EXPLANATORY STATEMENT
STATUTORY RULES 1984 NO. 6
ISSUED BY AUTHORITY OF THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
HEALTH INSURANCE (PATHOLOGY SERVICES) REGULATION AMENDMENT
Sub-section 133(1) of the Health Insurance Act 1973 (‘the Act’) provides that the Governor-General may make regulations, not inconsistent with the Act, prescribing all matters required or permitted by the Act to be prescribed, or which are necessary or convenient to be prescribed for carrying out or giving effect to the Act.
An approved pathology practitioner is defined in sub-section 3(1) of the Act to mean, in addition to the Commonwealth, the Northern Territory, and statutory authorities specified in writing by the Minister, a person in respect of whom there is in force an undertaking accepted by the Minister under section 16C of the Act.
Sub-section 16A(1) of the Act provides that a Commonwealth medical benefit is not payable in respect of a pathology service unless a practitioner determined the service was necessary, and certain other requirements are met. Sub-section 16A(1), from 1 February 1984, applies similarly to medicare benefit. Arising from paragraph 16A(1)(a) of the Act, pathology services required to be referred to an approved pathology practitioner to be
rendered must be referred by means of a request made in writing as prescribed, or if made otherwise than in writing, subsequently confirmed in writing as prescribed. Such a request would be made by the practitioner originally determining the service to be necessary or by another approved pathology practitioner.
Particulars for the purposes of paragraph 16A(1)(a) of the Act to be specified in a request or confirmation of a request to an approved pathology practitioner for the rendering of a pathology service are prescribed in Regulation 5 of the Health Insurance (Pathology Services) Regulations. Regulation 5 was extensively amended by Statutory Rules No. 254 with effect from 1 February 1984. Arising from this amendment, paragraph (d) of Regulation 5 required a request or confirmation of a request to specify.
“the service to which the instrument relates by means of a description sufficient to identify the item that relates to that service and the number of that item”.
During the course of administrative preparations for the implementation of the amendments of Regulation 5, it became evident that it was impracticable to require, as well as a description of services, the specification of
item numbers, being items in the Medical Benefits Schedule, on all requests. The Statutory Rules therefore omit the words “and the number of that item” from paragraph (d) of Regulation 5.
The proposed Statutory Rules came into operation on 2 February 1984.