Federal Register of Legislation - Australian Government

Primary content

Determinations/Health as amended, taking into account amendments up to Health Insurance Legislation Amendment (Flood Affected Areas) Determination 2019
Administered by: Health
Registered 26 Jul 2019
Start Date 01 Jul 2019

 

Commonwealth Coat of Arms

Health Insurance (Section 3C General Medical Services - General Practitioner Telehealth Services) Determination 2018

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 3

Compilation date:                              1 July 2019

Includes amendments up to:            Health Insurance Legislation Amendment                                                                 (Flood Affected Areas) Determination 2019

Registered:                                         26 July 2019

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C General Medical Services - General Practitioner Telehealth Services) Determination 2018 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.

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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.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. 1

3.       Authority.. 1

4.       Definitions. 1

5.       Treatment of relevant services. 3

6.       Application of items. 3

7.       Application of provisions of the general medical services table. 3

Schedule 1 – Relevant Services.. 4

Endnotes. 6

Endnote 1—About the endnotes. 6

Endnote 2—Abbreviation key.. 7

Endnote 3—Legislation history.. 8

Endnote 4—Amendment history.. 9

 


 

1.         Name

This determination is the Health Insurance (Section 3C General Medical Services - General Practitioner Telehealth Services) Determination 2018.

3.         Authority

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

4.         Definitions

(1)        In this Determination:

Act means the Health Insurance Act 1973.

drought affected eligible area means an area within New South Wales, Queensland or Victoria that is a Modified Monash 3 area, Modified Monash 4 area, Modified Monash 5 area, Modified Monash 6 area or Modified Monash 7 area.

focussed psychological strategies means any of the following mental health care management strategies which have been derived from evidence‑based psychological therapies:

                     (a)  psycho‑education;

                     (b)  cognitive‑behavioural therapy which involves cognitive or behavioural interventions;

                     (c)  relaxation strategies;

                     (d)  skills training;

                     (e)  interpersonal therapy.

mental disorder means a significant impairment of any or all of an individual’s cognitive, affective and relational abilities that:

(a)  may require medical intervention; and

                     (b)  may be a recognised, medically diagnosable illness or disorder; and

                     (c)  is not dementia, delirium, tobacco use disorder or mental retardation.

Modified Monash 4 area means a Statistical Area Level 1 under the ASGS that:

(a)          is categorised under the ASGS as RA 1 (Inner Regional Australia) or RA 2 (Outer Regional Australia); and

(b)          satisfies any of the following criteria:

(i)           the area is in an Urban Centre and Locality with a 2013 estimated resident population of at least 5,000 but no more than 15,000;

(ii)          the area is in an Urban Centre and Locality, the geographic centre of which is no more than 10 kilometres road distance from the boundary of another Urban Centre and Locality with a 2013 estimated resident population of at least 5,000 but no more than 15,000;

(iii)         the area is not in an Urban Centre and Locality, but the geographic centre of the area is no more than 10 kilometres road distance from the boundary of an Urban Centre and Locality with a 2013 estimated resident population of at least 5,000 but no more than 15,000; and

(c)          is not a Modified Monash 2 area, Modified Monash 3 area or Modified Monash 7 area.

Modified Monash 5 area means a Statistical Area Level 1 under the ASGS that:

(a)          is categorised under the ASGS as RA 1 (Inner Regional Australia) or RA 2 (Outer Regional Australia); and

(b)          is not a Modified Monash 2 area, Modified Monash 3 area, Modified Monash 4 area or Modified Monash 7 area.

Modified Monash 6 area means a Statistical Area Level 1 under the ASGS that:

(a)          is categorised under the ASGS as RA 3 (Remote Australia); and

(b)          is not a Modified Monash 7 area.

Modified Monash 7 area means a Statistical Area Level 1 under the ASGS that:

(a)          is entirely located on an island or islands more than 5 kilometres from the Australian mainland or Tasmania, as measured between coastlines at the low water mark; or

(b)          is located on Magnetic Island; or

(c)          is categorised under the ASGS as RA 4 (Very Remote Australia).

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

telehealth eligible area means an area that is a Modified Monash 4 area, Modified Monash 5 area, Modified Monash 6 area or Modified Monash 7 area.

 (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.

5.         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.

6.         Application of items

Items 2121, 2150, 2196, 2729 and 2731 do not apply if the patient or the general practitioner travels to a place to satisfy the requirement in paragraph (d) of the item.

7.         Application of provisions of the general medical services table

Clause 2.22.7 of the general medical services table shall have effect as if items 2729 and 2731 were also specified in this clause.


