EXPLANATORY STATEMENT
Issued by the authority of the Minister for Human Services
Medicare Australia Act 1973
Direction
Background
Section 4 of the Medicare Australia Act 1973 (the Act) establishes Medicare Australia. Sections 5 and 8AG of the Act create the office of Chief Executive Officer of Medicare Australia (CEO), with statutory functions. The CEO is, under the Minister for Human Services and through the Secretary to the Department of Human Services, responsible for managing Medicare Australia.
Medicare Australia is a specialist service delivery agency and has substantial experience in processing claims and making payments to beneficiaries of the Government’s major health programs.
Section 5 of the Act sets out a number of mechanisms for conferral of functions on the CEO. Paragraph 5(1)(d) of the Act provides that the CEO has any functions that the Minister for Human Services, by writing, directs the CEO to perform.
Section 28 of the Medicare Australia (Functions of Chief Executive Officer) Direction 2005 (the Functions Direction) confers on the CEO a function to maintain a register of general practitioners who have completed certain mental health training under the 2001-02 Better Outcomes in Mental Health Care Initiative.
The manner in which that function is to be performed is set out in section 28 of the Medicare Australia (Performance of Chief Executive Officer’s Powers and Functions) Direction 2005 (the Performance Direction), which is made under subsection 8(1) of the Medicare Australia Act 1973.
Entry on the register established under section 28 of the Functions Direction is a legal requirement for general practitioners who wish to render certain mental health services under Medicare, being items specified in the Health Insurance (General Medical Services Table) Regulations 2006 (the Health Regulations).
On 1 May 2007 amendments to the Health Regulations came into force which repealed a number of ‘3 Step Mental Health Process’ items previously set out in Subgroup 4 of Group A18 and Subgroup 4 of Group A19 of the Health Regulations. Those were items for which entry on the register established by the CEO under section 28 of the Functions Direction was a prerequisite.
As a result of the repeal of 3 Step Mental Health Process items, section 28 of the Functions Direction requires a simple amendment to omit redundant material which relates to those items.
Section 28 will continue to provide that the CEO maintain a register of general practitioners who are qualified to provide Focussed Psychological Strategies Services (being items set out in Subgroup 2 of Group A20 of the Health Regulations).
The Performance Direction, which is not a legislative instrument, is also being amended to reflect the recent changes made to the Health Regulations.
Details of Direction
Section 1 – Name of Direction
This section provides for the Amending Direction to be named the “Medicare Australia (Functions of Chief Executive Officer) Amendment Direction 2007 (No 1)”.
Section 2 – Commencement
This section provides for the Amending Direction to commence on the day after it is registered as a legislative instrument.
Section 3 – Amendment of Medicare Australia (Functions of Chief Executive Officer) Direction 2005
This section provides that the Functions Direction is amended as set out in Schedule 1.
Schedule 1 – Amendments
Item [1] – Subsection 28(2)
This item amends subsection 28(2) to remove redundant references and to enable the CEO to continue to maintain a register of general practitioners who may provide Focussed Psychological Strategies Services under the Better Health Outcomes in Mental Health Care Initiative administered by the Department of Health and Ageing.
Consultation
The Direction was settled after consultation with the Department of Health and Ageing.
The Direction is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
Overview
The Medicare Australia (Functions of Chief Executive Officer) Amendment Direction 2007 (No 1) was enacted to address a gap identified in the Medicare Australia (Functions of Chief Executive Officer) Direction 2005, which required updating in light of legislative changes. This Direction was introduced to streamline and modernise the administrative functions of the Chief Executive Officer of Medicare Australia, ensuring that the register of general practitioners qualified to provide mental health services under Medicare is kept current and relevant. The Direction was settled following consultation with the Department of Health and Ageing, reflecting a coordinated approach to health policy implementation. The primary objective of this amendment is to ensure the CEO can continue to maintain an updated register of general practitioners eligible to provide Focussed Psychological Strategies Services, thereby facilitating the efficient delivery of mental health services under Medicare.
Scope and Application
The Medicare Australia (Functions of Chief Executive Officer) Amendment Direction 2007 (No 1) amends the Medicare Australia (Functions of Chief Executive Officer) Direction 2005, which confers functions on the Chief Executive Officer of Medicare Australia. This Amendment Direction applies to the Chief Executive Officer of Medicare Australia, who is responsible for managing the agency and maintaining the register of general practitioners qualified to provide certain mental health services under the Medicare system. The Direction adjusts the scope of the CEO’s function to reflect recent changes in the Health Insurance (General Medical Services Table) Regulations 2006, specifically by removing references to repealed ‘3 Step Mental Health Process’ items and retaining the requirement to maintain a register for Focussed Psychological Strategies Services. The Direction applies nationally across Australia as it is a legislative instrument made under the Medicare Australia Act 1973 and is subject to the Legislative Instruments Act 2003. This legislative amendment ensures that the functions of the CEO remain aligned with the current regulatory requirements for mental health services under Medicare.
Key Provisions
The key sections of the Medicare Australia (Functions of Chief Executive Officer) Amendment Direction 2007 (No 1) primarily revolve around amending the Medicare Australia (Functions of Chief Executive Officer) Direction 2005. Section 3 of the Amending Direction specifies that the Functions Direction is amended as outlined in Schedule 1. Specifically, Item [1] of Schedule 1 amends subsection 28(2) to remove outdated references related to the repealed '3 Step Mental Health Process' items and to enable the CEO to continue maintaining a register of general practitioners qualified to provide Focussed Psychological Strategies Services. These amendments ensure that the register remains relevant and aligned with current mental health service requirements under Medicare.
The obligations imposed by this Act on the Chief Executive Officer (CEO) of Medicare Australia are primarily focused on the maintenance of a specific register. Under section 28 of the Functions Direction, as amended by this Direction, the CEO is mandated to maintain a register of general practitioners who have completed certain mental health training. This register is essential for general practitioners to render specific mental health services under Medicare, particularly Focussed Psychological Strategies Services. The CEO's role is further detailed in section 28 of the Performance Direction, which outlines the manner in which these functions are to be performed.
There are no explicit offences, penalties, or civil/criminal consequences outlined within the text of the Amending Direction itself. However, the failure to comply with the requirements to maintain the register as stipulated in the amended Functions Direction could potentially lead to general practitioners being ineligible to provide certain Medicare-subsidised mental health services. This could result in indirect financial implications for both the practitioners and their patients, as well as potential administrative issues for Medicare Australia in processing claims for these services. The primary consequence of non-compliance would be the inability of the general practitioners to legally provide the specified mental health services under the Medicare program.