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Determinations/Health as amended, taking into account amendments up to Health Insurance (Section 3C General Medical Services – Medicare Indexation) Amendment Determination 2019
Administered by: Health
Registered 18 Jul 2019
Start Date 01 Jul 2019

Commonwealth Coat of Arms of Australia

Health Insurance (Section 3C General Medical Services – Heart Health Assessment No.2) Determination 2019

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 1

Compilation date:                           1 July 2019

Includes amendments up to:         F2019L00605

Registered:                                      18 July 2019

 

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C General Medical Services – Heart Health Assessment No.2) Determination 2019 that shows the text of the law as amended and in force on 1 July 2019 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self-repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

  

  

  


Contents

1.               Name  4

2.               Commencement 4

3.               Authority  4

4.               Repeal 4

5.               Definitions  4

6.               Treatment of relevant services  5

7.               Application of item 699  5

8.               Application of item 177  5

Schedule 1 – relevant services  7

Endnotes  8

Endnote 1—About the endnotes                                                                        8

Endnote 2—Abbreviation Key                                                                          9

Endnote 3—Legislation history  10

Endnote 4—Amendment history  11

 


 

1.    Name

This Determination is the Health Insurance (Section 3C General Medical Services – Heart Health Assessment No.2) Determination 2019.

2.    Commencement

(1)        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

1 April 2019

 

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.    Authority

This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.

4.    Repeal

The Health Insurance (Section 3C General Medical Services – Heart Health Assessment) Determination 2019 is repealed.

5.    Definitions

(1)               In this Determination:

Act means the Health Insurance Act 1973.

health screening service has the same meaning as in subsection 19(5) of the Act.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.

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

Schedule means a Schedule to this Determination.

Note:       The following terms are defined in subsection 3(1) of the Act:

·         clinically relevant service

·         general medical services table

·         item

·         professional service

(2)        Unless the contrary intention appears, a reference in this Determination to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 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.    Treatment of relevant services

                   For subsection 3C(1) of the Act a relevant service, provided in accordance with this Determination and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a)                    it were both a professional service and a medical service; and

(b)                   there were an item in the general medical services table that:

(i)                      related to the service; and

(ii)                    specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

7.    Application of item 699

 

(1)        Clause 2.17.1 of the general medical services table shall have effect as if item 699 contained in the Schedule was also specified in clause 2.17.1.

 

(2)        Clause 2.17.14 of the general medical services table shall have effect as if item 699 contained in the Schedule was also specified in clause 2.17.14.

 

(3)        For any particular patient, item 699 is not applicable:

(a)                    more than once in a 12 month period; or

(b)                    if, prior to a service, the patient has been provided a service mentioned in Group A14 of the general medical services table within the previous 12 months.

8.    Application of item 177

 

(1)                  Item 177 applies only to a service provided in the course of a personal attendance by a single medical practitioner on a single patient.

 

(2)               A health assessment mentioned in item 177 must not include a health screening service.

 

(3)               A separate consultation must not be performed in conjunction with a health assessment mentioned in item 177, unless clinically necessary.

 

(4)               Practice nurses, Aboriginal health workers and Aboriginal and Torres Strait Islander health practitioners may assist medical practitioners in performing a health assessment mentioned in item 177, in accordance with accepted medical practice, and under the supervision of the medical practitioner.

 

(5)               For the purposes of subsection 8(4) of this Determination, assistance may include activities associated with:

 

(a)                    information collection; and

(b)                    at the direction of the medical practitioner – provision to patients of information on recommended interventions.

(6)               For any particular patient, item 177 is not applicable:

(a)                    more than once in a 12 month period; or

(b)                    if, prior to a service, the patient has been provided a service mentioned in Group A7, Subgroup 5 of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018 within the previous 12 months.

 


 

Schedule 1 – relevant services

 

Category 1 – Professional Attendances

Group A14 – Health assessments

Item

Service

Fee ($)

699

Professional attendance for a heart health assessment by a general practitioner at consulting rooms lasting at least 20 minutes and including:

(a) collection of relevant information, including taking a patient history; and

(b) a basic physical examination, which must include recording blood pressure and cholesterol; and

(c) initiating interventions and referrals as indicated; and

(d) implementing a management plan; and

(e) providing the patient with preventative health care advice and information..

86.95

 

 

Category 1 – Professional Attendances

Group A7 – Acupuncture and Non-Specialist Practitioner Items

Subgroup 5 – Non-Specialist Practitioner health assessments

Item

Service

Fee ($)

177

Professional attendance for a heart health assessment by a medical practitioner at consulting rooms (other than a specialist or consultant physician) lasting at least 20 minutes and including:

(a) collection of relevant information, including taking a patient history; and

(b) a basic physical examination, which must include recording blood pressure and cholesterol; and

(c) initiating interventions and referrals as indicated; and

(d) implementing a management plan; and

(e) providing the patient with preventative health care advice and information.

69.55

 


Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Editorial changes

The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.

If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

 

Endnote 2—Abbreviation key

 

ad = added or inserted

o = order(s)

am = amended

Ord = Ordinance

amdt = amendment

orig = original

c = clause(s)

par = paragraph(s)/subparagraph(s)

C[x] = Compilation No. x

    /sub‑subparagraph(s)

Ch = Chapter(s)

pres = present

def = definition(s)

prev = previous

Dict = Dictionary

(prev…) = previously

disallowed = disallowed by Parliament

Pt = Part(s)

Div = Division(s)

r = regulation(s)/rule(s)

ed = editorial change

reloc = relocated

exp = expires/expired or ceases/ceased to have

renum = renumbered

    effect

rep = repealed

F = Federal Register of Legislation

rs = repealed and substituted

gaz = gazette

s = section(s)/subsection(s)

LA = Legislation Act 2003

Sch = Schedule(s)

LIA = Legislative Instruments Act 2003

Sdiv = Subdivision(s)

(md) = misdescribed amendment can be given

SLI = Select Legislative Instrument

    effect

SR = Statutory Rules

(md not incorp) = misdescribed amendment

Sub‑Ch = Sub‑Chapter(s)

    cannot be given effect

SubPt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

    commenced or to be commenced

 

Endnote 3—Legislation history

 

Name

Registration

Commencement

Application, saving and transitional provisions

Health Insurance (Section 3C General Medical Services – Heart Health Assessment No.2) Determination 2019

25 Mar 2019 (F2019L00361)

1 Apr 2019 (s 2(1) item 1)

 

Health Insurance (Section 3C General Medical Services – Medicare Indexation) Amendment Determination 2019

11 Apr 2019 (F2019L00605)

Sch 1 (items 8, 9): 1 July 2019 (s 2(1) item 1)

 

Endnote 4—Amendment history

 

Provision affected

How affected

Schedule 1

 

Schedule 1........................

am F2019L00605