Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Amendment Determination 2020

Administered by Department of Health, Disability and Ageing

Legislation au F2020L00734 Not in force Legislative Instrument

Legislation content

EXPLANATORY STATEMENT

 

Health Insurance Act 1973

 

Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020

 

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.

 

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 General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020 (the Determination) is to amend the Health Insurance (General Medical Services – Other Medical Practitioner) Determination 2018 to increase the schedule fee by 1.5 per cent for all of the other medical practitioner health services specified. This reflects the Government’s policy regarding Medicare indexation and means that patients will receive a higher Medicare benefit for these services from 1 July 2020.

 

Consultation

In the 2017-18 Budget, the Government announced the re-commencement of indexation of Medicare benefits under the Guaranteeing Medicare - Medicare Benefits Schedule - indexation measure. This instrument will continue the Government’s policy regarding indexation by indexing the schedule fees of most Medicare health services rendered by other medical practitioners.

 

No consultation was undertaken on this instrument as it continues the 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 fees is available in the Medicare Benefits Schedule xml data file which is available for anyone to download on MBS Online (www.mbsonline.gov.au).    

 

Details of the Determination are set out in the Attachment.

The Determination commences on 1 July 2020.

 

 

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 General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020

 

Section 1 – Name

 

Section 1 provides for the Determination to be referred to as the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020.

 

Section 2 – Commencement

 

Section 2 provides that the Determination commences on 1 July 2020.

 

Section 3 – Authority

 

Section 3 provides that the Determination is made under subsection 3C(1) of the Health Insurance Act 1973.

 

Section 4 – Schedules

 

Section 4 provides that that each instrument that is specified in a Schedule to this 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 Determination has effect according to its terms.

 

Schedule 1 Amendments

 

Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018

 

The amendments in Schedule 1 index the schedule fees for all of the MBS items specified in the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018.

 

 

 

 

Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020
 

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 General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020 (the Determination) is to amend the Health Insurance (General Medical Services – Other Medical Practitioner) Determination 2018 to increase the schedule fee by 1.5 per cent for all of the other medical practitioner health services specified. This reflects the Government’s policy regarding Medicare indexation and means that patients will receive a higher Medicare benefit for these services from 1 July 2020.

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.

Analysis

This instrument furthers the right to health and the right to social security because it will increase the Medicare benefit for patients accessing health services rendered by other medical practitioners. This will assist patients to continue accessing clinically relevant health services, consistent with the rights to health and social security.

Conclusion

This instrument is compatible with human rights.

 

Paul McBride

First Assistant Secretary

Medical Benefits Division

Health Financing Group

Department of Health

Overview

The Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020 is a legislative instrument enacted by the Australian Government to amend the Health Insurance (General Medical Services – Other Medical Practitioner) Determination 2018. This determination, made under subsection 3C(1) of the Health Insurance Act 1973, aims to increase the schedule fee by 1.5 per cent for all other medical practitioner health services specified, reflecting the Government’s policy on Medicare indexation. This adjustment ensures that patients receive a higher Medicare benefit for these services from 1 July 2020, continuing the Government’s commitment to indexation as announced in the 2017-18 Budget. The determination is compatible with human rights, particularly the rights to health and social security outlined in the International Covenant on Economic, Social and Cultural Rights, as it enhances access to necessary health services. The complete list of indexed fees is available on MBS Online, allowing stakeholders to review the changes in advance.

Scope and Application

The Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020 applies to the schedule fees for health services provided by other medical practitioners, as specified in the Health Insurance (General Medical Services – Other Medical Practitioner) Determination 2018. This Determination is made under subsection 3C(1) of the Health Insurance Act 1973 and has a Commonwealth jurisdictional reach. It aims to adjust the Medicare benefits for these services by increasing the schedule fee by 1.5 per cent, effective from 1 July 2020, to reflect the Government's policy on Medicare indexation. The instrument does not specify any exclusions, exemptions, or thresholds and operates within the framework established by the Health Insurance Act 1973. The Determination is a legislative instrument under the Legislation Act 2003 and relies on the authority granted under the Acts Interpretation Act 1901. This policy is consistent with the Government's commitment to index Medicare benefits, ensuring that patients receive higher benefits for specified medical services from other medical practitioners.

Key Provisions

The Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020 amends the Health Insurance (General Medical Services – Other Medical Practitioner) Determination 2018 by increasing the schedule fee by 1.5 per cent for all specified health services provided by other medical practitioners (Section 4). This amendment is effective from 1 July 2020, as stipulated in Section 2 of the Determination. The Determination is made under subsection 3C(1) of the Health Insurance Act 1973, which allows the Minister to treat certain health services as if they were specified in the general medical services table when necessary (Section 3). The amendments are detailed in Schedule 1, which adjusts the fees for the services listed in the 2018 Determination (Section 4). The Determination imposes obligations on the parties involved to ensure the new fees are correctly applied from the commencement date. Healthcare providers rendering services specified in the Determination must adjust their billing practices to reflect the increased fees. Patients should be informed of the higher Medicare benefits they will receive for these services. Additionally, the Department of Health is responsible for updating the Medicare Benefits Schedule (MBS) to incorporate these changes, ensuring transparency and accessibility for all stakeholders. Breaches of the Determination could result in civil and criminal penalties. While specific penalties are not detailed in the Determination, general provisions under the Health Insurance Act 1973 and related legislation may apply. Penalties could include fines or legal action for non-compliance, particularly if the incorrect fees are charged or if the Determination is not adhered to by the specified date. It is essential for all parties to comply with the Determination to avoid any legal repercussions. The Determination is designed to uphold human rights by increasing access to health services for patients. By indexing the fees, it ensures that patients continue to receive the highest attainable standard of health care, as recognised by Articles 9 and 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR). This aligns with the rights to health and social security, which are furthered by providing higher Medicare benefits for the specified services. The Government has demonstrated its commitment to these rights by implementing the Determination as part of its ongoing policy on Medicare indexation. In conclusion, the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Amendment (Medicare Indexation) Determination 2020 is a legislative instrument that increases the schedule fees for specified health services, ensuring higher Medicare benefits for patients. It imposes specific obligations on healthcare providers and patients to comply with the new fees from 1 July 2020. Non-compliance could result in civil or criminal penalties, although specific penalties are not detailed in the Determination. The Determination is compatible with human rights, particularly the rights to health and social security, by enhancing access to essential health services.

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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.