EXPLANATORY STATEMENT
Health Insurance Act 1973
Health Insurance (Section 3C Determination) Revocation Determination 2012
Issued by the Authority of the Minister for Health
Authority
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 shall, in specified circumstances and for specified statutory provisions, be treated as if it were so listed. The general medical services table is set out in the Health Insurance (General Medical Services Table) Regulations, which are remade each year.
Purpose
The purpose of this Determination is to revoke the Health Insurance (Other non-referred services) Determination 2012 (the 2012 Determination) made on 27 January 2012 and the Health Insurance Determination HS/1/1997 (the 1997 Determination) made on 30 May 1997.
Background
The 2012 Determination
The Health Insurance (General Medical Services Table) Regulations 2011 which commenced on 1 November 2011 contained several changes intended to improve the readability of the legislation. However, one of these changes resulted in the item descriptors for all non-referred attendance services under Group A2 of the general medical services table incorrectly describing the group of practitioners intended to have access to these services. As a result, a number of medical practitioners who had previously been eligible to bill for Group A2 services, such as specialists, consultant physicians and general practitioners registered on the Vocational Register, could no longer validly access Group A2 attendance items.
The 2012 Determination remedied this error by creating new Medicare items corresponding to the non-referred attendance services under Group A2 but which could be accessed by the full cohort of practitioners who had been able to provide these services prior to 1 November 2011.
The Health Insurance (General Medical Services Table) Amendment Regulations 2012 (No. 3) will be taken to have amended the general medical services table with effect from 1 November 2011 to correct the drafting errors associated with Group A2 services. All practitioners who are currently able to access the non-referred services under the 2012 Determination will be eligible to use Group A2 items from 1 July 2012 and the 2012 Determination will therefore become redundant.
The 1997 Determination
Prior to June 1997 the Act allowed for an increase in the Medicare benefit payable for services of unusual length or complexity. Section 11 of the Act provided for the (then) Health Insurance Commission to increase the benefit in accordance with principles set by the Medical Benefits Advisory Committee. Section 11 of the Act was repealed with effect from 19 June 1997.
The 1997 Determination created new Medicare items for certain long or difficult procedures, to ensure that practitioners could continue to receive higher benefits in recognition of the additional time and skill required to perform the service. It was made as an interim measure pending the inclusion of the new items in the general medical services table during its next amendment. The items in the 1997 Determination were included in the general medical services table on 1 November 1997 and the 1997 Determination should have been revoked at the same time. However, this was not done.
A recent Departmental review of determinations made under section 3C of the Act identified the 1997 Determination as redundant and it is now being revoked.
Details of the Determination are as follows:
- section 1 provides that the Determination is the Health Insurance (Section 3C Determination) Revocation Determination 2012;
- section 2 provides that the Determination commences on the day it is registered on the Federal Register of Legislative Instruments; and
- section 3 provides that the Determination revokes the 2012 Determination and the 1997 Determination.
Consultation
No consultation has been undertaken on the making of this instrument. Following the 1 July 2012 amendments to the general medical services table the 2012 Determination will become redundant. The 1997 Determination has also been rendered redundant as the items were included in the general medical services table on 1 November 1997.
The Act specifies no conditions that need to be satisfied before the power to make the Determination may be exercised.
This Determination commences on the day it is registered on the Federal Register of Legislative Instruments.
The Determination is a legislative instrument for the purposes of the Legislative Instruments Act 2003.