EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health and Ageing
Health Insurance Act 1973
Health Insurance (Permitted benefits – pathology services) Amendment Determination 2008
This Determination is made under section 23DZZIG of the Health Insurance Act 1973 (the Act).
Part IIBA of the Act contains provisions that are directed at preventing requesters of pathology services and diagnostic imaging services from (either directly or indirectly) asking for or accepting, or being offered or provided, any benefits (other than permitted benefits) in order to induce the requesters to request the services from providers of those services. It also contains provisions protecting requesters of pathology services and diagnostic imaging services from (either directly or indirectly) being threatened in order to induce the requesters to request the services from providers of those services.
Part IIBA of the Act regulates behaviour whereby providers (or persons connected to them) offer or provide benefits to requesters (or persons connected to them). It also regulates behaviour whereby requesters (or persons connected to them) seek or accept benefits from providers (or persons connected to them). Such behaviour may be prohibited by the Act unless the benefit in question is a “permitted benefit”. The Act prescribes a number of benefits which are permitted, and these generally relate to transactions that are of an arms-length bone-fide commercial nature.
Section 23DZZIG of the Act allows the Minister to determine, by legislative instrument, that a specified class of benefits asked for or accepted by, or offered or provided to, a specified class of persons is a permitted benefit.
The Health Insurance (Permitted benefits – pathology services) Determination 2008 (the Principal Determination) sets out the benefits that are permitted, and the conditions under which they are permitted, in relation to pathology.
The Health Insurance (Permitted benefits – pathology services) Amendment Determination 2008 (the Determination) amends the Principal Determination by:
(i) clarifying the description of a type of good currently listed in the Principle Determination (i.e “Punch biopsy” in item 15 of the table in item 9 of Schedule 1); and
(ii) inserting a further type of good (“disposable vaginal speculums”) used for the collection of pathology specimens for testing by an accredited pathology laboratory as a permitted benefit. This item was inadvertently omitted from the Principal Determination.
CONSULTATION
Section 18 of the Legislative Instruments Act 2003 specifically provides for circumstances where consultation may not be necessary or appropriate. One of these circumstances is where the instrument is considered minor or machinery in nature, and does not substantially alter existing arrangements.
Because this Determination is amending the Principal Determination to:
(i) clarify the description of a type of good currently listed in the Principal Determination; and
(ii) include, as a permitted benefit, a type of good that had been inadvertently omitted from the Principal Determination;
the amendments to the Determination are considered to be minor and machinery in nature.
Extensive consultation was carried out with professional and industry bodies representing pathology providers during the development of the Principal Determination.
Therefore, no further consultation has been undertaken in the development of this Determination.
A detailed explanation of the provisions contained in the Determination is set out in the Attachment.
The Determination commences on the day after it is registered.
The Determination is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
ATTACHMENT
Health Insurance (Permitted benefits – pathology services) Amendment Determination 2008
Explanation of Clauses
Section 1
This section provides that the name of the Determination is the Health Insurance (Permitted benefits – pathology services) Amendment Determination 2008.
Section 2
Section 2 provides that the Determination commences on the day after it is registered.
Section 3
Section 3 provides that Schedule 1 to the Determination amends the Health Insurance (Permitted benefits – pathology services) Determination 2008 (the Principal Determination).
Schedule 1
The following items amend the table in item 9 of Schedule 1 to the Principal Determination, which currently lists the range of goods used for the collection of pathology specimens for testing by an accredited pathology laboratory that are permitted benefits:
Item [1] amends the table in item 9 of Schedule 1 to the Principle Determination by adding the word “instruments” after the words “Punch biopsy” to clarify the description of this good in item 15 of the table.
Item [2] amends the table in item 9 of Schedule 1 to the Principal Determination by inserting, after item 29 of that table, “Disposable vaginal speculums” (as new item 30). This good was inadvertently omitted from the table in item 9 of Schedule 1 when the Principal Determination was made.