EXPLANATORY STATEMENT
STATUTORY RULES 1987 NO.33
ISSUED BY AUTHORITY OF THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
HEALTH INSURANCE (VARIATION OF FEES AND MEDICAL SERVICES) (NO. 46) REGULATIONS
Section 133 of the Health Insurance Act 1973 (“the Act”) provides in part that the Governor-General may make regulations, not inconsistent with the Act, 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 the fees for medical services set out in the table of general medical services in Schedule 1 to the Act. Schedule 1 contains items setting out the description of each medical service, the fee for the calculation of medicare benefit applicable in each State and rules for the interpretation of the table.
Section 4 of the Act provides that the table of general medical
services may be varied or replaced by regulations. The Health Insurance (Variation of Fees and Medical Services) (No. 44) Regulations, as amended, prescribe the present table of general medical services pursuant to section 4 of the Act.
The Minister for Health has agreed to certain recommendations which have been made by the Medicare Benefits Review Committee, which was established in part to recommend measures to encourage the provision of efficient and appropriate health care. The Committee has made several recommendations which are intended to simplify the process by which referrals are conducted to a consultant physician or a specialist.
At present, rule 3 of the rules for the interpretation of the table of general medical services is the main provision dealing with the circumstances in which a referral to a consultant physician or a specialist may be made. In order to implement the recommendations of the Medicare Benefits Review Committee, the Health Insurance (Variation of Fees and Medical Services) (No. 46) Regulations amend the rules for interpretation to provide for three new alternative systems of referral. The first is the preparation of a formal letter of referral. The second is the making of an informal written communication. The third is the making of an oral request.
The rules for interpretation are also amended to provide
for situations where a written referral has been prepared but has subsequently been lost, stolen or destroyed, and where a service is rendered by a consultant physician or a specialist and where the consultant physician or specialist forms the opinion that it is necessary that the service be rendered as quickly as possible.
The rules for interpretation are also amended to implement the recommendation of the Committee that the period during which a referral may authorise treatment should be limited to a maximum of 12 months.
Regulation 2 provides for the regulations to come into operation on 7 March 1987.