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Determinations/Health as made
This determination will implement the 65% Extended Medicare Safety Net (EMSN)benefit cap on new obstetric items that will be implemented from 1 November 2017. It also repeals the Health Insurance (Extended Medicare Safety Net) Determination 2009, which is due to sunset on 1 April 2020, and continues the existing EMSN benefit caps on other items that currently apply under that instrument.
Administered by: Health and Aged Care
Registered 24 Aug 2017
Tabling HistoryDate
Tabled HR04-Sep-2017
Tabled Senate04-Sep-2017
Table of contents.

Health Insurance (Extended Medicare Safety Net) Determination 2017

Health Insurance Act 1973

 

I, GREG HUNT, Minister for Health, make this Determination under section 10B of the Health Insurance Act 1973.

 

Dated 15 August 2017

 

Greg Hunt

 

Minister for Health

 


Contents

1       Name of Determination. 3

2       Commencement 3

3       Definitions. 3

4.      Maximum increases for items under sections 10ACA and  10ADA of the Act 3

5.      Repeal 10

 


 

1       Name of Determination

                This Determination is the Health Insurance (Extended Medicare Safety Net) Determination 2017.

2       Commencement

Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

The later of:

(a) 1 November 2017; and

(b) the day after this instrument has been approved by each House of Parliament.

However, the provisions do not commence at all if the event mentioned in paragraph (b) does not occur.

 

Note:          This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

             (2)  Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3       Definitions

                In this Determination:

Act means the Health Insurance Act 1973.

diagnostic imaging services table means the table prescribed under section 4AA of the Act.

general medical services table means the table prescribed under section 4 of the Act.

Schedule fee has the meaning given in subsection 8 (1A) of the Act.

4.      Maximum increases for items under sections 10ACA and 10ADA of the Act

         (1)   For section 10B of the Act:

                (a)    subsections 10ACA(7A) and 10ADA(8A) apply to the items of the general medical services table listed in column 1 of the table below; and

               (b)    the maximum increases for these items are listed in column 2.

 

Item

Maximum increase ($)

13200

1 675.50

13201

2 432.15

13202

64.95

13203

108.15

13206

64.95

13209

10.90

13210

5.30

13212

70.35

13215

48.70

13218

702.65

13221

21.70

13251

108.15

14201

15 percent of the Schedule fee for the item

 

14202

15 percent of the Schedule fee for the item

16399

24.10

16400

11.05

16401

54.90

16404

32.95

16406

108.15

16407

65 percent of the Schedule fee for the item

16408

65 percent of the Schedule fee for the item

16500

32.95

16501

65.90

16502

22.00

16504

22.00

16505

22.00

16508

22.00

16509

22.00

16511

109.75

16512

32.95

16514

16.55

16515

175.60

16518

175.60

16519

329.15

16520

329.15

16522

438.90

16527

175.60

16528

329.15

16530

65 percent of the Schedule fee for the item

16531

65 percent of the Schedule fee for the item

16533

65 percent of the Schedule fee for the item

16534

65 percent of the Schedule fee for the item

16564

219.45

16567

219.45

16570

219.45

16571

219.45

16573

219.45

16590

219.45

16591

109.75

16600

32.95

16603

65.90

16606

131.75

16609

252.40

16618

104.30

16624

142.65

16627

307.25

32500

110 percent of the Schedule fee for the item

32520

15 percent of the Schedule fee for the item

32522

10 percent of the Schedule fee for the item

32523

15 percent of the Schedule fee for the item

32526

10 percent of the Schedule fee for the item

42702

15 percent of the Schedule fee for the item

45560

35 percent of the Schedule fee for the item

82100

21.70

82105

16.30

82110

21.70

82115

54.10

82130

16.30

82135

21.70

82140

16.30

Note   Items 82100, 82105, 82110, 82115, 82130, 82135 and 82140 appear in the determination made under subsection 3C(1) of the Act with respect to midwife and nurse practitioner services.  The determination operates so that the items are to be treated as if the items were in the general medical services table.       

