EXPLANATORY STATEMENT
STATUTORY RULES 1985 NO. 229
ISSUED BY AUTHORITY OF THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
HEALTH INSURANCE (VARIATION OF FEES AND MEDICAL SERVICES) (NO. 39) REGULATIONS
Section 133 of the Health Insurance Act 1973 (‘the Act’) provides in part 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. 37) Regulations, as previously amended, prescribe the present table of medical services pursuant to 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 increased 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, determined further increases to these fees to apply from 23 September 1985. The Treasurer, the Minister for Employment and Industrial Relations, and the Minister for Health, on behalf of the Government, had previously agreed to accept the determination of the inquiry.
The determination of the inquiry involved an increase of 4.28% in the level of the fees. The effect of this has been, for example, to increase 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 $33.00 to $34.50, and the corresponding amount of medicare benefit from $28.05 to $29.35.
The statutory rules amend the Health Insurance (Variation of Fees and Medical Services) (No. 37) 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 23 September 1985.