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 – Queensland) Direction 2023 - Legislation

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

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 – Queensland) Direction 2023

I, Louise Riley, Acting First Assistant Secretary, Medical Benefits Division, Health Resourcing Group, delegate for the Minister for Health and Aged Care, 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
29 June 2022, that Medicare benefits shall be payable in respect of professional services provided by health services in Queensland 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 Queensland dated 9 June 2022; 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: 83 605 426 759) and the Queensland Department of Health (ABN: 75 818 456 675) dated 9 June 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 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 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 commences on 1 January 2024 and ceases to have effect at the end of 30 July 2025 unless earlier revoked.

Date this 14 day of December 2023

Louise Riley

Acting First Assistant Secretary

Medicare Benefits and Digital Health Division

Health Resourcing Group

Department of Health and Aged Care

SCHEDULE A

MEDICARE BENEFITS SCHEDULE ITEMS At 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 – queensland

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
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 - Queensland

Approved locations:

Location	Practice Name	Legal Name	Street Address	Mailing Address
Alpha (Outreach service of Barcaldine)	Alpha Hospital and Multipurpose Health Service	Central West Hospital and Health Service	1 Burns Street Alpha QLD 4724	1 Burns Street ALPHA QLD 4724
Aramac (Outreach service of Barcaldine)	Aramac Primary Health Clinic	Central West Hospital and Health Service	2 Lodge Street Aramac QLD 4726	2 Lodge Street ARAMAC QLD 4726
Babinda	Babinda Hospital Multipurpose Health Service	Cairns and Hinterland Hospital and Health Service	128 Munro Street, Babinda, QLD 4861	PO Box 160 BABINDA QLD 4861
Barcaldine	Barcaldine Hospital Multi-Purpose Health Service	Central West Hospital and Health Service	25 Oak Street, Barcaldine, QLD 4725	25 Oak Street BARCALDINE QLD 4725
Biggenden	Biggenden Multipurpose Health Service	Wide Bay Hospital and Health Service	57 Alice Street, Biggenden, QLD 4621	57 Alice St BIGGENDEN QLD 4621
Blackall	Blackall Hospital	Central West Hospital and Health Service	189 Landsborough Highway, Blackall, QLD 4472	PO Box 131 BLACKALL QLD 4472
Blackwater	Blackwater Hospital Multipurpose Health Service	Central Queensland Hospital and Health Service	41 McKenzie Street, Blackwater, Qld 4717	PO Box 47 BLACKWATER QLD 4717
Boulia	Boulia Primary Health Centre	Central Queensland Hospital and Health Service	49 Wills Street, Boulia, QLD 4829	PO Box 24 BOULIA QLD 4829
Capella	Capella Outpatients Clinic	Central Queensland Hospital and Health Service	5 Slider Street, Capella, QLD 4723	5 Slider Street CAPELLA QLD 4723
Cardwell	Cardwell Community Health Centre	Townsville Hospital and Health Service	Victoria Street, Cardwell, QLD 4819	PO Box 391 CARDWELL QLD 4819
Cecil Plains (Outreach service of Millmerran)	Millmerran Multipurpose Health Service – Outreach Primary Clinic (Cecil Plains)	Darling Downs Hospital and Health Service	Co located at Anglicare, 24 Geraghty Street, Cecil Plains, QLD 4407	Co located at Anglicare 24 Geraghty Street CECIL PLAINS QLD 4407
