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2008-2009
THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA
HOUSE OF REPRESENTATIVES
HEALTH INSURANCE AMENDMENT (DIAGNOSTIC IMAGING ACCREDITATION) BILL 2009
EXPLANATORY MEMORANDUM
(Circulated by authority of the Minister for Health and Ageing,
the Hon. Nicola Roxon, MP)
HEALTH INSURANCE AMENDMENT (DIAGNOSTIC IMAGING ACCREDITATION) BILL 2009
OUTLINE
The Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2009
(the Bill) will make amendments to the Health Insurance Amendment
(Diagnostic Imaging Accreditation) Act 2007 (the DIA Act) to broaden the
scope of the Diagnostic Imaging Accreditation Scheme (the Scheme).
The Scheme is set out in the Health Insurance Act 1973 (the HIA) and
provides for the accreditation of diagnostic imaging premises and bases for
mobile diagnostic imaging equipment. The framework for the Scheme is set
out in section 16EA and Division 5, Part IIB, of the HIA. Specific
provisions of the Scheme are provided by regulations and other subordinate
legislation.
The Scheme is being implemented in two stages. Under the Stage I Scheme,
which commenced on 1 July 2008, practices providing radiology services are
required to be accredited for those services to attract Medicare benefits.
Under the Stage II Scheme, which will commence on 1 July 2010, practices
providing non-radiology services, or a combination of radiology and non-
radiology services, will need to be accredited, or hold 'deemed
accreditation', to provide Medicare eligible diagnostic imaging services.
Non-radiology diagnostic imaging services are cardiac ultrasound and
angiography, obstetric and gynaecological ultrasound, and nuclear medicine
imaging services.
The Bill will amend the DIA Act to provide transitional arrangements for
premises and bases which are in operation prior to 1 July 2010, which are
not accredited under the Stage I Scheme and which provide either non-
radiology services or a combination of non-radiology and radiology
services, to register for 'deemed accreditation' under the Stage II Scheme.
This will enable those practices to continue to provide Medicare eligible
services following the commencement of the Stage II Scheme on 1 July 2010.
There will be around 1,400 practices eligible to register for 'deemed
accreditation' under the transitional arrangements.
The registration period for 'deemed accreditation' will operate from 1
April 2010 up to and including 30 June 2010. 'Deemed accreditation' will
cease on 1 July 2011, or earlier if a practice providing non-radiology
services obtains accreditation prior to that date. Practices with 'deemed
accreditation' will need to obtain accreditation by demonstrating
compliance with three entry level standards under the Scheme, the full
suite of standards under the Scheme or accreditation based on recognition
of accreditation under the Medical Imaging Accreditation Program before 1
July 2011.
Accreditation arrangements for practices accredited under the Stage I
Scheme for radiology services will continue under the Stage II Scheme.
Financial Impact Statement
The measure to broaden the scope of the Scheme is being developed and
implemented within the Department of Health and Ageing's existing program
budget including the cost of $649,000 (GST exclusive) for 2009-10 to 2013-
14 of modifying the Medicare Australia payment systems. The costs of
participating in the Scheme and becoming accredited will be met by the
practices which provide non-radiology services under Medicare.
Regulation Impact Statement
A Business Cost Calculator (BCC) has been undertaken in respect of Stage II
of the Diagnostic Imaging Accreditation Scheme. The BCC report (Office of
Best Practice Regulation reference number 10411) is set out below.
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HEALTH INSURANCE AMENDMENT (DIAGNOSTIC IMAGING ACCREDITATION) BILL 2009
NOTES ON CLAUSES
Clause 1 - Short Title
This clause provides for the Bill, once enacted, to be cited as the Health
Insurance Amendment (Diagnostic Imaging Accreditation) Act 2009.
Clause 2 - Commencement
This clause provides that clauses 1 to 3 to commence on Royal Assent.
The Schedule, which provides for the transition of practices providing non-
radiology services into the Stage II Diagnostic Imaging Accreditation
Scheme (the Stage II Scheme), will commence on start of the day of Royal
Assent or 1 April 2010, whichever is the later. This will allow existing
practices providing non-radiology services, or a combination of non-
radiology and radiology services, not accredited under the Scheme, to
register for 'deemed accreditation' before 1 July 2010, thereby ensuring
the continuation of Medicare benefits for these types of services from 1
July 2010.
Clause 3 - Schedule(s)
This clause provides that each Act that is specified in a Schedule to this
Bill is amended or repealed as set out in the applicable items in the
Schedule concerned, and any other item has effect according to its terms.
In this Bill the Schedule amends the Health Insurance Amendment (Diagnostic
Imaging Accreditation) Act 2007 to include new transitional arrangements
for practices providing non-radiology services.
SCHEDULE 1 - AMENDMENT OF THE HEALTH INSURANCE AMENDMENT (DIAGNOSTIC
IMAGING ACCREDITATION) ACT 2007
Item 1 - After item 12 of Schedule 1
This item inserts new section 12A into Schedule 1 of the DIA Act, which
provides transitional provisions applying to proprietors of practices
providing non-radiology diagnostic imaging services which have never been
accredited under the Diagnostic Imaging Accreditation Scheme (the Scheme).
