Health Insurance (Section 3C General Medical Services – Anterior and Posterior Pelvic Ring Disruption) Determination 2021

Administered by Department of Health, Disability and Ageing

Legislation au F2021L00821 Not in force Legislative Instrument

Legislation content

Health Insurance (Section 3C General Medical Services – Anterior and Posterior Pelvic Ring Disruption) Determination 2021

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 1

Compilation date: 1 July 2021

Includes amendments up to: F2021L00944

Registered: 27 July 2021

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C General Medical Services – Anterior and Posterior Pelvic Ring Disruption) Determination 2021 that shows the text of the law as amended and in force on 1 July 2021 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self-repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

 

 

 

Contents

1. Name

2. Commencement

3. Authority

4. Definitions

5. Treatment of relevant services

Schedule 1 – relevant services

Endnotes

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

 

1.  Name

 This instrument is the Health Insurance (Section 3C General Medical Services – Anterior and Posterior Pelvic Ring Disruption) Determination 2021.

2.  Commencement

(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

1 July 2021

 

 Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3.  Authority

  This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4.  Definitions

(1) In this instrument:

Act means the Health Insurance Act 1973.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.

Schedule means a Schedule to this instrument.

Note: The following terms are defined in subsection 3(1) of the Act:

         clinically relevant service;

         general medical services table;

         item;

         professional service.

(2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

 

5.  Treatment of relevant services

 

For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a)                    it were both a professional service and a medical service; and

(b)                    there were an item in the general medical services table that:

  1.       related to the service; and
  2.       specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

Schedule 1 – relevant services

 

Group T8 – Surgical Operations

Subgroup 15 – Orthopaedic

Column 1

Item

Column 2

Description

Column 3

Fee ($)

47491

Combined anterior and posterior pelvic ring disruption, including sacroiliac joint disruption, treatment of fracture by open reduction and internal fixation of both anterior and posterior ring segments

(Anaes.) (Assist.) (H)

1,616.30

Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Editorial changes

The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.

If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

Endnote 2—Abbreviation key

ad = added or inserted

o = order(s)

am = amended

Ord = Ordinance

amdt = amendment

orig = original

c = clause(s)

par = paragraph(s)/subparagraph(s)

C[x] = Compilation No. x

/subsubparagraph(s)

Ch = Chapter(s)

pres = present

def = definition(s)

prev = previous

Dict = Dictionary

(prev…) = previously

disallowed = disallowed by Parliament

Pt = Part(s)

Div = Division(s)

r = regulation(s)/rule(s)

ed = editorial change

reloc = relocated

exp = expires/expired or ceases/ceased to have

renum = renumbered

effect

rep = repealed

F = Federal Register of Legislation

rs = repealed and substituted

gaz = gazette

s = section(s)/subsection(s)

LA = Legislation Act 2003

Sch = Schedule(s)

LIA = Legislative Instruments Act 2003

Sdiv = Subdivision(s)

(md) = misdescribed amendment can be given

SLI = Select Legislative Instrument

effect

SR = Statutory Rules

(md not incorp) = misdescribed amendment

SubCh = SubChapter(s)

cannot be given effect

SubPt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

commenced or to be commenced

 

Endnote 3—Legislation history

 

Name

Registration

Commencement

Application, saving and transitional provisions

Health Insurance (Section 3C General Medical Services – Anterior and Posterior Pelvic Ring Disruption) Determination 2021

24 June 2021 (F2021L00821)

1 July 2021 (s 2(1) item)

 

Health Insurance Legislation Amendment (Section 3C General Medical Services – GP Mental Health Treatment Plan Review) Determination 2021

30 June 2021 (F2021L00919)

Sch 2: repealed before commencing (s 2(1) item 3)

as repealed by

 

 

 

Health Insurance Legislation Amendment (Section 3C General Medical Services – GP Mental Health Treatment Plan Review) Determination (No. 2) 2021

1 July 2021 (F2021L00944)

Sch 1: 30 June 2021 (s 2(1) item 2)

 

Health Insurance Legislation Amendment (Section 3C General Medical Services – GP Mental Health Treatment Plan Review) Determination (No. 2) 2021

1 July 2021 (F2021L00944)

Sch 3: 1 July 2021 (s 2(1) item 4)

 

Endnote 4—Amendment history

 

Provision affected

How affected

s 2.....................

rep LA s 48D

Schedule 1

 

Schedule 1................

am F2021L00944

 

 

Overview

The Health Insurance (Section 3C General Medical Services – Anterior and Posterior Pelvic Ring Disruption) Determination 2021 was enacted to address a gap in the provision of health services for anterior and posterior pelvic ring disruptions, specifically for treatments involving open reduction and internal fixation of both anterior and posterior ring segments. This legislative instrument was made under subsection 3C(1) of the Health Insurance Act 1973 by the Parliament of Australia. The policy objective of this determination is to ensure that specified services related to the treatment of anterior and posterior pelvic ring disruptions are treated as both professional and medical services under the relevant provisions of the Act, thereby facilitating appropriate reimbursement for these critical medical procedures.

Scope and Application

The Health Insurance (Section 3C General Medical Services – Anterior and Posterior Pelvic Ring Disruption) Determination 2021 applies to relevant services specified in the Schedule to the Determination, which are health services related to the treatment of anterior and posterior pelvic ring disruptions, including sacroiliac joint disruption, through open reduction and internal fixation of both anterior and posterior ring segments. This instrument is made under subsection 3C(1) of the Health Insurance Act 1973 and commenced on 1 July 2021. It applies nationally, covering all persons and entities involved in providing or receiving these specific health services under the Act and related regulations, as well as the National Health Act 1953. The services specified in the Schedule are treated as both professional and medical services, with a designated fee for each State as outlined. The Determination ensures that these services are recognised and reimbursed accordingly within the Medicare framework, subject to the terms and conditions of the Act and related legislation. There are no stated exclusions or exemptions in this Determination, though the scope is limited to the specified services in the Schedule.

Key Provisions

The Health Insurance (Section 3C General Medical Services – Anterior and Posterior Pelvic Ring Disruption) Determination 2021 (the Determination) specifies that certain health services related to the treatment of anterior and posterior pelvic ring disruption will be recognised as both a professional service and a medical service under the Health Insurance Act 1973 (the Act). According to Section 5 of the Determination, these services, when provided in accordance with the Determination and as a clinically relevant service, will be treated as if they were both a professional service and a medical service, and as if there were an item in the general medical services table that related to the service and specified a fee for the service in relation to each state. The Determination imposes obligations on health service providers and insurers to ensure that the specified services are billed and reimbursed in accordance with the provisions of the Act and the Determination. Providers must adhere to the stipulated fees and billing requirements for these services, while insurers are obligated to process claims in line with the fees and criteria outlined in the Schedule attached to the Determination. The Determination does not explicitly outline specific offences, penalties, or civil/criminal consequences for breaches. However, any non-compliance with the requirements set out in the Determination could potentially lead to disputes between service providers and insurers, which may be subject to resolution under the relevant provisions of the Act or other applicable laws. Providers who fail to comply with the fee structure or billing requirements may face reimbursement issues or other financial consequences, while insurers who do not adhere to the stipulated payment rates could face claims or complaints from service providers. The specific consequences of non-compliance would depend on the nature and extent of the breach, as well as the applicable laws and regulations governing health insurance and medical services in Australia.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.