EXPLANATORY STATEMENT
STATUTORY RULES 1984 NO. 265
ISSUED BY AUTHORITY OF THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
HEALTH INSURANCE (VARIATION OF FEES AND MEDICAL
SERVICES) (NO. 34) REGULATIONS
Section 133 of the Health Insurance Act 1973 (‘the Act’) provides that the Governor-General may make regulations prescribing all matters required or permitted by the Act to be prescribed, or necessary or convenient to be prescribed for carrying out or giving effect to the Act.
Schedule 1 to the Act contains a table of medical services and rules for the interpretation of the table. The table of medical services contains items which set out the description of each medical service, and the fee for the calculation of medicare benefit applicable in each State in respect of the service.
Section 4 of the Act provides that the table of medical services, items or rules of interpretation in Schedule 1 to the Act may be varied or
replaced by regulations, and that regulations replacing such a table may be amended by regulations. The Health Insurance (Variation of Fees and Medical Services) (No. 32) Regulations, as previously amended, prescribe the present table of medical services in pursuance of Section 4 of the Act.
Section 9 of the Act provides that medicare benefit shall be calculated by reference to fees for medical services set out in the table of medical services in Schedule 1 to the Act. Medicare benefit is normally payable, in accordance with section 10 of the Act, at a rate of 85% of the relevant fee specified in the table of medical services. An additional amount of medicare benefit is payable where required to ensure that the difference between the benefit normally payable and the fee specified in the table of medical services does not exceed $10.00 in relation to a single professional service, or an aggregate of $150.00 per patient in a year in relation to multiple professional services.
The table of medical services contains 4 items relating exclusively to attendances by
optometrists who are participating optometrists under the Act. The fees specified in these items have been adjusted annually since 1975 following either negotiations with the Australian Optometrical Association or an independent public inquiry. An independent inquiry, conducted by Mr Deputy President K.C. McKenzie of the Australian Conciliation and Arbitration Commission, recommended further increases to these fees for 1984. The Government had agreed to accept the recommendations flowing from the inquiry at the time of its setting up. A recommended interim increase to the fees of 8.9% from 1 September 1984 was given effect to by the Health Insurance (Variation of Fees and Medical Services) (No. 33) Regulations. A further increase to the fees of 1.06% was then recommended by Mr Deputy President McKenzie with effect from 1 October 1984. The effect of this increase was, for example, to raise the fee specified in item 180 of the table of medical services, relating to a sole or first attendance in a single course of attention by a participating optometrist, from $32.50 to $33.00.
The statutory rules further amend the Health Insurance (Variation of Fees and Medical Services) (No. 32) Regulations by substituting the increased fees for attendances by participating optometrists in the relevant items of the table of medical services set out in the Schedule to those regulations.
The statutory rules came into operation on 1 October 1984.