National Health Amendment Regulations 2000 (No. 1) 2000 No. 2
EXPLANATORY STATEMENT
STATUTORY RULES 2000 No. 2
Issued by authority of the Minister for Health and Aged Care
National Health Act 1953
National Health Amendment Regulations 2000 (No. 1)
Section 140 of the National Health Act 1953 (the Act) provides that the Governor-General may make Regulations for the purposes of the Act.
Subsection 140(2) of the Act enables the regulations to preclude or modify a specified provision of the Act relating to an applicable benefits arrangement for a specified registered health benefits organisation. This provision is used to enable registered health benefits organisations to pay health insurance benefits under their applicable benefits arrangements to contributors participating in pilot or demonstration schemes that could lead to an enhancement of the health insurance industry. For example, they allow the participating funds to pay health insurance benefits for hospital type treatment rendered to patients in community settings. The participating funds would then be eligible to receive payments under the Health Benefits Reinsurance Trust Fund.
Regulation 4B of the National Health Regulations extends the definition of "applicable benefits arrangement" in section 5A of the Act in respect of specified registered health benefits organisations participating in specified programs.
The Amending Regulations amend regulation 4B to:
* extend the Hornsby Ku-ring-gai Coordinated Care Trial, which expired on 31 December 1999, to 31 August 2000 (Schedule 1); and
* establish the Epworth Hospital-in-the-Home Pilot Project and specify the funds participating in that Project (Schedule 2). The Project will trial the concept of providing hospital type treatment to patients in their home.
Details of the Amending Regulations are set out in the Attachment.
Regulations 1 to 3 (formal provisions) and Schedule 1 (amendments to extend the Hornsby Ku-ring-gai Co-ordinated Care Trial) commenced on 1 January 2000.
Schedule 1 extending the Hornsby Ku-ring-gai Co-ordinated Care trial commenced on 1 January 2000 to ensure the continuous operation of the trial which expired on 31 December 1999. This retrospectivity does not infringe subsection 48(2) of the Acts Interpretation Act 1901 in that it confers a benefit, rather than a liability, on the participating funds. Had the regulations not been backdated, there would have been an interregnum during which the trial would not have been authorised by law. The participating funds would have been required to meet the full costs of any benefits paid during the interregnum under their ancillary tables rather than their applicable benefits arrangements and, as a consequence, would not have been eligible to receive payments from the Health Benefits Reinsurance Trust Fund.
Schedule 2 (amendments to establish the Epworth Hospital-in-the-Home trail) commenced on gazettal.
ATTACHMENT
NOTES ON CLAUSES
Regulation 1 provides that the Regulations may be cited as the National Health Amendment Regulations 2000 (No. 1).
Regulation 2 provides that:
Regulations 1 to 3 and Schedule 1 (amendments to extend the Hornsby Ku-ring-gai Coordinated Care Trial) commence on 1 January 2000.
Schedule 2 (amendments to establish the Epworth Hospital-in-the-Home trail) commence on gazettal.
Regulation 3 provides that the National Health Regulations 1954 are amended by Schedules 1 and 2.
Items 1, 2 and 3 of Schedule 1 amend subregulations 4B(4) and 4B(7) and Schedule 3 (Part 4, item 1) by replacing the reference to 3 1 December 1999 with a reference to 3 1 August 2000. These amendments will have the effect of extending the Hornsby Ku-ring-gai Coordinated Care Trial until 31 August 2000.
Item 1 of Schedule 2 inserts a new subregulation 4B(5B). New subregulation 4B(5B) specifies the funds participating in the Epworth Hospital-in-the-Home Pilot Project and provides that they are affected by the modifications to subsections 5A(1) and (3) of the Act that are set out in Part 7 of Schedule 3 until 28 February 2001.
Item 2 of Schedule 2 inserts a new subregulation 4B(10) which provides that the Epworth Hospital-in-theHome Pilot Project has effect until 28 February 2001.
Item 3 of Schedule 2 inserts a new Part 7 into Schedule 3 of the Regulations. New Part 7 outlines the modifications to section 5A of the Act in respect of the funds participating in the Epworth Hospital-in-theHome Pilot Project and defines some of the key terms used in those modifications.
