Health Insurance (Statutory Rules 1992 Nos. 95 and 119) (Repeal) 1992 No.
120
EXPLANATORY STATEMENT
STATUTORY RULES 1992 No. 120
Issued by the authority of the Minister for Health, Housing and Community Services.
Health Insurance Act 1973
Health Insurance (Statutory Rules 1992 Nos. 95 and 119) (Repeal).
Section 133 of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make regulations for the purposes of the Act.
Section 4AA of the Act provides that regulations may prescribe a table of diagnostic imaging services. The Health Insurance (Diagnostic Imaging Services Table) Regulations prescribe such a table.
Section 9 of the Act provides that, in effect, Medicare benefits shall be calculated by reference to the fees for diagnostic imaging services set out in the table of diagnostic imaging services (the table) in the Schedule to the Act.
The Repeal regulations repeal Statutory Rules 1992 Nos.95 and 119 which were due to come into operation from 1 May 1992. Statutory Rules 1992 No.95 provided for a new item structure for Diagnostic Radiology when rendered at a "CP" (comprehensive practice), "OP" (other practice) or "NS" (non-specialist radiologist practice). In addition, certain items in the Diagnostic Imaging Services Table, identified with the symbol "(A)", required the attendance of a specialist radiologist for eligibility for Medicare benefits. Exemptions from compliance with the requirements were also provided for. Statutory Rules 1992 No.119 extended the exemptions, for mammography items, when rendered in certain breast clinics.
These regulations arise following the presentation of the report of the Standing Committee on Community Affairs to the Senate on 28 April 1992, recommending, among other things, that:
"1. The Health Insurance (1991-1992 Diagnostic Imaging Services Table) Regulations (Amendment) be disallowed at this stage, and that, to avoid any difficulties arising from the fact that the commencement date for the Regulations is 1 May 1992, the Minister be asked to repeal the Regulations."
The effect of the Repeal regulations is that the proposed restructure will not be implemented and that the current regulations (that have applied from 1 December 1991) will continue unchanged.
Overview
The Health Insurance (Statutory Rules 1992 Nos. 95 and 119) (Repeal) 1992 No. 120 was enacted to address an issue regarding the implementation of new regulations for diagnostic imaging services under the Health Insurance Act 1973. These regulations were intended to introduce a new item structure for diagnostic radiology services and specify requirements for specialist radiologist attendance for certain diagnostic imaging services to be eligible for Medicare benefits. However, following a recommendation by the Standing Committee on Community Affairs, the Minister for Health, Housing and Community Services was prompted to repeal the proposed regulations to prevent any difficulties that might arise from their implementation on 1 May 1992. The objective of the repeal was to ensure continuity in the existing regulatory framework without disruption, thereby maintaining the status quo until further amendments could be appropriately considered and implemented.
Scope and Application
The Health Insurance (Statutory Rules 1992 Nos. 95 and 119) (Repeal) 1992 No. 120 applies to the Health Insurance Act 1973, specifically addressing the proposed changes to the diagnostic imaging services table as outlined in Statutory Rules 1992 Nos. 95 and 119. This repeal effectively halts the implementation of the new item structure for Diagnostic Radiology and the associated requirements for specialist radiologist attendance, which were scheduled to take effect on 1 May 1992. As a result, the existing regulations that have been in place since 1 December 1991 will remain unchanged. This legislation applies nationally within the Commonwealth of Australia, affecting entities and practitioners engaged in diagnostic imaging services that are eligible for Medicare benefits. The repeal was enacted in response to a recommendation from the Standing Committee on Community Affairs to the Senate, ensuring that no disruptions occur due to the proposed changes.
Key Provisions
The primary sections of the Health Insurance (Statutory Rules 1992 Nos. 95 and 119) (Repeal) 1992 No. 120 involve the repeal of two sets of regulations previously made under the Health Insurance Act 1973 (the Act). Section 133 of the Act allows the Governor-General to make regulations for the purposes of the Act, and Section 4AA specifies that these regulations may include a table of diagnostic imaging services. The Health Insurance (Diagnostic Imaging Services Table) Regulations prescribed such a table, and Section 9 of the Act states that Medicare benefits are calculated by reference to the fees for these services as set out in the table. The Repeal regulations (No. 120) specifically repeal Statutory Rules 1992 Nos. 95 and 119, which were originally intended to be implemented from 1 May 1992, and effectively nullify the proposed changes.
The obligations and requirements imposed by the Repeal regulations are primarily focused on maintaining the status quo in the administration of diagnostic imaging services under Medicare. The Act continues to require that Medicare benefits be calculated by reference to the existing table of diagnostic imaging services, as set out in the Health Insurance (Diagnostic Imaging Services Table) Regulations. By repealing the amendments proposed in Statutory Rules 1992 Nos. 95 and 119, the current fee structure and eligibility criteria for these services remain unchanged. This means that diagnostic imaging services will continue to be governed by the existing regulations, without the new item structure or additional requirements for specialist radiologist attendance as outlined in the repealed rules.
The consequences of non-compliance with the Act, particularly concerning the continued application of the existing diagnostic imaging services table, could have significant implications. While the Repeal regulations themselves do not create new offences or penalties, any failure to adhere to the requirements of the Health Insurance Act 1973 could result in legal repercussions. For example, providers or beneficiaries who do not comply with the stipulated fee structures or eligibility criteria could face penalties under the Act, including potential fines or other civil or criminal sanctions. However, the specific penalties for non-compliance with the diagnostic imaging services provisions are not detailed in the Repeal regulations themselves, and would typically be addressed under the general provisions of the Act or related legislation.