EXPLANATORY STATEMENT
STATUTORY RULES 1986 NO. 195
ISSUED BY AUTHORITY OF THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
HEALTH INSURANCE (VARIATION OF FEES AND MEDICAL SERVICES (NO. 42) 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.
Section 9 of the Act provides that medicare benefits shall be calculated by reference to fees for medical services set out in the table of medical services in Schedule 1 to the Act. Schedule 1 contains items setting out the description of each medical service and the fee for the calculation of medicare benefit applicable in each State. Medicare benefit is normally payable, in accordance with section 10 of the Act, at a rate of 85% of the relevant fee set out 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 set out 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.
Section 4 of the Act provides that the table of medical services 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 amended (“the Regulations”), prescribe the present table of medical services pursuant to section 4 of the Act. The present table is set out in the Schedule to the Regulations, with Rules for interpretation.
The Minister for Health has agreed to the recommendations which have been made by the Medical Benefits Schedule Revision Committee. The Committee is a non-statutory body, comprising representatives of the Australian Medical Association and the Commonwealth, which advises the Minister for Health on revisions which should be made to the table of medical services. The Committee has made recommendations in connection with the addition, deletion or alteration of the description of a number of items in the table.
The Health Insurance (Variation of Fees and Medical Services) (No. 42) Regulations give effect to the recommendations of the Committee. They also omit Part VII of the table of medical services, which sets out items relating to the provision of pathology services. In accordance with the amendments to the Act made by the Health Legislation Amendment Act 1986 (Act No. 75 of 1986, assented to on 24 June 1986), these items will now be prescribed in a separate table which will be amended when necessary by Ministerial determination rather than by regulations.
These Regulations also amend the Rules for the interpretation of the table of medical services to reflect the addition or deletion of certain items.
Regulation 2 provides for the amendments to come into operation on 1 August 1986.