Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018

Administered by Department of Health, Disability and Ageing

Legislation au F2018L00719 Not in force Legislative Instrument

Legislation content

Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 3

Compilation date: 1 July 2020

Includes amendments up to: F2020L00748

Registered: 26 August 2020

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018 that shows the text of the law as amended and in force on 1 July 2020 (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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.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 of Determination

3. Authority

4. Definitions

5. Treatment of relevant services

6. Application of items 35581 and 35582

7. Application of provisions of the general medical services table

Schedule 1 – relevant services

Endnotes 4

Endnote 1—About the endnotes 4

Endnote 2—Abbreviation Key 5

Endnote 3—Legislation history 6

Endnote 4—Amendment history 7

 

 

1.                  Name of Determination

This Determination is the Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018.

3.                  Authority

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

4.                  Definitions

(1) In this Determination:

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 Determination.

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

         clinically relevant service

         item

         general medical services table

         professional service

(2) Unless the contrary intention appears, a reference in this Determination 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 Determination 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 Group T8 of the general medical services table that:

(i) related to the service; and

(ii) specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

6.                  Application of items 35581 and 35582

For items 35581 and 35582 the size of the excised graft material must be histologically tested and confirmed.

7.                  Application of provisions of the general medical services table

(1) Clause 1.2.6 of the general medical services table shall have effect as if the items contained in the Schedule were also specified in subclause 1.2.6(1).

(2) Clause 1.2.7 of the general medical services table shall have effect as if the items contained in the Schedule were also specified in subclause 1.2.7(1).

Schedule 1 – relevant services

 

Group T8 – Surgical Operations

Subgroup 4—Gynaecological

Item

Service

Fee ($)

35570

Anterior vaginal compartment repair by vaginal approach for pelvic organ prolapse (involving repair of urethrocele and cystocele), using native tissue without graft, other than a service associated with a service to which item 35573, 35577 or 35578 applies (H) (Anaes.) (Assist.)

571.15

35571

Posterior vaginal compartment repair by vaginal approach for pelvic organ prolapse involving repair of one or more of the following:

(a) perineum;

(b) rectocoele;

(c) enterocoele;

using native tissue without graft, other than a service associated with a service to which item 35573, 35577 or 35578 applies (H) (Anaes.) (Assist.)

571.15

35573

Anterior and posterior vaginal compartment repair by vaginal approach for pelvic organ prolapse (involving anterior and posterior compartment defects), using native tissue without graft, other than a service associated with a service to which item 35577 or 35578 applies (H) (Anaes.) (Assist.)

856.85

35577

Manchester (Donald Fothergill) operation for pelvic organ prolapse (includes cervical amputation, anterior and posterior native tissue vaginal wall repairs without graft) (H) (Anaes.) (Assist.)

695.60

35581

Vaginal procedure for excision of graft material in symptomatic patients with graft related complications, including graft related pain or discharge and bleeding related to graft exposure, less than 2cm2 in its maximum area, either singly or in multiple pieces, other than a service associated with a service to which item 35582 or 35585 applies (H) (Anaes.) (Assist.)

571.15

35582

Vaginal procedure for excision of graft material in symptomatic patients with graft related complications, including graft related pain or discharge and bleeding related to graft exposure, more than 2cm2 in its maximum area, either singly or in multiple pieces, other than a service associated with a service to which item 35581 or 35585 applies (H) (Anaes.) (Assist.)

856.85

35585

Abdominal procedure either open, laparoscopic or robotic, for removal of graft material in patients symptomatic with graft related complications, including graft related pain or discharge and bleeding related to graft exposure or where the graft has penetrated adjacent organs such as the bladder (including urethra) or bowel, including retroperitoneal dissection and mobilisation of bladder and/or bowel, other than a service associated with a service to which item 35581 or 35582 applies (H) (Anaes.) (Assist.)

