EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health and Ageing
Health Insurance Act 1973
Health Insurance (Requirements for Allied Health Professionals) Determination 2005
Subregulation 3A(2) of the Health Insurance Regulations 1975 (the Regulations) enables the Minister to make a written determination specifying additional requirements that must be met by allied health professionals who provide certain allied health services.
An allied health professional must meet the applicable requirements in subregulation 3A(2) of the Regulations and in this Determination in order to be able to provide certain allied health services that will be eligible for a Medicare benefit. The circumstances in which an allied health service will attract a Medicare benefit and the relevant fees are described in the items created under the Medicare Benefits Schedule, as set out in a separate Determination made by the Minister under section 3C of the Health Insurance Act 1973 (the Act) – the Health Insurance (Allied Health and Dental Services) Determination 2005. An amendment to this Determination (Health Insurance (Allied Health and Dental Services) Determination Amendment 2005 (No. 2) prescribes the fees and requirements for an eligible exercise physiology service.
The purpose of this Determination is to revoke the previous Determination and add exercise physiology eligibility requirements. This Determination specifies additional eligibility requirements for the following types of allied health professionals:
- Aboriginal health workers
- Audiologists
- Dietitians
- Mental health workers
- Occupational therapists
- Podiatrists
- Speech pathologists
- Diabetes educators
- Exercise Physiologists
All but diabetes educators and exercise physiologists were previously specified in the previous Determination, Health Insurance (Requirements for Allied Health Professionals) Determination 2004. Diabetes educators were added under Health Insurance (Requirements for Allied Health Professionals) Amendment Determination 2004. This new Determination replaces these Determinations.
Details of this Determination are set out in the Attachment.
The Determination commences on 1 January 2006.
Consultation
The Department of Health and Ageing consulted with the allied health and dental care initiative’s consultative group regarding the inclusion of exercise physiologists. The group includes representatives from the Australian Divisions of General Practice, the Australian Medical Association, the Royal Australian College of General Practitioners, the Rural Doctors Association, all national peak bodies representing eligible allied health professional groups, the Australian Dental Association and Medicare Australia. The Australian Association of Exercise and Sports Science were also involved in developing the requirements of the item.
ATTACHMENT
DETAILS OF THE HEALTH INSURANCE (REQUIREMENTS FOR ALLIED HEALTH PROFESSIONALS) DETERMINATION 2004
Section 1 provides for the Determination to be referred to as the Health Insurance (Requirements for Allied Health Professionals) Determination 2005.
Section 2 provides for the Determination to commence on 1 January 2006.
Section 3 revokes the earlier Determination.
Section 4 provides an explanation of terms used in the Determination.
Section 5 explains that the purpose of the Determination is to specify additional requirements that must be met by allied health professionals who provide certain allied health services. These requirements are in addition to the eligibility requirements specified in paragraphs 3A(2)(a) and (b) of the Health Insurance Regulations 1975.
Section 6 sets out the eligibility requirements that apply to Aboriginal health workers.
Section 7 sets out the eligibility requirements that apply to audiologists.
Section 8 sets out the eligibility requirements that apply to dietitians.
Section 9 sets out the eligibility requirements that apply to mental health workers. A mental health worker is an allied health professional who provides a mental health service, including an Aboriginal health worker, a mental health nurse, an occupational therapist, a psychologist, and a social worker.
Section 10 sets out the eligibility requirements that apply to occupational therapists.
Section 11 sets out the eligibility requirements that apply to podiatrists.
Section 12 sets out the eligibility requirements that apply to speech pathologists.
Section 13 sets out the eligibility requirements that apply to diabetes educators.
Section 14 sets out the eligibility requirements that apply to exercise physiologists.