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 – Western Australia 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 – Western Australia 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 Western Australia 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 Western Australia 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 Western Australia (ABN: 28 684 750 332) 1 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 – WEStern Australia

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 – Western Australia

Approved locations and outreach services:

Location	Practice Name	Street Address	Mailing Address
Bridgetown	Bridgetown Hospital	28 Peninsula Road, Bridgetown, WA 6255	PO Box 136 BRIDGETOWN WA 6255
Carnarvon	Carnarvon Hospital	Cleaver Street Carnarvon WA 6701	PO Box 417 CARNARVON WA 6701
Burringurrah	Burringurrah Nursing Post	Sixth Street Burringurrah Community	C/- PO Box 417 CARNARVON WA 6701
Coral Bay	Coral Bay Nursing Post	67 Robinson Street Coral Bay WA 6701	67 Robinson Street CORAL BAY WA 6701
Denham	Shark Bay Silver Chain Health Centre	53 Hughes Street Denham WA 6537	53 Hughes Street DENHAM WA 6537
Gascoyne Junction	Gascoyne Junction Outreach Clinic	C/- Community Resource Centre Lot 4 Scott Street Gascoyne Junction WA 6705	C/- PO Box 417 CARNARVON WA 6701
Useless Loop	Useless Loop Medical Centre	1 Wilson Rise Useless Loop WA 6537	1 Wilson Rise USELESS LOOP WA 6537
Derby	Derby Hospital	67-71 Clarendon Street Derby WA 6728	PMB 938 DERBY WA 6728
Lombadina	Lombadina Health Centre	Lot 404 Lombadina Road Dampier Peninsula WA 6725	PMB 6 via BROOME WA 6725
Looma	Looma Clinic	19H Ngaliwanya Street Camballin WA 6728	PMB 903 via DERBY WA 6728
One Arm Point	One Arm Point Health Centre	One Arm Point Community 89 One Arm Point Rd Broome WA 6725	PMB 13 via BROOME WA 6725
Exmouth	Exmouth Health Service	Lot 1448 Lyon Street, Exmouth, WA 6707	Lot 1448 Lyon Street EXMOUTH WA 6707
Fitzroy Crossing	Fitzroy Crossing Health Service	82 Fallon Road Fitzroy Crossing WA 6765	PO Box 5 FITZROY CROSSING WA 6765
Bayulu	Bayulu Clinic	Lot 10 Lamey Ave St Georges Ranges Via Fitzroy Crossing WA 6765	PO Box 27 Bayulu Community Via FITZROY CROSSING WA 6765
Nookanbah	Nookanbah Clinic	Nookanbah Community Fitzroy Crossing WA 6765	PO Box 14 FITZROY CROSSING WA 6765
Wangkatjungka	Wangkatjungka Clinic	Wangkatjungka Clinic Christmas Creek Fitzroy Crossing WA 6765	PO Box 288 FITZROY CROSSING WA 6765
Halls Creek	Halls Creek Hospital	70 Roberta Ave Halls Creek WA 6770	70 Roberta Ave HALLS CREEK WA 6770
Yiyili	Yiyili Clinic	Lot 1 Louisa Downs Rd Halls Creek WA 6770	PMB 12 HALLS CREEK WA 6770
Katanning	Katanning Health Service	11-31 Kobeelya Avenue Katanning WA 6317	Katanning Hospital Site Francis Street KATANNING WA 6317
Gnowangerup	Gnowangerup Hospital	3493 Broomehill-Gnowangerup Road Gnowangerup WA 6335	3493 Broomehill-Gnowangerup Road GNOWANGERUP WA 6335
Kojonup	Kojonup Hospital	36-50 Spring Street Kojonup WA 6395	36-50 Spring Street KOJONUP WA 6395
Tambellup	Tambellup Health Centre	30 Norrish Street Tambellup WA 6320	30 Norrish Street TAMBELLUP WA 6320
Kununurra	Kununurra District Hospital	96 Coolibah Drive Kununurra WA 6743	PO Box 239 KUNUNURRA WA 6743
Kalumburu	Kalumburu Health Clinic	138 Kalumburu Bvd Kalumburu WA 6740	PMB 12 via WYNDHAM WA 6740
Warmun	Warmun Health Clinic	Ord Street Warmun WA 6749	Ord Street WARMUN WA 6749
Laverton	Laverton District Hospital	2 Beria Road, Laverton, WA 6440	2 Beria Road LAVERTON WA 6440
Leonora	Leonora District Hospital	967 Sadie Canning Drive, Leonora, WA 6438	967 Sadie Canning Drive LEONORA WA 6438
Meekatharra	Meekatharra Hospital	Savage Street Meekatharra, WA 6642	Savage Street MEEKATHARRA WA 6642
Norseman	Norseman District Hospital	1 Talbot Street, Norseman, WA 6443	1 Talbot Street NORSEMAN WA 6443
Onslow	Onslow Hospital	73 Second Avenue, Onslow, WA 6710	73 Second Avenue ONSLOW WA 6710
Mount Barker	Plantagenet – Cranbrook Health Service	59 Langton Road, Mount Barker, WA 6324	59 Langton Road MOUNT BARKER WA 6324
Ravensthorpe	Ravensthorpe Health Centre	Martin Street Ravensthorpe WA 6346	PO Box 53 RAVENSTHORPE WA 6346
Bremer Bay	Bremer Bay Health Centre	29 John Street Bremer Bay WA 6339	29 John Street BREMER BAY WA 6339
Jerramungup	Bremer Bay (Jerramungup) Health Centre	7 Kokoda Road Jerramungup WA 6337	7 Kokoda Road JERRAMUNGUP WA 6337
Denham	Shark Bay WA Health and Community Service incl Useless Loop	53 Hughes Street, Denham, WA 6537	53 Hughes Street DENHAM WA 6537
Manjimup	Warren (Manjimup) Health Service	16 Hospital Avenue, Manjimup, WA 6258	16 Hospital Avenue MANJIMUP WA 6258
Wyndham	Wyndham District Hospital	43 Minderoo St, Wyndham, WA 6740	43 Minderoo St WYNDHAM WA 6740

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 – Western Australia Direction 2022

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