EXPLANATORY STATEMENT
Health Insurance Act 1973
Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Amendment (Aboriginal and Torres Strait Islander Health Assessments) Determination 2025
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 GMST) shall, in specified circumstances and for specified statutory provisions, be treated as if it were specified in the GMST.
The GMST 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 (the GMST Regulations).
This instrument is made pursuant to subsection 33(3) of the Acts Interpretation Act 1901, which provides that a power to make a legislative or administrative instrument includes the power to repeal, rescind, revoke amend, or vary any that instrument in the same manner and subject to the same conditions.
Purpose
The Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Amendment (Aboriginal and Torres Strait Islander Health Assessments) Determination 2025 (the Amendment Determination) amends the Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Determination 2021 (the Principal Determination) from 1 March 2026 to implement changes to health assessment services for people of Aboriginal or Torres Strait Islander descent.
More specifically, the Amendment Determination makes changes with respect to telehealth video attendance services described in Medicare Benefits Schedule (MBS) items 92004 and 92011 to:
- better align these existing health assessment services for people of Aboriginal or Torres Strait Islander descent with best practice, by specifying the clinical requirements for those services in the descriptors for the relevant items; and
- ensure holistic care for patients receiving these health assessment services.
The Amendment Determination will commence immediately after the Health Insurance Legislation Amendment (2026 Measures No. 1) Regulations 2026 (the March 2026 Regulations). Subject to the making of legislation, the March 2026 Regulations will amend the GMST Regulations to clarify the requirements for MBS items for face-to-face health assessment services for people of Aboriginal or Torres Strait Islander descent described in items 715 and 228. The Amendment Determination will mirror the March 2026 Regulations changes for telehealth equivalent services described in items 92004 and 92011.
The changes listed in the Amendment Determination were agreed to as part of the 2025-26 Budget under the Strengthening Medicare measure.
Consultation
The changes made by the Amendment Determination were informed by public consultation pursuant to the Department of Health, Disability and Ageing’s review of MBS health assessment items, which was conducted in line with recommendations by the MBS Review Taskforce in 2020. Stakeholder submissions - including from the Royal Australian College of General Practitioners and the National Aboriginal Community Controlled Health Organisation - were supportive of the changes. The sector was also consulted on both the revised item descriptors and subclauses.
The Amendment Determination is a legislative instrument for the purposes of the Legislation Act 2003.
The Amendment Determination commences immediately after the commencement of the Health Insurance Legislation Amendment (2026 Measures No. 1) Regulations 2026.
Details of the Amendment Determination are set out in the Attachment.
Authority: Subsection 3C(1) of the
Health Insurance Act 1973
ATTACHMENT
Details of the Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Amendment (Aboriginal and Torres Strait Islander Health Assessments) Determination 2025
Section 1 – Name
Section 1 provides for the instrument to be referred to as the Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Amendment (Aboriginal and Torres Strait Islander Health Assessments) Determination 2025 (the Amendment Determination).
Section 2 – Commencement
Section 2 provides for the Amendment Determination to commence immediately after the commencement of the Health Insurance Legislation Amendment (2026 Measures No. 1) Regulations 2026.
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 General Medical Services – Telehealth Attendances) Determination 2021 (the Principal Determination)
Items 1 and 2 amend clause 1.1.03 of the Principal Determination to transfer the clinical requirements and restrictions in subclauses 1.1.03(1) and (6) into the descriptors of Medicare Benefits Schedule (MBS) items 92004 and 92011 (see amendment items 3 and 4).
Items 3 and 4 amend MBS items 92004 and 92011, respectively, to repeal and substitute the current descriptors for those items. The revised item descriptors contain service requirements and restrictions previously set out in subclauses 1.1.03(1) and (6), and specify that these health assessment services include planning to manage the patient’s health priorities and undertaking or arranging any required investigations.
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 – Telehealth Attendances) Amendment (Aboriginal and Torres Strait Islander Health Assessments) Determination 2025
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 Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Amendment (Aboriginal and Torres Strait Islander Health Assessments) Determination 2025 (the Amendment Determination) amends the Health Insurance (Section 3C General Medical Services – Telehealth Attendances) Determination 2021 (the Principal Determination) from 1 March 2026 to implement changes to health assessment services for people of Aboriginal or Torres Strait Islander descent.
More specifically, the Amendment Determination makes changes with respect to telehealth video attendance services described in Medicare Benefits Schedule (MBS) items 92004 and 92011 to:
- better align these existing health assessment services for people of Aboriginal or Torres Strait Islander descent with best practice, by specifying the clinical requirements for those services in the descriptors for the relevant items; and
- ensure holistic care for patients receiving these health assessment services.
The Amendment Determination will commence immediately after the Health Insurance Legislation Amendment (2026 Measures No. 1) Regulations 2026 (the March 2026 Regulations). Subject to the making of legislation, the March 2026 Regulations will amend the GMST Regulations to clarify the requirements for MBS items for face-to-face health assessment services for people of Aboriginal or Torres Strait Islander descent described in items 715 and 228. The Amendment Determination will mirror the March 2026 Regulations changes for telehealth equivalent services described in items 92004 and 92011.
The changes listed in the Amendment Determination were agreed to as part of the 2025-26 Budget under the Strengthening Medicare measure.
Human rights implications
This instrument engages Articles 2, 3, 9, 12, 16, and 26 of the International Covenant on Economic Social and Cultural Rights (ICESCR), specifically the rights to equality and non-discrimination, 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 reflects contemporary clinical practice by maintaining existing health assessment services for people of Aboriginal or Torres Strait Islander descent. The instrument makes amendments to better reflect clinical requirements for existing telehealth health assessment services in relevant item descriptors, clearly setting out service requirements whilst also continuing to promote holistic patient care.
Conclusion
This instrument is compatible with human rights as it maintains the right to health, right to social security and the right of equality and non-discrimination.
Roland Balodis
A/g Assistant Secretary
MBS Policy and Reviews Branch
Medicare Benefits and Digital Health Division
Health Resourcing Group
Department of Health, Disability and Ageing