Childers	Childers Multipurpose Health Service	Wide Bay Hospital and Health Service	44 Broadhurst Street, Childers, QLD 4660	PO Box 62 CHILDERS QLD 4660
Chillagoe	Chillagoe Primary Health Centre	Cairns and Hinterland Hospital and Health Service	21 Hospital Avenue, Chillagoe, QLD 4871	PO Box 4 CHILLAGOE QLD 4871
Collinsville	Collinsville Multipurpose Health Service	Mackay Hospital and Health Service	81-91 Garrick Street, Collinsville, QLD 4804	PO Box 56 COLLINSVILLE QLD 4808
Cow Bay (Outreach service of Mossman)	Cow Bay Primary Health Centre	Cairns and Hinterland Hospital and Health Service	69 Tea Tree Road Diwan QLD 4873	PMB 3 CAPE TRIBULATION QLD 4873
Dimbulah	Dimbulah Primary Health Centre	Cairns and Hinterland Hospital and Health Service	1-5 Stephen Street, Dimbulah, QLD 4872	PO Box 148 DIMBULAH QLD 4872
Dirranbandi	Dirranbandi Multipurpose Health Service	South West Hospital and Health Service	Corner of Jane and Crothers Streets, Dirranbandi, QLD 4486	PO Box 20 DIRRANBANDI QLD 4486
Eidsvold	Eidsvold Multipurpose Health Service	Wide Bay Hospital and Health Service	Cracow Rd, Eidsvold, QLD 4627	PO Box 40 EIDSVOLD QLD 4627
Gayndah	Gayndah Hospital	Wide Bay Hospital and Health Service	69 Warton Street, Gayndah, QLD 4625	PO Box 41 GAYNDAH QLD 4625
Gin Gin	Gin Gin Hospital	Wide Bay Hospital and Health Service	5 King Street, Gin Gin, QLD 4671	PO Box 14 GIN GIN QLD 4671
Hughenden	Hughenden Multipurpose Health Service	Townsville Hospital and Health Service	Richmond Hill Drive, Hughenden, QLD 4821	PO Box 228 HUGHENDEN QLD 4821
Inglewood	Inglewood Multipurpose Health Service	Darling Downs Hospital and Health Service	Cunningham Highway, Inglewood, QLD 4387	PO Box 42 INGLEWOOD QLD 4387
Injune	Injune Multipurpose Health Service	South West Hospital and Health Service	Fifth Avenue, Injune, QLD 4454	PO Box 35 INJUNE QLD 4454
Isisford	Isisford Primary Health Centre	Central West Hospital and Health Service	St Helena Street, Isisford, QLD 4731	St Helena Street ISISFORD QLD 4731
Jandowae	Jandowae Health Services	Darling Downs Hospital and Health Service	Jandowae Hospital, 13 Dalby Street, Jandowae, QLD 4410	PO Box 75 JANDOWAE QLD 4410
Jericho (Outreach service of Barcaldine)	Jericho Health Clinic	Central West Hospital and Health Service	19 Pasteur Street Jericho QLD 4728	19 Pasteur Street JERICHO QLD 4728
Jundah	Jundah Primary Health Centre	Central West Hospital and Health Service	1 Hospital Road, Jundah, QLD 4736	PO Box 26 JUNDAH QLD 4736
Longreach	Longreach Hospital	Central West Hospital and Health Service	Corner Jabiru and Plover Streets, Longreach, QLD 4730	Corner Jabiru and Plover Streets LONGREACH QLD 4730
Maleny	Maleny Soldiers Memorial Hospital	Sunshine Coast Hospital and Health Service	17 Bean St, Maleny, QLD 4552	17 Bean Street MALENY QLD 4552
Miles	Miles Health Service	Darling Downs Hospital and Health Service	5-11 Colamba Street, Miles, QLD 4415	PO Box 187 MILES QLD 4415
Millmerran	Millmerran Multipurpose Health Service	Darling Downs Hospital and Health Service	50 Commens Street, Millmerran, QLD 4357	50 Commens Street MILLMERRAN QLD 4357
Mitchell	Mitchell Multipurpose Health Service	South West Hospital and Health Service	95 Ann Street, Mitchell, QLD 4465	95 Ann Street MITCHELL QLD 4465
Monto	Monto Hospital	Wide Bay Hospital and Health Service	35 Flinders Street, Monto, QLD 4630	PO Box 220 MONTO QLD 4630
