Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006

__________________________________________________________________

I, TONY ABBOTT, Minister for Health and Ageing, make this Determination under subsection 3C (1) of the Health Insurance Act 1973.

Dated                                     6/6/  2006

____________T Abbott____________________

Minister for Health and Ageing

Contents

1.           Name of Determination                                                                             3

2.           Commencement                                                                                      3

3.           Cessation                                                                                               3

4.           Revocation of Health Insurance Determination HS/2/2000                            3

5.           Interpretation                                                                                           3

6.           Circumstances where this Determination applies                                        3

7.           Treatment of a relevant service                                                                  4

Schedule -     Specified health services                                                              5

1.                      Name of Determination

This Determination is the Health Insurance (Diabetes Testing in Aboriginal and Torres Strait Islander Primary Health Care Sites) Determination HS/01/2006.

2.                      Commencement

This Determination is taken to have commenced on 1 January 2006. 

3.                      Cessation

This Determination will cease to have effect at the end of 30 June 2009.

4.                      Revocation of Health Insurance Determination HS/2/2000

This Determination revokes Health Insurance Determination HS/2/2000.

5.                      Interpretation

(1)        In this Determination:

the Act means the Health Insurance Act 1973.

item means an item in the Schedule.

QAAMS Program means the program, known as the Quality Assurance in Aboriginal Medical Services Program, funded by the Department of Health and Ageing as a program to provide education, training, quality assurance, quality control and on-going support services for point of care diabetes testing in Aboriginal Community Controlled Health Services and Aboriginal Medical Services.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in the Schedule.

Note          Unless the contrary intention appears, expressions used in this Determination have the same meanings as in the Act—see section 13 of the Legislative Instruments Act 2003.

(2)        Unless the contrary intention appears, in this Determination a reference to a provision of the Act or regulations made under the Act as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

6.                      Circumstances where this Determination applies

(1)        This Determination applies to a relevant service only where all of the following circumstances apply:

(a)                    where a direction made by the First Assistant Secretary of the Office for Aboriginal and Torres Strait Islander Health under section 19(2) of the Act to enable the payment of medicare benefits for professional services provided in Aboriginal and Torres Strait Islander communities applies to the service; and

(b)                   where the service is rendered by or on behalf of a medical practitioner; and

(c)                    where the practitioner referred to in paragraph (b) is:

(i)                      an employee of an organisation that is receiving funding from the Commonwealth, a State or a Territory; or

(ii)                     an employee of a State or Territory; and

(d)                   where the practitioner referred to in paragraph (b), or the organisation for which the practitioner works, is participating in the QAAMS Program; and

(e)                    where the practitioner referred to in paragraph (b) has determined the service to be necessary for his or her patient.

Note   The circumstance in paragraph (d) mirrors the requirement in section 16A(1)(a) of the Act that the treating practitioner requesting a pathology service must determine that the service is necessary.

7.                      Treatment of a relevant service

A relevant service shall be treated as if:

(a)                    it were both a professional service and a medical service for the purposes of the provisions of the Act, the National Health Act 1953, the Health Insurance Regulations 1975 and the National Health Regulations 1954 that make provision in respect of professional services or medical services, other than provisions that make provision for pathology services specifically; and

(b)                   there were an item in the pathology services table that related to the relevant service and specified in respect of the service a fee in relation to a State, being the fee specified in the Schedule in relation to the State specified.

Schedule -        Specified health services

Note    Section 3C (7) of the Act deems an internal Territory to form part of the State of New South Wales.