EXPLANATORY STATEMENT
Health Insurance Act 1973
Health Insurance (MRI Crohn’s disease) Amendment Determination 2015
Issued by the Authority of the Minister for Health
Authority
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may determine in writing that a health service not listed in the Diagnostic Imaging Services Table (the Table) shall, in specified circumstances and for specified statutory provisions, be treated as if it were so listed. The Table is set out in the Health Insurance (Diagnostic Imaging Services Table) Regulation 2014 (the DIST Regulation) which is remade each year.
Purpose
The purpose of the Health Insurance (MRI Crohn’s disease) Amendment Determination 2015 (the Determination) is to amend the Health Insurance (MRI Crohn’s disease) Determination 2014 (MRI Crohn’s disease Determination) to provide the authority to provide MRI scans for Crohn’s disease on partial Medicare‑eligible units.
Background
In April 2014, the Medical Services Advisory Committee (MSAC) recommended the addition of three new Medicare Benefits Schedule (MBS) items (along with three corresponding half-rebate alternatives for services performed on older equipment) for MRI scans for Crohn’s disease. MSAC did not discuss whether or not these items should apply to services performed using partial Medicare-eligible equipment. The MRI Crohn’s disease Determination provides that the MBS items only apply where, amongst other things, services relating to the items are performed using Medicare-eligible equipment. This Determination enables the items to apply in respect of services performed using partial Medicare-eligible equipment.
Details of the Determination are set out in the Attachment.
This Determination commences on 1 March 2015.
This Determination is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
Consultation
The Department received post-implementation feedback from the Royal Australian and New Zealand College of Radiologists (RANZCR) and the Australian Diagnostic Imaging Association (ADIA) requesting a reconsideration of the availability of the service items for MRI scans for Crohn’s disease. The Department agreed that the requested amendment aligned with the spirit of MSAC’s recommendations. This Determination authorises the amendments requested by RANZCR and ADIA.
ATTACHMENT
Details of the Health Insurance (MRI Crohn’s disease) Amendment Determination 2015
1 Name of Determination
Section 1 states that the name of the Determination is the Health Insurance MRI Crohn’s disease) Amendment Determination 2015.
2 Commencement
Section 2 states that the Determination commences on 1 March 2015.
3 Authority
Section 3 provides that the Determination is made under the Act.
4 Amendment of Health Insurance (MRI Crohn’s disease) Determination 2014
Section 4 provides that Schedule 1 amends the MRI Crohn’s disease Determination.
Schedule
[1] Section 7
Item [1] amends section 7 of the MRI Crohn’s disease Determination to insert a reference to subclause 2.5.1(2) of the DIST Regulation. This amendment is required so that the MBS items in the MRI Crohn’s disease Determination are available in respect of services performed using partial Medicare-eligible equipment.
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Health Insurance (MRI Crohn’s disease) Amendment Determination 2015
This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.
Overview of the Legislative Instrument
The purpose of the Health Insurance (MRI Crohn’s disease) Amendment Determination 2015 (the Determination) is to amend the Health Insurance (MRI Crohn’s disease) Determination 2014 (the MRI Crohn’s disease Determination) so that the items described in the MRI Crohn’s disease Determination will apply to services performed using partial Medicare-eligible equipment.
Human rights implications
The right to health
The right to health – the right to the enjoyment of the highest attainable standard of physical and mental health – is contained in article 12(1) of the International Covenant on Economic, Social and Cultural Rights (ICESCR). The UN Committee on Economic, Social and Cultural Rights (the Committee) has stated that health is a ‘fundamental human right indispensable for the exercise of other human rights’, and that the right to health is not to be understood as a right to be healthy, but rather entails a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health.
Right to Social Security
The right to social security is contained in article 9 of the ICESCR. The right requires that a country must, within its maximum available resources, ensure access to a social security scheme that provides a minimum essential level of benefits to all individuals and families that will enable them to acquire at least essential health care. Countries are obliged to demonstrate that every effort has been made to use all resources that are at their disposal in an effort to satisfy, as a matter of priority, this minimum obligation.
The Committee has stated that the notion of ‘the highest attainable standard of health’ takes into account both the conditions of the individual and the country’s available resources. The right may be understood as a right of access to a variety of public health and health care facilities, goods, services, programs and conditions necessary for the realisation of the highest attainable standard of health.
The Committee has also stated that with respect to the right to social security that the qualifying conditions for benefits must be reasonable, proportionate and transparent.
This Determination increases access to affordable MRI services for Crohn’s disease through subsidisation of services provided using partial Medicare-eligible equipment.
There is no incompatibility with the right to health or social security because the legislation is for a legitimate objective and reasonable, necessary and proportionate in the circumstances.
Conclusion
This Legislative Instrument is compatible with human rights as it has a positive effect on human rights issues.