In summary, the transitional arrangements provide that as long as a
practice providing non-radiology services, or a combination of non-
radiology and radiology services, has lodged a notice with a person
designated by the Minister before 1 July 2010, services rendered from the
diagnostic imaging premises or base will continue to be eligible for
Medicare benefits until 30 June 2011, by which time the practice will need
to be accredited.
Subitem 1 sets out the conditions under which the transitional provisions
apply to proprietor's of diagnostic imaging premises or a base for mobile
diagnostic imaging equipment providing non-radiology diagnostic imaging
procedures. The transitional provisions for providers of non-radiology
services will apply to a proprietor of diagnostic imaging premises or a
base for mobile diagnostic imaging equipment if the premises or base has
been in operation before 30 June 2010, provides non-radiology services and
has not been accredited under the Scheme.
Subitem 2 provides that a non-radiology diagnostic imaging procedure means
a procedure described in the following items in the Health Insurance
(Diagnostic Imaging Services Table) Regulations:
. subgroup 2 of Group 11 (cardiac ultrasound);
. subgroup 5 of Group 11 (obstetric and gynaecological ultrasound);
. items 59903-59925 (inclusive) (cardiac angiography);
. items 59971-59973 (inclusive) (cardiac angiography);
. subgroup 16 of Group 13 (cardiac procedure); and
. Group 14 (nuclear medicine imaging).
Subitem 3 provides for the type of diagnostic imaging services a proprietor
may register. That is, a proprietor may register premises or a base for:
. one or more non-radiology diagnostic imaging procedures (i.e. diagnostic
imaging practices providing only non-radiology services); or
. one or more non-radiology procedures and one or more other diagnostic
imaging procedures (i.e. diagnostic imaging practices not accredited
under the Scheme providing a combination of non-radiology and radiology
services).
Subitem 4 provides that a proprietor of diagnostic imaging premises or a
base may lodge a notice with the person designated by the Minister no later
than 30 June 2010. After 30 June 2010 diagnostic imaging premises or a
base requiring accreditation will need to obtain accreditation against
entry level standards or full suite standards under the Scheme, or
accreditation based on recognition of accreditation under the Medical
Imaging Accreditation Program if the practice wants to provide Medicare
eligible diagnostic imaging services after 1 July 2011.
Subitem 5 provides that if a person designated by the Minister approves a
form for the notice to register diagnostic imaging premises or a base for
deemed accreditation, the notice, lodged by the proprietor of the premises
or base must be in that form.
Subitem 6 provides that a person designated by the Minister may charge a
fee for lodgement of the notice for deemed accreditation.
Subitem 7 deems premises or a base for mobile diagnostic imaging equipment
to be accredited for the purpose of subsection 16EA(1) of the HIA once the
proprietor of that premises or base registers the premises or base in
accordance with subitems (3) to (6) no later than 30 June 2010.
Subitem 8 provides that a proprietor may add one or more diagnostic imaging
procedures to the deemed accreditation by lodging a notice, no later than
30 June 2011 with the person designated by the Minister.
Subitem 9 provides that deemed accreditation only applies to diagnostic
imaging premises or a base identified in the notice. The deemed
accreditation is location specific and cannot be transferred to another
diagnostic imaging premises or base.
Subitem 10 provides that deemed accreditation is not affected if there is a
change to the proprietor of a diagnostic imaging premises or base during
the deemed accreditation.
Subitem 11 provides for the cessation of deemed accreditation. Deemed
accreditation ceases:
a) on the day a diagnostic imaging premises or a base has been granted
accreditation under the Scheme; or
b) if accreditation has been refused:
(i) on the day the proprietor's rights to have the decision
reconsidered are exhausted or have expired: or
(ii) on 30 June 2011;
whichever is the later; or
c) on 30 June 2011 in any other cases which may include, but are not
limited to, the following circumstances:
(i) where a proprietor of diagnostic imaging premises or a base
fails to apply for accreditation for the diagnostic imaging
procedures that are covered by the deemed accreditation before 1
July 2011; or
(ii) where a proprietor of a diagnostic imaging premises or a base
applies for accreditation before 1 July 2011 and the approved
accreditor has not made a decision in relation to their
application.
Subitem 12 provides that the Minister may, by legislative instrument,
designate a person with whom the notice under subitem (4) is to be lodged.
The legislative instrument will be subject to the Legislative Instruments
Act 2003 which means it must be registered on the Federal Register of
Legislative Instruments, tabled in Parliament and is subject to
disallowance.
Subitem 13 allows the Minister to delegate to the Secretary of the
Department, or to an SES employee in the Department, his or her power under
subitem (12) to designate the persons who will be able to accept notices
for deemed accreditation pursuant to subitem (4).
Subitem 14 provides that any term defined in the HIA that is used in this
item 12A has the same meaning as defined in the HIA.