Commonwealth Numbered Regulations - Explanatory Statements

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HEALTH INSURANCE REGULATIONS (AMENDMENT) 1992 NO. 42

STATUTORY RULES 1992 No. 42

Issued by the authority if the Minister for Health, Housing and Community Services

Health Insurance Act 1973

Health Insurance Regulations (Amendment)

The Health Insurance Act 1973 (the Act) provides for the payment of medicare benefits for professional services rendered by medical practitioners and for certain professional services rendered by dental practitioners and optometrists.

Section 133 of the Act provides that the Governor-General may make regulations for the purposes of the Act.

The specific details of these amendments to the Health Insurance Regulations are set out in the attachment. In summary, these amendments contain discrete provisions which:

•       repeal the regulations required to give effect to the Government's decision to abolish the medicare co-payment of $2.50, the $1.00 transaction fee and the $3.50 rebate reduction, all of which were introduced on 1 December 1991, and

•       specify those diagnostic imaging services eligible for medicare benefits following requests by physiotherapists and podiatrists.

ATTACHMENT

DETAILS OF HEALTH INSURANCE REGULATIONS (AMENDMENT)

The regulations delete the definitions 'concessional beneficiary', 'patient contribution', 'prescribed GP service' and 'safety-net concession card, from regulation 2 and repeal regulation 2AC which specifies prescribed GP services'.

The regulations restrict medicare benefits to X-rays of the spine and pelvis when requested by a physiotherapist and to X-rays of the foot when requested by a podiatrist.

The definition of "requester number" in regulation 2 has been amended to make provision for the allocation, by the Health Insurance Commission, of identification numbers to physiotherapists and podiatrists.

Regulation 2ADAAB has been amended to prescribe the particular items of service that may be requested by physiotherapists and podiatrists. Items 57503, 57521 and 57527 in the diagnostic imaging services table relate to the radiological examination of extremities and the provision of a report. The Health Insurance (1991-1992 Diagnostic Imaging Services Table) Regulations prescribe such a table.

Subregulation 2ADA(1A) has been amended by repealing paragraphs (c) and (d) which relate to particulars to be included on patient's accounts, etc., for prescribed GP services where the patient is a concessional beneficiary.

Subregulation 2ADA(4) has been amended to require the provision of specified details of the specialist in diagnostic radiology providing the professional service. The existing provisions have been amended to apply where the services specified are provided by medical practitioners who are not specialists in diagnostic radiology.

Subregulation 2ADA(7) has been amended to include reference to physiotherapists and podiatrists.

A new regulation 2CF has been inserted requiring certain information on patients' accounts or receipts and on medicare direct-billed claims regarding practitioners, including physiotherapists and podiatrists, who request imaging services.