrasound |
I3
| Diagnostic Radiology
| 1 | Radiographic examination of extremities |
2 | Radiographic examination of shoulder or pelvis | ||
3 | Radiographic examination of head | ||
4 | Radiographic examination of spine | ||
5 | Cardiovascular | ||
6 | Radiographic examination of thoracic region | ||
7 | Radiographic examination of urinary tract | ||
8 | Radiographic examination of alimentary tract and biliary system | ||
12 | Radiographic examination with opaque or contrast media | ||
I6 | Management of bulk billed Services | ||
Pathology Services Table
Group | Group Name |
P1 | Haematology |
P2 | Chemical |
P9 | Simple Basic Pathology Tests |
P12 | Management of bulk billed services |
SCHEDULE B
Approved Modified Monash 4-7 Practice Locations AS AGREED IN THE MEMORANDUM OF UNDERSTANDING BETWEEN THE DEPARTMENT OF HEALTH AND THE MURRUMBIDGEE LOCAL HEALTH DISTRICT
Approved primary care Modified Monash Model (MMM) 4 locations:
MMM 4 location | Practice Name | Street Address | Mailing Address |
Young | Young District Medical Centre | 16 Cloete Street Young | 16 Cloete Street Young |
Cootamundra | Cootamundra Medical Centre | 44 Cooper Street Cootamundra | 44 Cooper Street Cootamundra |
Deniliquin | Deniliquin Clinic | 409 George Street Deniliquin | 409 George Street Deniliquin |
Approved primary care Modified Monash Model (MMM) 5 locations:
MMM 5 location | Practice Name | Street Address | Mailing Address |
Gundagai | Gundagai Medical Centre | 95 Sheridan Street Gundagai | 95 Sheridan Street Gundagai |
Temora | Temora Medical Centre | 296-298 Hoskins Street Temora | 296-298 Hoskins Street Temora |
Narrandera | Narrandera Medical Centre | Victoria Square Narrandera | Victoria Square Narrandera |
Note: The name of this instrument was amended on registration as the instrument as lodged did not have a unique name (see subsection 10(2), Legislation Rule 2016).