Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales Direction 2022 - Legislation

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales Direction 2022

I, Nigel Murray, Assistant Secretary, MBS Policy and Specialist Services Branch,

Medical Benefits Division, Health Resourcing Group, delegate for the Minister for Health, acting under subsection 19(2) of the Health Insurance Act 1973, hereby:

(1) REVOKE the Direction made under subsection 19(2) of the Act that was granted on
16 December 2021, that Medicare benefits shall be payable in respect of professional services provided by health services in New South Wales that are a part of the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative, as described in the Memorandum of Understanding between the Australian Government and New South Wales dated 13 December 2016; and

(2) 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 New South Wales (ABN: 92 697 899 630) 13 May 2022 as part of the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative relating to primary care services 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 profession 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 part of an episode of hospital treatment (as defined in Section 121-5 of the Private Health Insurance Act 2007); and

(i) is provided at an approved Modified Monash Model 5-7 area (as defined in Section 7.1.1 of the general medical services table) practice location specified in Schedule B; and

is a professional non-referred service provided by a state remunerated medical practitioner, participating midwife, or participating nurse practitioner; or
is a professional referred service provided by a state remunerated allied health and dental health practitioner; and

DECLARED that this Direction shall have effect from the date of signature until
30 July 2025 inclusive unless earlier revoked.

Date this 29th day of June 2022

Nigel Murray

Assistant Secretary

MBS Policy and Specialist Services Branch

Medical Benefits Division

Health Resourcing Group

Department of Health

SCHEDULE A

MEDICARE BENEFITS SCHEDULE ITEMS AS Approved Practice Locations AS AGREED under the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South wales

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
A9	Contact lenses – attendances
A10	Optometrical attendances
A11	Urgent attendance after hours
A14	Health assessments
A15	GP management plans, team care arrangements, multidisciplinary care plans
A17	Domiciliary and residential management plans
A18	General Practitioner attendance associated with PIP incentive payments to which no other item applies
A19	Other non-referred attendances associated with PIP incentive payments to which no other item applies
A20	General Practitioner mental health treatment
A22	General Practitioner after-hours attendances to which no other item applies
A23	Other non-referred after-hours attendances to which no other item applies
A27	Pregnancy support counselling
A30	Medical practitioner (including General Practitioner, specialist or consultant physician) telehealth attendances*
A35	Services for patients in Residential Aged Care Facilities
A40	Telehealth and phone services	1	General practice telehealth services
		2	General practice phone services
		3	Focussed psychological strategies telehealth services
		10	Focussed psychological strategies phone services
		11	Health assessments for Aboriginal and Torres Strait Islander People - telehealth services
		13	GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance
		15	GP pregnancy support counselling telehealth services
		16	GP pregnancy support counselling phone services
		17	GP, Specialist and Consultant Physician Autism Service Telehealth Service
		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
		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
		39	GP and Other Medical Practitioner - urgent after hours service in unsociable hours phone services
		40	GP Blood borne viruses, sexual or reproductive health consultation telehealth service
A41	Additional focussed psychological strategies
A42	Mental health planning for care recipients of a residential aged care facility
A43	Care recipient of a Residential Aged Care Facility planning and contribution items
A45	Nicotine and Smoking Cessation Counselling
M1	Management of bulk-billed services
M3	Allied Health services
M6	Psychological therapy services
M7	Focussed psychological strategies
M8	Pregnancy support counselling
M9	Allied Health group services
M10	Autism, pervasive developmental disorder and disability services
M11	Allied Health services for Indigenous Australians who have had a health check
M12	Services provided by a Practice Nurse or Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner
M14	Nurse Practitioners
M15	Diagnostic audiology services
M16	Eating Disorder services
M18	Allied health telehealth services	1	Psychological therapies telehealth services
		2	Psychologist focussed psychological strategies telehealth services
		3	Occupational therapist focussed psychological strategies telehealth services
		4	Social worker focussed psychological strategies telehealth services
		5	Nurse practitioner telehealth services
		6	Psychological therapies phone services
		7	Psychologist focussed psychological strategies phone service
		8	Occupational therapist focussed psychological strategies phone services
		9	Social worker focussed psychological strategies phone services
		10	Nurse practitioner phone services
		11	General allied health telehealth services
		12	General allied health phone services
		13	Pregnancy support counselling telehealth services
		14	Pregnancy support counselling phone services
		15	Autism, pervasive developmental disorder and disability telehealth services
		16	Autism, pervasive developmental disorder and disability phone services
		17	Telehealth attendance to person of Aboriginal and Torres Strait Islander descent
		18	Phone attendance to person of Aboriginal and Torres Strait Islander descent
		23	COVID-19 Follow up service provided by a practice nurse or Aboriginal and Torres Strait Islander health practitioner – Telehealth Services
		25	COVID-19 Allied health, group dietetics telehealth services
		26	COVID-19 Allied health, group dietetics phone
M25	Additional psychological therapy services
M26	Additional focussed psychological strategies (allied mental health)
M27	Initial psychological therapy services
M28	Initial focussed psychological strategies (allied mental health)
M29	Additional allied health services
M30	Allied health services for Indigenous Australians in RACF
M31	Allied health group services in RACF
D1	Miscellaneous diagnostic procedures and investigations	1	Neurology
		2	Ophthalmology
		5	Vascular
		7	Gastroenterology and colorectal
		8	Genito/urinary physiological investigations
D2	Nuclear medicine (non-imaging)
T1	Miscellaneous therapeutic procedures	6	Gastroenterology

