EXPLANATORY STATEMENT
Health Insurance Act 1973
Health Insurance (Section 3C Cleft Lip and Cleft Palate Services - Indexation) Amendment Determination 2023
Subsection 3C(1) of the Health Insurance Act 1973 (the Act) provides that the Minister may, by legislative instrument, determine that a health service not specified in an item in the general medical services table (the Table) shall, in specified circumstances and for specified statutory provisions, be treated as if it were specified in the Table.
The Table is set out in the regulations made under subsection 4(1) of the Act. The most recent version of the regulations is the Health Insurance (General Medical Services Table) Regulations 2021.
This instrument relies on subsection 33(3) of the Acts Interpretation Act 1901 (AIA). Subsection 33(3) of the AIA provides that where an Act confers a power to make, grant or issue any instrument of a legislative or administrative character (including rules, regulations or by-laws), the power shall be construed as including a power exercisable in the like manner and subject to the like conditions (if any) to repeal, rescind, revoke, amend, or vary any such instrument.
Purpose
The purpose of the Health Insurance (Section 3C Cleft Lip and Cleft Palate Services - Indexation) Amendment Determination 2023 (the Amendment Determination) is to amend the Health Insurance (Section 3C Cleft Lip and Cleft Palate Services) Determination 2020 (the Principal Determination) to apply indexation and to make consequential amendments to item 75621.
Schedule 1 of the Amendment Determination will apply annual indexation by increasing the schedule fee for all items in the Principal Determination by 3.6 per cent from 1 July 2023. This means that patients will receive a higher Medicare benefit for these services from 1 July 2023.
Schedule 2 of the Amendment Determination will also make consequential amendments to item 75621 to align the item with the broader review of the Medical Benefits Schedule (MBS) plastics and reconstructive surgery items by the MBS Review Taskforce. As these changes are made in alignment with changes made by the Health Insurance Legislation Amendment (2023 Measures No. 1) Regulations 2023, they are considered minor and administrative in nature.
Consultation
No consultation was undertaken on the indexation of the MBS services in Schedule 1 of the Amendment Determination, as this change continues business-as-usual implementation of the Government’s policy on Medicare indexation which is expected by stakeholders to be applied on 1 July of each year. The complete list of all indexed schedule fees will be distributed to stakeholders through the release of the 1 July 2023 MBS xml data file.
The department did not undertake consultation on the changes made in Schedule 2 of the Amendment Determination, as the changes are consequential and minor in nature.
Details of the Determination are set out in the Attachment.
The Determination will commence in two parts. The changes outlined in Schedule 1 will commence on 1 July 2023. The changes outlined in Schedule 2 will commence immediately after the commencement of the provisions covered by Schedule 1.
The Determination is a legislative instrument for the purposes of the Legislation Act 2003.
Authority: Subsection 3C(1) of the
Health Insurance Act 1973
ATTACHMENT
Details of the Health Insurance (Section 3C Cleft Lip and Cleft Palate Services - Indexation) Amendment Determination 2023
Section 1 – Name
Section 1 provides for the Amendment Determination to be referred to as the Health Insurance (Section 3C Cleft Lip and Cleft Palate Services - Indexation) Amendment Determination 2023.
Section 2 – Commencement
Section 2 provides that sections 1 to 4 and Schedule 1 of the Amendment Determination will commence on 1 July 2023; and Schedule 2 of the Amendment Determination will commence immediately after the commencement of the provisions covered by Schedule 1.
Section 3 – Authority
Section 3 provides that the Amendment Determination is made under subsection 3C(1) of the Health Insurance Act 1973.
Section 4 – Schedules
Section 4 provides that each instrument that is specified in a Schedule to this Amendment Determination is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Amendment Determination has effect according to its terms.
Schedule 1 – Amendments
Health Insurance (Section 3C Cleft Lip and Cleft Palate Services) Determination 2020
Schedule 1 - Indexation
Item [1] amends Section 8 Subsection (1) to apply indexation to all items contained in the Health Insurance (Section 3C Cleft Lip and Cleft Palate Services) Determination 2020. Indexation will be applied by 3.6%, which is represented as 1.036 in the Amendment Determination.
