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Determinations/Health as amended, taking into account amendments up to Health Insurance (Health Care Homes) Amendment Determination 2019
Administered by: Health
Registered 02 Aug 2019
Start Date 16 Jul 2019
To be repealed 30 Jun 2021
Repealed by Self Repealing
Table of contents.

Commonwealth Coat of Arms of Australia

Health Insurance (Health Care Homes) Determination 2017

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 1

Compilation date:                              16 July 2019

Includes amendments up to:            F2019L00986

Registered:                                         2 August 2019

 

About this compilation

This compilation

This is a compilation of the Health Insurance (Health Care Homes) Determination 2017 that shows the text of the law as amended and in force on 16 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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

  

  

  



1.                  Name

                        This Determination is the Health Insurance (Health Care Homes) Determination 2017.

2.                  Commencement

            This Determination is taken to:

(a)         have commenced on 1 October 2017; and

(b)         is repealed at the end of 30 June 2021.

3.                  Authority

This Determination 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.

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.

Health Care Homes trial site means a medical practice:

(a)      in respect of which a grant was made by the Commonwealth under the Health Care Homes Grant Program; and

(b)     that is participating in the Health Care Homes Program.

Health Care Homes Program means the program of that name administered by the Department of Health. 

Schedule means a Schedule to this Determination.

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

·         clinically relevant service

·         item

·         general medical services table

·         medical practitioner

·         participating nurse practitioner

·         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.

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.         Limitation on item 6087

For item 6087:

(a)        the service must be provided to the patient for the purposes of the Health Care Homes Program; and

(b)        the service may be provided to the patient individually or as part of a group.

7.         Effect of bulk-billing

Item 6087 does not apply to a relevant service if:

(a)        the person to whom medicare benefit is or would, but for this section, be payable, enters into an agreement for the purposes of section 20A of the Act to assign his or her right to the payment of the benefit to the medical practitioner or participating nurse practitioner by whom, or on whose behalf, the service is provided; and

(b)        the medical practitioner or participating nurse practitioner accepts the assignment in full payment of his or her fee for the service provided.

8.         Application of provisions of the general medical services table

Clauses 1.2.7, 1.2.8 and 1.2.9 of the general medical service table have effect as if item 6087 were also specified in those provisions.

           


Schedule 1 – relevant services

 

 

Group A34 – Health Care Homes

Item

Service

Fee ($)

6087

Attendance, including by telephone or videoconference, on a patient participating in the Health Care Homes Program by or on behalf of a medical practitioner (including a general practitioner but not including a specialist or consultant physician) or participating nurse practitioner employed or otherwise engaged by the Health Care Home trial site at which the patient is enrolled - each patient.  

1.15

 


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 (Health Care Homes) Determination 2017

29 Sept 2017 (F2017L01310)

1 Oct 2017 (s 2(a))

 

Health Insurance (Health Care Homes) Amendment Determination 2019

15 July 2019 (F2019L00986)

16 July 2019 (s 2)

 

Endnote 4—Amendment history

 

Provision affected

How affected

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

am F2019L00986

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

ed C1

s 8.............................................

am F2019L00986

 

Endnote 5—Editorial changes

In preparing this compilation for registration, the following kinds of editorial change(s) were made under the Legislation Act 2003.

 

Section 6 (heading)

 

Kind of editorial change

 

Change to spelling

 

Details of editorial change

 

The heading to section 6 refers to “Limitiation” rather than “Limitation”.

 

This compilation was editorially changed to omit the word “Limitiation” and substitute the word “Limitation” to correct the spelling.