* Note: Claims under any item Group A30 in the General Medical Services Table may only be exempt from Subsection 19(2) of the HIA 1973 when the services are claimed by a General Practitioner.

General Medical Services Table – permitted items

Group	Group Name	Items	Item overview
A29	Early intervention services for children with autism, pervasive developmental disorder or disability	139	Professional attendance by a general practitioner for assessment, diagnosis and preparation of a treatment and management plan for a patient with an eligible disability.
A36	Eating disorder services	90250-90257, 90264, 90265, 90271-90282	Eating disorder services provided by General Practitioners or Medical Practitioners
A40	COVID-19 services	92170, 92171, 92176, 92177	General Practitioner and Other Medical Practitioner items
A44	General Practice attendance for assessing patient suitability for a COVID-19 vaccine	93625, 93627, 93635, 93637, 93645, 93647, 93654, 93656, 93661, 93666, 10660, 10661	General Practice Attendance for Assessing Patient Suitability for a COVID-19 Vaccine
D1	Miscellaneous diagnostic procedures and investigations	11300-11318, 11330, 11333-11339, 11503-11507, 11512, 11707, 12000-12004, 12012-12024, 12200, 12306-12326	Non-referred services only
M13	Midwifery services	82100-82115, 82130-82152	Midwifery items
T1	Miscellaneous therapeutic procedures	13105-13110	Haemodialysis provided by a registered nurse, Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner in a very remote location.
T4	Obstetrics	16400, 16406-16500, 16502-16591, 91850, 91855, 91851, 91856, 91852, 91857, 91853, 91858, 91855	Antenatal and postnatal attendances
T8	Surgical operations	30001-30006, 30010, 30023, 30026-30055, 30061-30072, 30187, 30189, 30192-30219, 47015, 47042, 47057, 47069, 47301, 47348, 47354, 47361, 47387, 47423, 47444, 47453, 47462, 47466. 47471, 47543, 47561, 47579, 47595, 47663, 47735, 47904-47918	Minor surgical procedures
O1	Consultations	51700- 51703, 54001-54004	Dental practitioner attendances

Diagnostic Imaging Services Table

Group	Group Name
I1	Ultrasound
I3	Diagnostic radiology
I6	Management of bulk-billed services