1,519.20

 

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—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018

6 June 2018 (F2018L00719)

1 July 2018 (s 2)

 

Health Insurance (Section 3C General Medical Services – Medicare Indexation) Amendment Determination 2019

11 Apr 2019 (F2019L00605)

Sch 1 (item 22): 1 July 2019 (s 2(1) item 1)

Health Insurance Legislation Amendment (Section 3C – Medical and Diagnostic Imaging Services) Determination 2020

29 Apr 2020 (F2020L00518)

Sch 1 (items 9, 10): 1 May 2020 (s 2(1) item 1)

Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2020

18 June 2020 (F2020L00748)

Sch 1 (items 1-7): 1 July 2020 (s 2(1) item 1)

 

Endnote 4—Amendment history

 

Provision affected

How affected

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

rep LA s 48D

s 7.....................

am F2020L00518

Schedule 1

 

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

am F2019L00605; F2020L00748

 

Overview

The Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018 was enacted to address the need for the inclusion of specific medical services related to the transvaginal repair of pelvic organ prolapse and the excision of graft material under the Health Insurance Act 1973. This legislative instrument was made under subsection 3C(1) of the Act by the Parliament of Australia, aiming to ensure that these clinically relevant services are treated as both professional and medical services, with appropriate fees specified for each state. The policy objective of the Determination is to provide clarity and consistency in the billing and reimbursement of these services under the Medicare scheme, ensuring they are recognised and adequately compensated in alignment with other general medical services. This Determination operates by treating the specified services as if they were included in the general medical services table, thereby facilitating their recognition and inclusion in the Medicare Benefits Schedule. It also sets out specific requirements for the histological testing and confirmation of the size of excised graft material for certain procedures. The Determination ensures that the services are appropriately categorised and compensated, thereby improving access to necessary healthcare services for patients suffering from pelvic organ prolapse and graft-related complications.

Scope and Application

The Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018 applies to relevant services provided under the Health Insurance Act 1973. This determination specifies certain services related to the transvaginal repair of pelvic organ prolapse and the excision of graft material, ensuring they are treated as professional and medical services for Medicare purposes. The relevant services are detailed in Schedule 1 and are to be considered as items in Group T8 of the general medical services table, with specified fees. The determination applies across Australia, as it is a Commonwealth instrument. There are no explicit exclusions, but specific conditions apply, such as the requirement for histological testing of excised graft material for certain procedures. The application and fee structure of these services are further detailed and amended through subordinate instruments, as evidenced by the legislative history and amendment notes included in the endnotes of the determination.

Key Provisions

The Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018, under subsection 3C(1) of the Health Insurance Act 1973, specifies certain health services related to the transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material. These services are defined as 'relevant services' and are to be treated as both professional and medical services for the purposes of the Act. The fees for these services are detailed in a Schedule attached to the Determination (section 5). Specifically, the services involve repairs of the anterior and posterior vaginal compartments, using native tissue without graft, and excision of graft material in symptomatic patients with graft-related complications. The Determination imposes specific obligations on medical practitioners and entities involved in the provision of these services. For instance, for items 35581 and 35582, the size of the excised graft material must be histologically tested and confirmed (section 6). Furthermore, the items in the Schedule are to be treated as if they were specified in certain clauses of the general medical services table (section 7). These obligations ensure that the services are provided according to the standards and fees outlined in the Determination. Failure to comply with the provisions of this Determination may result in legal consequences. While the Determination itself does not explicitly state the penalties for non-compliance, breaches of the Health Insurance Act 1973 or related regulations could lead to civil or criminal penalties, depending on the nature and severity of the breach. Typically, penalties for such breaches can include fines and, in severe cases, imprisonment. The specific penalties would be governed by the broader legislative framework under which the Determination operates. In summary, the Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018 outlines specific services, imposes obligations on medical practitioners, and, while not explicitly detailing penalties, implies potential legal repercussions for non-compliance through its integration within the broader Health Insurance Act 1973 framework.

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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.