EXPLANATORY STATEMENT
STATUTORY RULES 1984 NO. 162
ISSUED BY THE AUTHORITY OF THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
HEALTH INSURANCE REGULATIONS (AMENDMENT)
Sub-section 133(1) of the Health 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 item, for the purposes of the Act, is defined in sub-section 3(1) of the Act as an item in the table of medical services, being the table of medical services prescribed under section 4 of the Act. A recognized hospital, for the purposes of the Act, is a hospital that is a recognized hospital for the purposes of an agreement under section 23F of the Act with a State or the Northern Territory for the provision of public hospital services, or a hospital declared by the Minister to be a recognized hospital
in the Australian Capital Territory or in a State or the Northern Territory where an agreement under section 23F has not been entered into.
Sub-section 17(1) of the Act provides that a medicare benefit is not payable in respect of a professional service in certain circumstances. Arising from paragraph 17(1)(aa) of the Act, medicare benefit is not payable if a professional service related to a “prescribed item” and was rendered to an in-patient or out-patient of a recognized hospital, or to other patients at a recognized hospital by a medical practitioner who was not acting in accordance with an approved agreement. An approved agreement for the purposes of section 17 of the Act is defined in sub-section 17(4) of the Act as an agreement in writing, in accordance with any relevant guidelines formulated by the Minister, between a medical practitioner and a recognized hospital that makes provision for the rendering at the hospital by the medical practitioner of professional services relating to items prescribed for the purposes of paragraph 17(1)(aa) of the Act.
Regulation 2ADAA of the Health Insurance Regulations (‘the Regulations’) prescribes for the purposes of paragraph 17(1)(aa) of the Act the items referred to in Schedule 5 to the Regulations. Regulation 2ADAA was inserted into the Regulations by Statutory Rules No. 5 of 1984 with effect from 1 March 1984.
The purpose of the regulations is the deletion of 42 items from those previously prescribed for the purposes of paragraph 17(1)(aa) of the Act. The Minister for Health had agreed, following discussions with the medical profession, that these items should not be the subject of section 17 of the Act. The regulations give effect to this by amending Schedule 5 to the Regulations.
The regulations are deemed to have come into effect on 1 March 1984. This retrospectivity of effect does not affect prejudicially the rights of any person or impose liabilities on any person in a manner contrary to sub-section 48(2) of the Acts Interpretation Act 1901.