Pathology Services Table

Group	Group Name
P9	Simple basic pathology tests
P12	Management of bulk-billed services
P13	Bulk-billing incentive

SCHEDULE B

Approved Practice Locations AS AGREED under the Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales

Approved locations:

Location	Practice Name	Street Address	Mailing Address
Balranald	Balranald Multi Purpose Service	41-43 Court Street Balranald NSW 2715	41-43 Court Street BALRANALD NSW 2715
Barham	Barham Multi-Purpose Service	80 Punt Road Barham NSW 2732	80 Punt Road BARHAM NSW 2732
Batlow	Batlow-Adelong Multi-Purpose Service	61-81 Pioneer Street Batlow NSW 2730	61-81 Pioneer Street BATLOW NSW 2730
Berrigan	Berrigan Health Service	47-49 Davis Street Berrigan NSW 2712	47-49 Davis Street BERRIGAN NSW 2712
Bingara	Bingara Multipurpose Service	Copeton Dam Road Bingara NSW 2404	Copeton Dam Road BINGARA NSW 2404
Blayney	Blayney Health Service	3 Osman Street Blayney NSW 2799	3 Osman Street BLAYNEY NSW 2799
Boorowa	Boorowa Multipurpose Service	62-80 Dry Street Boorowa NSW 2586	62-80 Dry Street BOOROWA NSW 2586
Coolamon	Coolamon-Ganmain Multipurpose Service	1 Doctor Buchanan Drive Coolamon NSW 2701	1 Doctor Buchanan Drive COOLAMON NSW 2701
Culcairn	Culcairn Multipurpose Service	51-55 Balfour Street Culcairn NSW 2660	51-55 Balfour Street CULCAIRN NSW 2660
Dareton	Dareton Primary and Community Health Centre	42-44 Tapio Avenue Dareton NSW 2717	42-44 Tapio Avenue DARETON NSW 2717
Dungog	Dungog Community Hospital	22 Hospital Road Dungog NSW 2420	22 Hospital Road DUNGOG NSW 2420
Finley	Finley Health Service	24 Dawe Avenue Finley NSW 2713	24 Dawe Avenue FINLEY NSW 2713
Gloucester	Gloucester Soldiers Memorial Hospital & Gloucester Community Health Centre	Church Street Gloucester NSW 2422	Church Street GLOUCESTER NSW 2422
Gundagai	Gundagai Health (Multipurpose) Service	50 Tor Street Gundagai NSW 2722	50 Tor Street GUNDAGAI NSW 2722
Guyra	Guyra Multipurpose Service	44-48 Sole Street Guyra NSW 2365	44-48 Sole Street GUYRA NSW 2365
Harden	Murrumburrah-Harden Hospital and Health Service	53 Scott Street Harden NSW 2587	53 Scott Street HARDEN NSW 2587
Hay	Hay District Hospital	351 Murray St Hay NSW 2711	351 Murray St HAY NSW 2711
Henty	Henty Multipurpose Service	7 Keighran Street Henty NSW 2658	7 Keighran Street HENTY NSW 2658
Hillston	Hillston Hospital and Health Service	48C Burns Street Hillston NSW 2675	48C Burns Street HILLSTON NSW 2675
Holbrook	Holbrook Hospital	30 Bowler Street Holbrook NSW 2644	30 Bowler Street HOLBROOK NSW 2644
Jerilderie	Jerilderie Hospital and Health Service	33-39 Southey Street Jerilderie NSW 2716	PO Box 116 JERILDERIE NSW 2716
Junee	Junee Multi-Purpose Service	67 Broadway Street Junee NSW 2663	67 Broadway Street JUNEE NSW 2663
Kyogle	Kyogle Multipurpose Service	Summerland Way Kyogle NSW 2474	Summerland Way KYOGLE NSW 2474
Lake Cargelligo	Lake Cargelligo Hospital and Health Service	34 Uabba Street Lake Cargelligo NSW 2672	34 Uabba Street LAKE CARGELLIGO NSW 2672