Schedule 2 – Amendments
Item [2] repeals and replaces item 75621 to make changes to subparagraph (a)(i) of the item descriptor. These changes are made in alignment with the broader review of the Medical Benefits Schedule (MBS) plastics and reconstructive surgery items by the MBS Review Taskforce, which have been implemented through the Health Insurance Legislation Amendment (2023 Measures No. 1) Regulations 2023. These amendments are considered minor and administrative in nature to incorporate changes made to items 45720 to 45754, which are being restructured under new item numbers by the Health Insurance Legislation Amendment (2023 Measures No. 1) Regulations 2023.
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Health Insurance (Section 3C Cleft Lip and Cleft Palate Services - Indexation) Amendment Determination 2023
This instrument 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.
Overview of the Determination
The purpose of the Health Insurance (Section 3C Cleft Lip and Cleft Palate Services - Indexation) Amendment Determination 2023 (the Amendment Determination) is to amend the Health Insurance (Section 3C Cleft Lip and Cleft Palate Services) Determination 2020 (the Principal Determination) to apply indexation and to make consequential amendments to item 75621.
Schedule 1 of the Amendment Determination will apply annual indexation by increasing the schedule fee for all items in the Principal Determination by 3.6 per cent from 1 July 2023. This means that patients will receive a higher Medicare benefit for these services from 1 July 2023.
Schedule 2 of the Amendment Determination will also make consequential amendments to item 75621 to align the item with the broader review of the Medical Benefits Schedule (MBS) plastics and reconstructive surgery items by the MBS Review Taskforce. As these changes are made in alignment with changes made by the Health Insurance Legislation Amendment (2023 Measures No. 1) Regulations 2023, they are considered minor and administrative in nature.
Human rights implications
This instrument engages Articles 9 and 12 of the International Covenant on Economic Social and Cultural Rights (ICESCR), specifically the rights to health and social security.
The Right to Health
The right to the enjoyment of the highest attainable standard of physical and mental health is contained in Article 12(1) of the ICESCR. The UN Committee on Economic Social and Cultural Rights (the Committee) has stated that the right to health is not a right for each individual to be healthy, but is a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health.
The Committee reports that the ‘highest attainable standard of health’ takes into account the country’s available resources. This right may be understood as a right of access to a variety of public health and health care facilities, goods, services, programs, and conditions necessary for the realisation of the highest attainable standard of health.
The Right to Social Security
The right to social security is contained in Article 9 of the ICESCR. It requires that a country must, within its maximum available resources, ensure access to a social security scheme that provides a minimum essential level of benefits to all individuals and families that will enable them to acquire at least essential health care. Countries are obliged to demonstrate that every effort has been made to use all resources that are at their disposal in an effort to satisfy, as a matter of priority, this minimum obligation.
The Committee reports that there is a strong presumption that retrogressive measures taken in relation to the right to social security are prohibited under ICESCR. In this context, a retrogressive measure would be one taken without adequate justification that had the effect of reducing existing levels of social security benefits, or of denying benefits to persons or groups previously entitled to them. However, it is legitimate for a Government to re-direct its limited resources in ways that it considers to be more effective at meeting the general health needs of all society, particularly the needs of the more disadvantaged members of society.
The right of equality and non-discrimination
The rights of equality and non-discrimination are contained in articles 2, 16 and 26 of the International Covenant on Civil and Political Rights (ICCPR). Article 26 of the ICCPR requires that all persons are equal before the law, are entitled without any discrimination to the equal protection of the law and in this respect, the law shall prohibit any discrimination and guarantee to all persons equal and effective protection against discrimination on any ground such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.
Analysis
This instrument will reflect contemporary clinical practice to ensure that patients continue to have access to health and social security through relevant subsidised medical services on the Medicare Benefits Schedule.
Conclusion
This instrument is compatible with human rights as it maintains the right to health and the right to social security.
Daniel McCabe
First Assistant Secretary
Medicare Benefits and Digital Health Division
Health Resourcing Group
Department of Health