Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Tasmania - Medical Services performed under the Single Employer Model Trial) Direction 2024 - Legislation

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Tasmania - Medical Services performed under the Single Employer Model Trial) Direction 2024

I, Louise Riley, Acting First Assistant Secretary, Medicare Benefits and Digital Health 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:

REVOKE the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Tasmania – Medical Services performed under the Single Employer Model Trial) Direction (No. 1) 2023 made under subsection 19(2) of the Act that was signed on 7 December 2023; and
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 Rural General Practice and Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health and Aged Care (ABN: 83 605 426 759), the Tasmanian Health Service (ABN: 15 359 196 040) and the Tasmanian Department of Health (ABN: 11 255 872 006) in relation to the rural general practice and rural generalists single employer model 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);

(ii) a patient who is not receiving the service as part of an episode of hospital treatment (as defined in Section 121-5 of the Private Health Insurance Act 2007); and

(iii) a patient who also is not receiving a service which attracts a payment through the 2020-2025 Addendum to the National Health Reform Agreement for a service rendered to a public patient; and

(i) at a general practice (as defined in Section 7.1.1 of the general medical services table); and

(ii) at:

a rural or remote practice location specified in Schedule B in Modified Monash Model 2-7 (as defined in Section 7.1.1 of the general medical services table); or
A location described in the Rural General Practice and Rural Generalist Single Employer Model Trial Memorandum of Understanding between the Department of Health and Aged Care, the Tasmanian Health Service and the Tasmanian Department of Health; and

(iii) by a participating rural generalist and rural general practice trainee mentioned in (a):

who is formally enrolled in a fellowship training program that meets the training standards of either:
1. the Australian College of Rural and Remote Medicine; and/or;
2. The Royal Australian College of General Practitioners.
who is employed by the Tasmanian Health Service for the provision of primary and acute care services; and

(iv) by one of the eighty rural generalist and rural general practice participants who are eligible to use this Direction at any one time.

DECLARE that this Direction commences on 29 January 2024 and ceases to have effect at the end of 30 June 2027 unless earlier revoked.

Date this 24 day of January 2024

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 AS AGREED under the tasmanian health service rural general practice and rural Generalist SINGLE EMPLOYER Model TRIAL

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
A15		2	Case conferences
A17	Domiciliary and residential medication management reviews
A20	GP Mental Health treatment	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	Attendance services for complex neurodevelopmental disorder or disability
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
A40	Telehealth and phone attendance 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 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	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
		37	Specialist, anaesthesia – Telehealth Services
		39	GP Sexual and Reproductive Health Consultation – Telehealth Service
		40	GP Sexual and Reproductive Health Consultation – Phone Service
A44	General practice attendance for assessing patient suitability for a COVID-19 vaccine
A46	COVID-19 management support service
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	Other 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	Gynaecological
		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	Bone age study and skeletal survey
		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 2-7 rural and remote Practice Locations AS AGREED under the Tasmanian health service rural general practice and rural Generalist SINGLE EMPLOYERModel TRIAL

Approved primary care Modified Monash Model (MMM) 2 locations:

MM2 Location	Practice Name	Legal Name	Street Address
Bellerive	Bellerive Doctors	Luckman, Paul Lamont	112 Cambridge Road, Bellerive TAS 7018
Bridgewater	Jordan River Health	Your Hobart Doctor Pty Ltd	9-11 Hurst Street, Bridgewater TAS 7030
Brighton	Brighton Regional Doctors	The Trustee for Dory and Pearl Unit Trust	174 Brighton Road, Brighton TAS 7030
Claremont	Ochre Medical Centre Claremont	Ochre Health Pty Limited	Claremont Plaza, shop 24-25, 35 Main Rd, Claremont, TAS 7011
East Launceston	High Street Family Practice	High Street Family Practice Pty Ltd	7 High Street, East Launceston TAS 7250
Exeter	Exeter Medical Centre	Exeter Medical Services Pty Ltd	102 Main Road, Exeter TAS 7275
Kingston	John Street Medical	John Street Medical Services Pty Limited	5 John Street, Kingston TAS 7050
Launceston	Launceston Medical Centre	Launceston Medical Centre Pty Ltd	247 Wellington Street, Launceston, TAS 7250
Legana	Legana Medical Centre	Exeter Medical Services Pty Ltd	16 Freshwater Point Road, Legana TAS 7277
Lenah Valley	Ochre Medical Centre Augusta Road	Ochre Health Pty Limited	120 Augusta Road, Lenah Valley, TAS 7008
Longford	Northern Midlands Medical Services	Northern Midlands Medical Services Pty Ltd	28 George Street, Longford TAS 7301
Moonah	Hopkins Street Medical Clinic	IPN Medical Centres Pty Ltd	67 Hopkins Street, Moonah TAS 7009
Newstead	Newstead Medical	A.J Fair & T.G Gardener & D.P Kirk	165 Elphin Road, Newstead TAS 7250
Prospect	Prospect Medical Centre	The trustee for PMC Launceston Trust	4 Trotters Lane, Prospect, TAS 7250
Sandy Bay	Churchill Avenue Medical Centre	IPN Medical Centres Pty Ltd	150 Churchill Avenue, Sandy Bay TAS 7005
Summerhill	Summerdale Medical Centre	N.A Filgate & D.F Rose & J.J Tempone & The Trustee for DMJH Discretionary Trust & The Trustee for the Lucas Family Trust	Corner Peel and Stanley Streets, Summerhill, TAS 7250

