EXPLANATORY STATEMENT
Issued by the Authority of the Minister for Health
Health Insurance Act 1973
Health Insurance (Review of GP Mental Health Treatment Plan) Revocation Determination 2012
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may, by writing, determine that a health service not listed in the general medical services table (the Table) shall, in specified circumstances and for specified statutory provisions, be treated as if it were so listed. The Table is set out in the Health Insurance (General Medical Services Table) Regulations, which is remade each year.
Purpose
The purpose of the Health Insurance (Review of GP Mental Health Treatment Plan) Revocation Determination 2012 (this Determination) is to revoke the Health Insurance (Review of GP Mental Health Treatment Plan) Determination 2011 (the 2011 Determination).
Background
Prior to 1 November 2011, GP mental health treatment plans were provided under items 2702 and 2710 in the Health Insurance (General Medical Services Table) Regulations 2010. With the revocation of those regulations and their remaking as the Health Insurance (General Medical Services Table) Regulations 2011, items 2702 and 2710 were replaced by four new items for the preparation of a GP mental health treatment plan, items 2700, 2701, 2715 and 2717.
Item 2712 of the Table provides for the review of a GP mental health treatment plan. In accordance with subclause 2.20.6(4) of the Table, medicare benefits may only be paid for item 2712 where certain prerequisites are met, one of which is that a GP mental health treatment plan has been prepared for the patient in the previous 12 months (paragraph 2.20.6(4)(a)). Due to a drafting oversight, paragraph 2.20.6(4)(a) of the Health Insurance (General Medical Services Table) Regulations 2011 provides that only GP mental health treatment plans prepared under new items 2700, 2701, 2715 and 2717 will trigger eligibility for a review of a plan under item 2712. Accordingly, patients who had received a plan under items 2702 or 2710 within the previous 12 months are not eligible to access a review of the plan under item 2712.
To remedy this oversight, the Health Insurance (Review of GP Mental Health Treatment Plan) Determination 2011 created a new item for the review of a GP mental health treatment plan, corresponding to item 2712, to ensure that patients who have received a plan in the previous 12 months under items 2702 or 2710 are able to receive medicare benefits for a review of that plan.
Amendments to subclause 2.20.6(4) of the Health Insurance (General Medical Services Table) Regulations 2011 taking effect 1 March 2012 will correct the drafting oversight in the Table and provide for GP mental health treatment plans prepared under items 2702 or 2710 to be reviewed under item 2712.
As patients provided with a GP mental health treatment plan under items 2702 or 2710 in the last 12 months will, from 1 March 2012, no longer need to rely on the 2011 Determination to access medicare benefits for a review of that plan, the 2011 Determination will become redundant. This Determination will therefore revoke the 2011 Determination from that date.
Commencement and cessation
This Determination commences on 1 March 2012 and ceases on 2 March 2012.
Consultation
No consultation has been undertaken. The drafting oversight in the Table that led to the creation of the 2011 Determination has now been fixed, and the 2011 Determination is therefore redundant.
Human Rights Statement of Compatibility
This Determination is compatible with the human rights and freedoms recognised or
declared in the international instruments listed in section 3 of the Human Rights
(Parliamentary Scrutiny) Act 2011.
A determination made under subsection 3C(1) of the Act is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
Overview
The Health Insurance (Review of GP Mental Health Treatment Plan) Revocation Determination 2012 was enacted to address a specific oversight in the Health Insurance (General Medical Services Table) Regulations 2011. This oversight affected the eligibility of patients who had received a GP mental health treatment plan under certain items prior to the new items being introduced, thereby impacting their ability to access a review of their plan. The determination revokes the Health Insurance (Review of GP Mental Health Treatment Plan) Determination 2011, which was created to temporarily address this issue. The determination is made under subsection 3C(1) of the Health Insurance Act 1973, allowing the Minister to adjust the listing of health services as necessary. The policy objective of this revocation is to ensure that patients who received a GP mental health treatment plan under the old items can now access a review without needing to rely on the now-redundant 2011 Determination, following the amendment to the regulations that takes effect from 1 March 2012.
Scope and Application
The Health Insurance (Review of GP Mental Health Treatment Plan) Revocation Determination 2012 applies to the Minister for Health and any individual or entity involved in the provision or claiming of benefits for GP mental health treatment plans under the Health Insurance Act 1973. It targets the oversight in the Health Insurance (General Medical Services Table) Regulations 2011 concerning the eligibility for reviews of GP mental health treatment plans. The determination is a Commonwealth instrument, impacting the provision of health services across Australia. It specifically excludes any plans prepared under the new items 2700, 2701, 2715 and 2717, as these are already covered by the corrected regulations. The revocation of the 2011 Determination, effective from 1 March 2012, aligns with the legislative changes set to correct the oversight in the Table.
Key Provisions
The Health Insurance (Review of GP Mental Health Treatment Plan) Revocation Determination 2012 (section 1) revokes the Health Insurance (Review of GP Mental Health Treatment Plan) Determination 2011 (section 2) to address a drafting oversight in the Health Insurance (General Medical Services Table) Regulations 2011. The 2011 Determination was introduced to allow patients who had received a GP mental health treatment plan under certain items to be eligible for a review of that plan. However, as the oversight has been corrected by amendments to the Regulations taking effect on 1 March 2012, the 2011 Determination will become redundant. Therefore, this Revocation Determination will revoke the 2011 Determination from 1 March 2012, ensuring that patients will no longer need to rely on the 2011 Determination to access Medicare benefits for a review of their GP mental health treatment plan.
The Revocation Determination imposes no new obligations or requirements on parties or entities governed by the Health Insurance Act 1973 (the Act). Instead, it revokes the 2011 Determination, which had previously created a new item for the review of a GP mental health treatment plan to address the drafting oversight in the Regulations. By revoking the 2011 Determination, the Revocation Determination ensures that the new item will no longer be necessary once the amendments to the Regulations take effect on 1 March 2012.
There are no offences, penalties, or civil/criminal consequences for breach associated with the Revocation Determination itself, as it is primarily a legislative instrument to revoke the 2011 Determination and does not impose any new requirements or obligations. However, it is important to note that the Health Insurance Act 1973 and the Health Insurance (General Medical Services Table) Regulations 2011 may still contain provisions that could result in penalties or consequences for breaches of the Act or the Regulations. For example, section 19A of the Act provides that a person who contravenes any provision of the Act or the Regulations is liable to a penalty not exceeding 100 penalty units (currently AUD 11,000) for each contravention. Additionally, section 19B of the Act allows for the recovery of benefits paid in error or where a person has been overpaid under the Act. The maximum penalties for contraventions of the Act and the Regulations are specified in the relevant provisions of the legislation.