Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Charleville and Western Areas Aboriginal and Torres Strait Islanders Community Health – Medical Services performed under the Single Employer Model Trial) Direction 2026

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Charleville and Western Areas Aboriginal and Torres Strait Islanders Community Health – Medical Services performed under the Single Employer Model Trial) Direction 2026

I, Steve Dunlop, delegate for the Minister for Health and Ageing, make the following Notifiable Instrument.

Dated         15 January 2026

Steve Dunlop

Acting Assistant Secretary
MBS Policy and Specialist Services Branch
Medicare Benefits and Digital Health Division
Health Resourcing Group

Department of Health, Disability and Ageing

Contents

1  Name

2  Commencement

3  Authority

4  Repeals

5  Definitions

6  Medicare benefits payable in respect of the Single Employer Model Trial

Schedule 1—Relevant services

Schedule 2—Approved clinic locations

1  Name

  This instrument is the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Charleville and Western Areas Aboriginal and Torres Strait Islanders Community Health – Medical Services performed under the Single Employer Model Trial) Direction 2026.

2  Commencement

1.     Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Note:  This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

1.     Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3  Authority

  This instrument is made under subsection 19(2) of the Health Insurance Act 1973.

4  Repeals

This instrument is repealed on 30 June 2028 at 11:59pm, unless repealed earlier.

5  Definitions

diagnostic imaging services table means the table prescribed under section 4AA of the HI Act.

eligible area has the meaning given by Part 7.1.1 of the Health Insurance (General Medical Services Table) Regulations 2021.

eligible person has the meaning given by subsection 3(1) of the HI Act.

general medical services table means the table prescribed under section 4 of the HI Act.

general practice has the meaning given by Part 7.1.1 of the Health Insurance (General Medical Services Table) Regulations 2021.

general practitioner has the meaning given by subsection 3(1) of the HI Act.

HI Act means the Health Insurance Act 1973.

hospital treatment has the meaning given by section 121‑5 of the Private Health Insurance Act 2007.

MBS means the Medicare Benefits Schedule.

MMM means the Modified Monash Model.

pathology services table means the table prescribed under section 4A of the HI Act.

professional service has the meaning given by subsection 3(1) of the HI Act.

prescribed medical practitioner has the meaning given by Part 7.1.1 of the Health Insurance (General Medical Services Table) Regulations 2021.

6  Medicare benefits payable in respect of the Single Employer Model Trial

A Medicare benefit shall be payable in respect of a professional service where the following are met.

1.    The professional service has been agreed to be provided under the First Nations led Single Employer Model Trial as per the Commonwealth Standard Grant Agreement between the Department of Health, Disability and Ageing (ABN: 83 605 426 759) and the Queensland Aboriginal and Islander Health Council (ABN: 97 111 116 762) and under the subcontracting arrangement between the Queensland Aboriginal and Islander Health Council and Charleville and Western Areas Aboriginal and Torres Strait Islanders Community Health (ABN: 84 826 588 748).
2.    The professional service is provided to the following:

1.     an eligible person;
2.   a patient who is not receiving the service as part of an episode of hospital treatment;
3.    a patient who also is not receiving a service which attracts a payment:

1. through Schedule K – Addendum to the National Health Reform Agreement: Revised Public Hospital Funding and Health Reform Arrangements (dated 2025) for a service rendered to a public patient; or
2. through another government arrangement outside of the Single Employer Model Trial for the professional service rendered to the patient.

1.    The professional service corresponds with an MBS group, subgroup or item specified in Schedule 1.

1.    The professional service referred to in paragraph (a) must be provided:
   1.     at a general practice; and
   2.   at a rural or remote location specified in Schedule 2; and
   3.  by a participating rural generalist or rural general practice trainee participating in the Single Employer Model Trial, who is employed by Charleville and Western Areas Aboriginal and Torres Strait Islanders Community Health for the provision of primary and acute care services, and who is formally enrolled in a fellowship training program that meets the standards of:

(A) the Australian College of Rural and Remote Medicine; and/or

(B) the Royal Australian College of General Practitioners.

Schedule 1—Relevant services

1.1 General Medical Services Table

For services listed in the below tables, all provisions of the HI Act and regulations made under the HI 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.

1.2 Non-Standard Primary Care Services Table

For services listed in the below table, this list of items includes MBS items that are not commonly claimed by doctors in primary care. Medical practitioners and health services must ensure they fulfil the MBS requirements for these items.

1.3 Diagnostic Imaging Services Table

1.4 Pathology Services Table

Schedule 2—Approved clinic locations