Lockhart	Lockhart Hospital and Health Service	53-55 Hebden Street Lockhart NSW 2656	53-55 Hebden Street LOCKHART NSW 2656
Manilla	Manilla Multipurpose Service	Court Street Manilla NSW 2346	Court Street MANILLA NSW 2346
Merriwa	Merriwa Multipurpose Service	Mackenzie Street Merriwa NSW 2329	Mackenzie Street MERRIWA NSW 2329
Murrurundi	Wilson Memorial Community Hospital Murrurundi & Murrurundi Community Health Centre	Corner Paradise and O'Connell Streets Murrurundi NSW 2338	PO Box 8 MURRURUNDI NSW 2338
Narrandera	Narrandera Health Service	54 Adams Street Narrandera NSW 2700	54 Adams Street NARRANDERA NSW 2700
Nimbin	Nimbin Multipurpose Service	35 Cullen Street Nimbin NSW 2480	35 Cullen Street NIMBIN NSW 2480
Nyngan	Nyngan Hospital and Community Health Service	Hoskins Street Nyngan NSW 2825	PO Box 96 NYNGAN NSW 2825
Oberon	Oberon Health Service	North St Oberon NSW 2787	North Street OBERON NSW 2787
Quirindi	Quirindi Health Service	50 Nowland Street Quirindi NSW 2343	50 Nowland Street QUIRINDI NSW 2343
Rylstone	Rylstone Multi-Purpose Service	Fitzgerald Street Rylstone NSW 2849	Fitzgerald Street RYLSTONE NSW 2849
Temora	Temora Health Service	169-189 Loftus Street Temora NSW 2666	169-189 Loftus Street TEMORA NSW 2666
Tocumwal	Tocumwal Health Service	6-12 Adams Street Tocumwal NSW 2714	6-12 Adams Street TOCUMWAL NSW 2714
Tottenham	Tottenham Multi-Purpose Service	10 Moondana Street Tottenham NSW 2873	10 Moondana Street TOTTENHAM NSW 2873
Trangie	Trangie Multi-Purpose Service	28 Harris Street Trangie NSW 2823	28 Harris Street TRANGIE NSW 2823
Trundle	Trundle Multi-Purpose Service	44 Brookview Street Trundle NSW 2875	44 Brookview Street TRUNDLE NSW 2875
Tullamore	Tullamore Multi-Purpose Service	Kitchener Street Tullamore NSW 2874	Kitchener Street TULLAMORE NSW 2874
Tumbarumba	Tumbarumba Multipurpose Service	4 Mitchell Street Tumbarumba NSW 2653	4 Mitchell Street TUMBARUMBA NSW 2653
Urana	Urana Health Multipurpose Service	127-129 Princess Street Urana NSW 2645	127-129 Princess Street URANA NSW 2645
Urbenville	Urbenville Multipurpose Service	45 Beaury Street Urbenville NSW 2475	45 Beaury Street URBENVILLE NSW 2475
Warialda	Warialda Multi-Purpose Service	Long Street Warialda NSW 2402	Long Street WARIALDA NSW 2402
Wee Waa	Wee Waa Community Hospital & Wee Waa Community Health Centre	60 Alma Street Wee Waa NSW 2388	PO Box 417 WEE WAA NSW 2388
Wentworth	Wentworth Health Services	Silver City Highway Wentworth NSW 2648	Silver City Highway WENTWORTH NSW 2648
West Wyalong	West Wyalong Hospital	70 Ungarie Road West Wyalong NSW 2671	70 Ungarie Road WEST WYALONG NSW 2671

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Council of Australian Governments’ Improving Access to Primary Care in Rural and Remote Areas – COAG s19(2) Exemptions Initiative – New South Wales Direction 2022

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