EXPLANATORY STATEMENT
STATUTORY RULES 1987 No. 160
HEALTH INSURANCE ACT 1973
HEALTH INSURANCE (VARIATION OF FEES AND MEDICAL SERVICES) (No 47) 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 in effect 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.
Section 4 of the Act provides, among other things, that the regulations may prescribe a table of medical services (other than pathology services) in accordance with the form of the table set out in Schedule 1 and that upon commencement of a regulation prescribing a table of medical services the table so prescribed has effect as if it were set out in Schedule 1 in the place of the table in that Schedule. The Health Insurance (Variation of Fees and Medical Services) Regulations prescribe such a table.
The Minister for Health agreed to recommendations which were 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 general medical services. The Committee recommended the addition, deletion or alteration of the description of a number of items in the table. Recommendations were also made by the Committee in connection with the adjustment of fees for medical services. The regulations reflect these recommendations.
The Minister for Health also agreed to certain recommendations made by the Medical Benefits Review Committee. This Committee was established to undertake a major review of the Medical Benefits Schedule and, amongst other things, to report on what action should be taken, for medicare benefits purposes and to simplify the Schedule to make it more readily understandable to practitioners. The Committee made recommendations to alter the description of the “Family Group Therapy” items and transfer those Services from Part 6 of the Schedule to Part 1. These now appear as items 170, 171 and 172.
The regulations also amend the Health Insurance (Variation of Fees and Medical Services) Regulations in a number of other ways flowing from the May Economic Statement. To effect savings in Medicare expenditure Cabinet has agreed, among other things, to -
(a) abolish the after-hours loading for all GP consultation items and provide partial compensation for brief and standard consultation items;
(b) (i) a new lower fee structure for computerised axial tomography (CAT);
(ii) a reduction in fees for existing non-specialist radiological services to a uniform 75 per cent of relevant specialist fees; and
(iii) a reduction of 25 per cent in the fee for item 793 (Ultrasound);
(c) a 5 per cent reduction in radiology fees, other than CAT and Ultrasound;
(d) in respect of optometrical services -
(i) halve the schedule fee for contact lens prescriptions;
(ii) preclude the use of item 182 for contact lenses; and
(iii) increase the minimum period between consultation episodes to 24 months;
(e) withdraw benefits from multiphasic health screening;
(f) changes to the schedule fees for -
• endoscopy;
• keratosis;
• consultants; and
• cataract surgery; and
(g) a schedule fee increase averaging 6.1 per cent across the board from 1 August 1987;
Additionally, the Minister also approved changes to the Schedule concerning -
• consultant physician services (other than psychiatry);
• ophthalmology;
• electrocardiography (ECG);
• obstetrics;
• intravenous drips.
The regulations reflect the above amendments.
The regulations also include amendments to the Rules for the Interpretation of the Table of General Medical Services. These amendments are largely consequential, but also include amendments to clarify the application of items to certain services and to make the Rules gender neutral.
The opportunity has also been taken to correct the following errors previously contained in the Schedule:
• Item 2732 - by omitting a reference to “Rule 19” and inserting a correct reference to “Rule 20”.
• Item 2734 - by deleting the previous reference to the item as number “234” and substituting the correct item number of “2734”.
• Item 6508 - by deleting the word “hysteroctomy” and substituting the correct word “hysterotomy”.
Authority: Section 133 of the Health Insurance Act 1973 Cabinet Decision 9511 of 8 May 1987.