 

Schedule 1 – Relevant Services

 

Group A20—Mental health care

Subgroup 2—Focussed psychological strategies

Item

Description

Fee ($)

2729

Professional attendance at consulting rooms by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 30 minutes, but less than 40 minutes if:

(a)     the attendance is by video conference; and

(b)     the patient is not an admitted patient; and

(c)     the patient is located within a telehealth eligible area; and

(d)     the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner.

       94.25

2731

Professional attendance at consulting rooms by a general practitioner, for the purpose of providing focussed psychological strategies for assessed mental disorders by a general practitioner registered with the Chief Executive Medicare as meeting the credentialing requirements for provision of this service, and lasting at least 40 minutes if:

(a)     the attendance is by video conference; and

(b)     the patient is not an admitted patient; and

(c)     the patient is located within a telehealth eligible area; and

(d)     the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner.

               134.85

Group A30—Medical Practitioner video conferencing consultation

Subgroup 3—Mental health and well-being video conferencing consultation

Item

Description

Fee ($)

2121

Professional attendance at consulting rooms by a general practitioner, lasting less than 20 minutes, for providing mental health services to a patient with mental health issues, if:

(a)     the attendance is by video conference; and

(b)     the patient is not an admitted patient; and

(c)     the patient and the general practitioner are located within a drought affected eligible area; and

(d)     the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner; and

(e)     the patient has an existing relationship with the general practitioner.

                44.90

2150

Professional attendance at consulting rooms by a general practitioner, lasting at least 20 minutes, for providing mental health services to a patient with mental health issues, if:

(a)     the attendance is by video conference; and

(b)     the patient is not an admitted patient; and

(c)     the patient and the general practitioner are located within a drought affected eligible area; and

(d)     the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner; and

(e)     the patient has an existing relationship with the general practitioner.

     86.95

2196

Professional attendance at consulting rooms by a general practitioner, lasting at least 40 minutes, for providing mental health services to a patient with mental health issues, if:

(a)     the attendance is by video conference; and

(b)     the patient is not an admitted patient; and

(c)     the patient and the general practitioner are located within a drought affected eligible area; and

(d)     the patient is, at the time of the attendance, at least 15 kilometres by road from the general practitioner; and

(e)     the patient has an existing relationship with the general practitioner.

       128.05


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

 

o = order(s)

ad = added or inserted

Ord = Ordinance

am = amended

orig = original

amdt = amendment

par = paragraph(s)/subparagraph(s)

c = clause(s)

    /sub‑subparagraph(s)

C[x] = Compilation No. x

pres = present

Ch = Chapter(s)

prev = previous

def = definition(s)

(prev…) = previously

Dict = Dictionary

Pt = Part(s)

disallowed = disallowed by Parliament

r = regulation(s)/rule(s)

Div = Division(s)

 

exp = expires/expired or ceases/ceased to have

reloc = relocated

    effect

renum = renumbered

F = Federal Register of Legislation

rep = repealed

gaz = gazette

rs = repealed and substituted

LA = Legislation Act 2003

s = section(s)/subsection(s)

LIA = Legislative Instruments Act 2003

Sch = Schedule(s)

(md) = misdescribed amendment can be given

Sdiv = Subdivision(s)

    effect

SLI = Select Legislative Instrument

(md not incorp) = misdescribed amendment

SR = Statutory Rules

    cannot be given effect

Sub‑Ch = Sub‑Chapter(s)

mod = modified/modification

SubPt = Subpart(s)

No. = Number(s)

underlining = whole or part not

 

    commenced or to be commenced

 

Endnote 3—Legislation history

 

Name

Registration

Commencement

Application, saving and transitional provisions

Health Insurance (Section 3C General Medical Services - General Practitioner Telehealth Services) Determination 2018

15 October 2018 (F2018L01430)

1 November 2018

 

Health Insurance (Section 3C General Medical Services – General Practice Telehealth Services) Amendment Determination 2018

29 October 2018 (F2018L01498)

Sch 1 (items 1–4): 1 November 2018

Health Insurance (Section 3C General Medical Services - General Practitioner Telehealth Services) Determination 2019

1 March 2019 (F2019L00226)

Sch 1 (items 1, 2): 2 March 2019 (s 2(1) item 1)

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

11 April 2019 (F2019L00605)

Sch 1 (items 10–14): 1 July 2019 (s 2(1) item 1)

Health Insurance Legislation Amendment (Flood Affected Areas) Determination 2019

7 June 2019 (F2019L00734)

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

 

Endnote 4—Amendment history

Provision affected

How affected

s 2.............................................

rep LA s 48D

s 4.............................................

am F2018L01498; F2019L00226; F2019L00734

s 6.............................................

am F2018L01498

s 7.............................................

am F2018L01498

Schedule 1

 

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

am F2018L01498; F2019L00226; F2019L00605; F2019L00734