Mossman	Mossman Multipurpose Health Service	Cairns and Hinterland Hospital and Health Service	9 Hospital Street, Mossman, QLD 4873	9 Hospital Street MOSSMAN QLD 4873
Moura	Moura Multipurpose Health Service	Central Queensland Hospital and Health Service	14 Nott Street, Moura, QLD 4718	14 Nott Street MOURA QLD 4718
Mundubbera	Mundubbera Health Service	Wide Bay Hospital and Health Service	96 Leichardt Street, Mundubbera QLD 4626	PO Box 35 MUNDUBBERA QLD 4626
Mungindi	Mungindi Multi-Purpose Health Service	South West Hospital and Health Service	90 Barwon St, Mungindi, QLD 2406	90 Barwon St MUNGINDI QLD 2406
Murgon	Murgon Health Service	Darling Downs Hospital and Health Service	Coronation Drive, Murgon, QLD 4605	Coronation Drive MURGON QLD 4605
Muttaburra (Outreach service of Barcaldine)	Muttaburra Primary Health Care Centre	Central West Hospital and Health Service	Edkins Street Muttaburra QLD 4732	Edkins Street MUTTABURRA QLD 4732
Nanango	Nanango Health Service	Darling Downs Hospital and Health Service	135 Brisbane Street, Nanango, QLD 4615	PO Box 60 NANANGO QLD 4615
Oakey	Oakey Health Services – Oakey Hospital	Darling Downs Hospital and Health Service	Cnr Beale and Fitzpatrick Streets, Oakey, QLD 4401	Cnr Beale and Fitzpatrick Streets OAKEY QLD 4401
Proserpine	Proserpine Hospital and Community Health Centre	Mackay Hospital and Health Service	26-32 Taylor Street, Proserpine, QLD 4800	PO Box 229 PROSERPINE QLD 4800
Quilpie	Quilpie Multipurpose Health Service	South West Hospital and Health Service	30 Gyrica Street, Quilpie, QLD 4480	PO Box 27 QUILPIE QLD 4480
Richmond	Richmond Multipurpose Health Service	Townsville Hospital and Health Service	Gallagher Drive, Richmond, QLD 4822	PO Box 24 RICHMOND QLD 4822
Sapphire	Gemfields Outpatient Clinic	Central Queensland Hospital and Health Service	984 Rubyvale Road, Sapphire, QLD 4702	PO Box 342 SAPPHIRE QLD 4702
Springsure	Springsure Multipurpose Health Service	Central Queensland Hospital and Health Service	21 Woodbine Street, Springsure, QLD 4722	PO Box 14 SPRINGSURE QLD 4722
Surat	Surat Hospital Multipurpose Health Service	South West Hospital and Health Service	2 Ivan St, Surat, QLD 4417	PO Box 2 SURAT QLD 4417
Tambo	Tambo Primary Health Care Centre	Central West Hospital and Health Service	Garden Street, Tambo, QLD 4478	Garden Street TAMBO QLD 4478
Tara	Tara Hospital	Darling Downs Hospital and Health Service	15 Bilton Street, Tara, QLD 4421	15 Bilton Street TARA QLD 4421
Taroom	Taroom Hospital	Darling Downs Hospital and Health Service	Taroom Hospital, 14 Miller Street, Taroom QLD 4420	PO Box 358 TAROOM QLD 4420
Texas	Texas Multipurpose Health Service	Darling Downs Hospital and Health Service	Mingoola Road, Texas, QLD 4385	PO Box 91 TEXAS QLD 4385
Tully	Tully Hospital	Cairns and Hinterland Hospital and Health Service	17 Bryant Street, Tully, QLD 4854	PO Box 489 TULLY QLD 4854
Wallumbilla	Wallumbilla Community Clinic	South West Hospital and Health Service	Stakeyard Road, Wallumbilla, QLD 4428	PO Box 21 WALLUMBILLA QLD 4428
Windorah	Windorah Primary Health Centre	Central West Hospital and Health Service	25 Cecil Street, Windorah, QLD 4481	25 Cecil Street WINDORAH QLD 4481
Winton	Winton Multipurpose Health Service	Central West Hospital and Health Service	70 Oondooroo Street, Winton, QLD 4735	PO Box 295 WINTON QLD 4735

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 – Queensland) Direction 2023

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