Overview
The National Health Amendment Regulations 2000 (No. 1) were enacted to address the need for continuing the Hornsby Ku-ring-gai Coordinated Care Trial and establishing the Epworth Hospital-in-the-Home Pilot Project. This regulation was made under the authority of the Minister for Health and Aged Care, pursuant to Section 140 of the National Health Act 1953. The primary objective of these amendments is to facilitate registered health benefits organisations in participating in pilot or demonstration schemes that could potentially enhance the health insurance industry by enabling them to pay health insurance benefits for hospital-type treatment rendered to patients in community settings, thus ensuring they remain eligible for payments under the Health Benefits Reinsurance Trust Fund.
These regulations were designed to avoid any legal interregnum that could result in participating funds bearing the full costs of benefits paid during the period when the trial would not be authorised by law. By backdating the commencement of the Hornsby Ku-ring-gai Coordinated Care Trial extension to 1 January 2000, the continuity of the trial was ensured. Meanwhile, the Epworth Hospital-in-the-Home Pilot Project was established to trial the concept of providing hospital-type treatment to patients in their homes, with the amendments taking effect upon gazettal.
Scope and Application
The National Health Amendment Regulations 2000 (No. 1) are a statutory instrument that amends the National Health Regulations 1954, made under section 140 of the National Health Act 1953. These regulations apply to registered health benefits organisations participating in specified pilot or demonstration schemes aimed at enhancing the health insurance industry. The primary objective of the regulations is to allow these organisations to pay health insurance benefits for hospital-type treatment rendered to patients in community settings, such as through the Hornsby Ku-ring-gai Coordinated Care Trial and the Epworth Hospital-in-the-Home Pilot Project. This amendment facilitates the trial of innovative health care delivery models and ensures that participating funds remain eligible for payments under the Health Benefits Reinsurance Trust Fund. The regulations extend the duration of the Hornsby Ku-ring-gai Coordinated Care Trial from 31 December 1999 to 31 August 2000 and establish the Epworth Hospital-in-the-Home Pilot Project, which will operate until 28 February 2001. Notably, the retrospective commencement of certain provisions does not contravene the Acts Interpretation Act 1901, as it confers a benefit rather than imposing a liability on the participating funds.
Key Provisions
The main operative sections of the National Health Amendment Regulations 2000 (No. 1) are primarily found in Regulation 3, which amends the National Health Regulations 1954, and in Schedules 1 and 2, which provide specific details on the amendments. Regulation 3 (subsection 140(2)) allows for the modification of specified provisions of the National Health Act 1953 relating to applicable benefits arrangements for certain registered health benefits organisations. Schedule 1 extends the Hornsby Ku-ring-gai Coordinated Care Trial, which expired on 31 December 1999, to 31 August 2000. Schedule 2 establishes the Epworth Hospital-in-the-Home Pilot Project and specifies the funds participating in that Project. The regulations also provide that the Hornsby Ku-ring-gai Coordinated Care Trial's extension will commence on 1 January 2000, while the Epworth Hospital-in-the-Home Pilot Project will commence on gazettal.
These regulations impose specific obligations on registered health benefits organisations participating in the Hornsby Ku-ring-gai Coordinated Care Trial and the Epworth Hospital-in-the-Home Pilot Project. For the Hornsby Ku-ring-gai Coordinated Care Trial, participating funds must ensure that their activities remain within the scope of the trial as extended to 31 August 2000. This includes adhering to the terms and conditions set forth in the applicable benefits arrangements, as modified by the regulations. For the Epworth Hospital-in-the-Home Pilot Project, participating funds must comply with the modifications to section 5A of the National Health Act 1953 as outlined in Part 7 of Schedule 3. This involves paying health insurance benefits for hospital type treatment rendered to patients in their homes and ensuring they are eligible to receive payments under the Health Benefits Reinsurance Trust Fund.
The National Health Amendment Regulations 2000 (No. 1) do not explicitly outline specific offences or penalties for breaches of the regulations. However, breaches of the National Health Act 1953 or any related regulations can result in civil or criminal consequences under the broader legislative framework. For instance, under the National Health Act 1953, failure to comply with the regulations could lead to penalties such as fines or other sanctions. The exact penalties would depend on the nature and severity of the breach, as well as any relevant provisions in other Acts or subordinate legislation. It is essential for participating funds to adhere strictly to the regulations to avoid any potential legal repercussions.