Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE (DIAGNOSTIC IMAGING SERVICES TABLE) AMENDMENT REGULATIONS 2001 (NO. 4) 2001 NO. 157

STATUTORY RULES 2001 No. 157

Issued by the Authority of the Minister for Health and Aged Care

Health Insurance Act 1973

Health Insurance (Diagnostic Imaging Services Table) Amendment Regulations 2001 (No. 4)

Section 133 of the Health Insurance Act 1973 (the Act) provides that the Governor-General may make Regulations for the purposes of the Act.

Section 4AA of the Act provides that the regulations may prescribe a table of diagnostic imaging services that sets out the items of diagnostic imaging services, the amount of fees applicable in respect of each item and rules for interpretation of the table.

The Health Insurance (Diagnostic Imaging Services Table) Regulations 2000 (the Principal Regulations) are regulations made for the purposes of section 4AA of the Act.

The Principal Regulations contain items of diagnostic imaging services, including magnetic resonance imaging (MRI) services. The rules of interpretation provide that Medicare benefits in respect of MRI services are only payable where the services are performed with 'eligible equipment'. 'Eligible equipment' is defined in rule 27 as equipment which is eligible equipment in accordance with rule 31 or 31A:

•       Rule 31 provides that 'eligible equipment' must be located in Australia in a medical practice, or the radiology department of a hospital, that offers a comprehensive range of diagnostic imaging procedures, that is, procedures that include x-ray, ultrasound and computed tomography procedures. Moreover, the equipment must satisfy certain 'time of installation' requirements; and

•       Rule 31A provides that equipment (other than equipment to which rule 31 applies) registered under the scheme administered by the Department titled 'MRI Additional Units' Eligibility Scheme', published in Gazette No., GN 20 on 23 May 2001 is 'eligible equipment'.

The purpose of the amending Regulations is to specifically identify, in a schedule to the Principal Regulations, the MRI units which are 'eligible equipment' under rule 31. This will replace the current 'time of installation' requirements. The amending Regulations also make provision for temporary and permanent replacement of eligible equipment.

The amending Regulations will still require an eligible provider to satisfy the Health Insurance Commission that he or she is a participant in the Royal Australasian College of Radiologists' Quality and Accreditation Program and that eligible services will be rendered with eligible equipment. However, the Commission will have greater flexibility as to the manner in which it satisfies itself of these matters.

Details of the amending Regulations are set out in the Attachment.

The amending Regulations commence on 1 July 2001.

ATTACHMENT

NOTES ON CLAUSES

Regulation 1 provides that the Regulations may be cited as the Health Insurance (Diagnostic Imaging Services Table) Amendment Regulations 2001 (No. 4).

Regulation 2 provides that the Regulations commence on 1 July 2001.

Regulation 3 provides that the Health Insurance (Diagnostic Imaging Services Table) Regulations 2000 are amended by Schedule 1.

Item 1 of Schedule 1 amends rule 30 in consequence of the amendments made by item 2.

Item 2 of Schedule 1 amends rule 30 by omitting subrules 30(2), (3) and (4). The effect of the amendments made by items 1 and 2 will be to require an eligible provider to satisfy the Health Insurance Commission that he or she is a participant in the Royal Australasian College of Radiologists' Quality and Accreditation Program and that eligible services will be rendered with eligible equipment. The previous regulations required that the Commission be given a statutory declaration in relation to these matters. Under these amendments the Commission will have greater flexibility as to the manner in which it satisfies itself of these matters.

Item 3 of Schedule 1 substitutes a new rule 31. New rule 31 provides that equipment is 'eligible equipment' if it is described in Schedule 2 of the regulations or if it is a permanent or temporary replacement for that equipment of which the Health Insurance Commission has been given prior notice.

Item 4 of Schedule 1 inserts a new Schedule 2 which specifies the equipment which is eligible equipment for the purposes of rule 31(2)(a).