         (2)   For section 10B of the Act:

                (a)    subsections 10ACA(7A) and 10ADA(8A) apply to items 11700, 14100, 20142, 30071, 31560, 32501, 32504, 32507, 34106, 35533, 37619, 42590, 42738, 42739, 42740, 45003, 45025, 45026, 45200, 45203, 45206, 45545, 45584, 45585, 45587, 45614, 45617, 45620, 45623, 45624, 45632, 45635, 45652 and 45659 of the general medical services table; and 

               (b)    the maximum increase for each item is 80 percent of the Schedule fee for that item.

         (3)   For section 10B of the Act:

                (a)    subsections 10ACA(7A) and 10ADA(8A) apply to each item in the Group of the general medical services table listed in the column of the table below; and

               (b)    the maximum increase for each item is 300 percent of the Schedule fee for that item or $500.00 for that item whichever represents the lesser amount.


 

 

Group

A1

A2

A3

A4

A5

A6

A7

A8

A9

A11

A12

A13

A14

A15

A17

A18

A19

A20

A21

A22

A23

A24

A26

A27

A28

A29

A30

T6

(4) For section 10B of the Act:

(a)   subsections 10ACA(7A) and 10ADA(8A) apply to each item in the Group of the general medical services table listed in the column of the table below; and

(b)   the maximum increase for each item is 300 percent of the Schedule fee for that item or $500.00 for that item whichever represents the lesser amount. 

Group

M3

M6

M7

M8

M9

M10

M11

M12

M14

M15

Notes   Items in groups M3, M6, M7, M8, M9, M10, M11 and M15 appear in the determination made under subsection 3C(1) of the Act with respect to allied health services. The determination operates so that the items are to be treated as if the items were in the general medical services table.

Items in group M14 appear in the determination made under subsection 3C(1) of the Act with respect to midwife and nurse practitioner services.  The determination operates so that the items are to be treated as if the items were in the general medical services table.

         (5)   For section 10B of the Act:

                (a)    subsections 10ACA(7A) and 10ADA(8A) apply to items 82120, 82125, 82150, 82151, and 82152 of the general medical services table; and

               (b)    the maximum increase for each item is 300 percent of the Schedule fee for that item or $500.00 for that item whichever represents the lesser amount.

Note   Items 82120, 82125, and 82150-82152 appear in the determination made under subsection 3C(1) of the Act with respect to midwife and nurse practitioner services.  The determination operates so that the items are to be treated as if the items were in the general medical services table.

         (6)   For section 10B of the Act:

                (a)    subsections 10ACA(7A) and 10ADA(8A) apply to the items of the diagnostic imaging services table listed in column 1 of the table below; and

               (b)    the maximum increases for these items are listed in column 2.

 

Item

Maximum increase ($)

55054

80 percent of the Schedule fee for the item.

55700

32.95

55701

16.50

55702

8.30

55703

16.55

55704

38.50

55705

16.55

55706

54.90

55707

38.50

55708

16.55

55709

22.00

55710

19.30

55711

8.30

55712

65.90

55713

27.50

55714

19.30

55715

22.00

55716

8.30

55717

11.05

55718

54.90

55719

32.95

55720

11.05

55721

65.90

55722

27.50

55723

22.00

55724

32.95

55725

22.00

55726

11.05

55727

11.05

55729

16.55

55730

8.30

55762

32.95

55763

16.50

55764

87.85

55765

44.00

55766

32.95

55767

16.50

55768

82.40

55769

41.25

55770

32.95

55771

16.50

55772

87.85

55773

44.00

55774

38.50

55775

19.30

Note   Items 55701, 55702, 55710, 55711, 55713, 55714, 55716, 55717, 55719, 55720, 55722, 55724, 55726, 55727, 55730, 55763, 55765, 55767, 55769, 55771, 55773 and 55775 appear in the determination made under subsection 3C(1) of the Act in relation to diagnostic imaging and capital sensitivity services. The determination operates so that the items are to be treated as if the items were in the diagnostic imaging services table.

 

5.      Repeal

This Determination repeals the Health Insurance (Extended Medicare Safety Net) Determination 2009.