Federal Register of Legislation - Australian Government

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SLI 2014 No. 10 Regulations as made
This regulation amends the Health Insurance (General Medical Services Table) Regulation 2013 to include a number of changes to Medicare services, including the introduction of a new item for the injection of botulinum toxin type A for adult patients with chronic migraine as recommended by the Medical Services Advisory Committee; and also implements an amendment to a capsule endoscopy item to remove age and time restrictions.
Administered by: Health
Registered 27 Feb 2014
Tabling HistoryDate
Tabled HR04-Mar-2014
Tabled Senate04-Mar-2014
Date of repeal 02 Mar 2014
Repealed by Division 1 of Part 5A of the Legislative Instruments Act 2003
Table of contents.

 

Health Insurance (General Medical Services Table) Amendment (Various Measures) Regulation 2014

 

Select Legislative Instrument No. 10, 2014

I, Quentin Bryce AC CVO, Governor‑General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulation under the Health Insurance Act 1973.

Dated 26 February 2014

Quentin Bryce

Governor‑General

By Her Excellency’s Command

Peter Dutton

Minister for Health

 

 

  

  


Contents

1............ Name of regulation.............................................................................. 1

2............ Commencement................................................................................... 1

3............ Authority............................................................................................. 1

4............ Schedule(s)......................................................................................... 1

Schedule 1—Amendments                                                                                                2

Health Insurance (General Medical Services Table) Regulation 2013            2

 


1  Name of regulation

                   This regulation is the Health Insurance (General Medical Services Table) Amendment (Various Measures) Regulation 2014.

2  Commencement

                   This regulation commences on 1 March 2014.

3  Authority

                   This regulation is made under the Health Insurance Act 1973.

4  Schedule(s)

                   Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1Amendments

  

Health Insurance (General Medical Services Table) Regulation 2013

1  Subclause 1.1.3(2) of Schedule 1 (paragraph (a) of the example)

Omit “health workers”, substitute “and Torres Strait Islander health practitioners”.

2  At the end of clause 2.5A.2 of Schedule 1

Add:

                   ; (p)  Rett’s disorder.

3  Subclause 2.16.4(3) of Schedule 1

Omit “health worker”, substitute “and Torres Strait Islander health practitioner”.

4  Schedule 1 (item 11820)

Repeal the item, substitute:

 

11820

Capsule endoscopy to investigate an episode of obscure gastrointestinal bleeding, using a capsule endoscopy device (including administration of the capsule, associated endoscopy procedure if required for placement, imaging, image reading and interpretation, and all attendances for providing the service on the day the capsule is administered) if:

(a) the patient to whom the service is provided:

(i) has recurrent or persistent bleeding; and

(ii) is anaemic or has active bleeding; and

(b) an upper gastrointestinal endoscopy and a colonoscopy have been performed on the patient and have not identified the cause of the bleeding; and

(c) the service has not been provided to the same patient on more than 2 occasions in the preceding 12 months; and

(d) the service is performed by a specialist or consultant physician with endoscopic training that is recognised by The Conjoint Committee for Recognition of Training in Gastrointestinal Endoscopy; and

(e) the service is not associated with balloon enteroscopy

2 039.20

5  Schedule 1 (item 11823, column headed “Description”, paragraph (c))

Omit “double”.

6  Subclauses 2.42A.1(1) and (2) of Schedule 1

Omit “18375”, substitute “18377”.

7  Schedule 1 (after item 18375)

Insert:

 

18377

Botulinum toxin type A (Botox), injection of, for the treatment of chronic migraine, including all injections in 1 day, if:

(a) the patient is at least 18 years of age; and

(b) the patient has experienced an inadequate response, intolerance or contraindication to at least 3 prophylactic migraine medications before commencement of treatment with botulinum toxin, as manifested by an average of 15 or more headache days per month, with at least 8 days of migraine, over a period of at least 6 months, before commencement of treatment with botulinum toxin; and

(c) the requirements relating to botulinum toxin type A under the Pharmaceutical Benefits Scheme are complied with

For each patient—applicable not more than twice except if the patient achieves and maintains at least a 50% reduction in the number of headache days per month from baseline after 2 treatment cycles (each of 12 weeks duration)

124.85

8  Schedule 1 (items 30680, 30682 and 30684)

Omit “Double balloon”, substitute “Balloon”.

9  Schedule 1 (item 30684)

Omit “or laser”, substitute “, laser coagulation or argon plasma”.

10  Schedule 1 (item 30686)

Omit “Double balloon”, substitute “Balloon”.

11  Schedule 1 (item 30686)

Omit “or laser”, substitute “, laser coagulation or argon plasma”.