Approved primary care Modified Monash Model (MMM) 3 locations:

MMM 3 location	Practice Name	Legal Name	Street Address
Burnie	Bass House Surgery	D.W Dow & Ian Wild & Associates Pty Ltd	83 Wilmot Street, Burnie TAS 7320
Burnie	Burnie General Practice	IPN Medical Centres Pty Ltd	35-37 Mount Street, Burnie TAS 7320
Devonport	Don Medical Clinic	The trustee for Don Medical Service Trust	7/48-54 Oldaker Street, Devonport TAS 7310
Ulverstone	Patrick Street Clinic	S Delitzsch & E Djakic & S Rubasighe & J Chaffey	6 Patrick Street, Ulverstone TAS 7315
Ulverstone	Victoria Street Clinic	The trustee for Victoria Street Medical Trust	39 Victoria Street, Ulverstone TAS 7315
Wynyard	Wynyard Medical Centre	The Trustee for Wynyard Medical Unit Trust	136-138 Goldie Street, Wynyard TAS 7325
Wynyard	Saunders Street Clinic	J and R Berryman Pty Ltd	37 Jackson Street, Wynyard TAS 7325

Approved primary care Modified Monash Model (MMM) 5 locations:

MMM 5 location	Practice Name	Legal Name	Street Address
Bridport	Ochre Medical Centre Bridport	Ochre Health Pty Limited	123 Main Street, Bridport, TAS7262
Campbell Town	Ochre Medical Centre Campbell Town	Ochre Health Pty Limited	70 High Street, Campbell Town TAS 7210
Cygnet	Ochre Medical Centre Cygnet	Ochre Health Pty Limited	14 George St, Cygnet, TAS 7112
Deloraine	Deloraine Medical Centre	Deloraine & Westbury Medical Pty Ltd	22 Tower Hill Street, Deloraine TAS 7304
Dover	Dover Medical Centre	Huon Valley Council	15 Chapman Avenue, Dover TAS 7117
Geeveston	Geeveston Medical Centre	Huon Valley Council	19 Arve Road, Geeveston, TAS 7116
George Town	George Town Medical Centre	Anne Street Medical Services Pty Ltd	49 Anne Street, George Town TAS 7253
Huonville	Ochre Medical Centre Huonville	Ochre Health Pty Limited	85 Main Street, Huonville, TAS 7109
Scottsdale	Ochre Medical Centre Scottsdale	Ochre Health Pty Limited	2 Fosters Rd, Scottsdale TAS 7260
St Helens	Ochre Medical Centre St Helens	Ochre Health Pty Limited	11 Pendrigh Place St Helens TAS 7216
Westbury	Westbury Medical Centre	Deloraine & Westbury Medical Pty Ltd	80 Meander Valley Rd, Westbury, TAS 7303

Approved primary care Modified Monash Model (MMM) 6 locations:

MM6 Location	Practice Name	Legal Name	Street Address
Alonnah	Ochre Medical Centre Bruny Island	Ochre Health Pty Limited	16 School Rd, Alonnah TAS 7150
Queenstown	Ochre Medical Centre Queenstown	Ochre Health Pty Limited	60-64 Orr Street, Queenstown TAS 7467
Rosebery	Ochre Medical Centre Rosebery	Ochre Health Pty Limited	1 Hospital Road, Rosebery, TAS 7470
Strahan	Ochre Medical Centre Strahan	Ochre Health Pty Limited	3 Bay Street, Strahan TAS 7468
Swansea	Swansea General Practice	Blazing Possums Pty Ltd	37 Wellington St, Swansea TAS 7190
Zeehan	Ochre Medical Centre Zeehan	Ochre Health Pty Limited	100 Main St Zeehan TAS 7469

Approved primary care Modified Monash Model (MMM) 7 locations:

MM7 Location	Practice Name	Legal Name	Street Address
Currie	Ochre Medical Centre King Island	Ochre Health Pty Limited	35 Edward Street, Currie TAS 7256
Whitemark	Ochre Medical Centre Flinders Island	Ochre Health Pty Limited	4 James Street, Whitemark TAS 7255

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Tasmania - Medical Services performed under the Single Employer Model Trial) Direction 2024

Administered by Department of Health, Disability and Ageing

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