EXPLANATORY STATEMENT
STATUTORY RULES 1987 No. 163
ISSUED BY AUTHORITY OF THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
HEALTH INSURANCE REGULATIONS (AMENDMENT)
Section 133 of the Health Insurance Act 1973 (“the Act”) provides in part that the Governor-General may make regulations, not inconsistent with the Act, prescribing all matters required or permitted by the Act or which are necessary or convenient to be prescribed for carrying out or giving effect to the Act.
Section 9 of the Act provides in effect that medicare benefits shall be calculated by reference to the fees for medical services set out in the table of general medical services in Schedule 1 to the Act. Section 4 of the Act provides, among other things, that the regulations may prescribe a table of medical services (other than pathology services) in accordance with the form of the table set out in Schedule 1 and, that upon commencement of a regulation prescribing a table of medical services, the table so prescribed has effect as if it were set out in Schedule 1 in the place of the table in that Schedule. The Health Insurance (Variation of Fees and Medical Services) Regulations prescribe such a table. Items 180, 182, 184 and 186 of the table relate to professional attendances by participating optometrists.
Section 13 provides, among other things, that the medicare benefit payable under item 186 of the table in respect of attendances in a course of attention of a patient not included in a prescribed class of patient is an amount equal to the medicare benefit payable if those attendances were attendances covered by item 182 of the table. Regulation 2AC of the Health Insurance Regulations prescribes the classes of patients for the purposes of paragraph 13(1)(a) of the Act. Paragraph (j) of that regulation prescribes as a class of patients patients in respect of whom a registered medical practitioner has prescribed, or recommended the prescription of, contact lenses.
These regulations amend regulation 2AC by omitting paragraph (j) and inserting in its place a new paragraph (j) prescribing as a class of patients those patients who by reason of some physical deformity are unable to wear spectacles and in respect of whom a medical practitioner or an optometrist has prescribed or recommended the prescription of contact lenses.
These regulations also create a new class of prescribed patient being patients in respect of whom an optometrist has certified that an ocular condition exists which requires for its correction the use of contact lenses and which condition is not referred to elsewhere in the classes prescribed by regulation 2AC.