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This instrument amends the Health Insurance (Section 3C Co-Dependent Pathology Services) Determination 2018 to enable the addition of entrectinib to Medicare Benefits Scheme (MBS) item 73344, and to amend item 73295 and list two new items 73301 and 73302 to expand testing for access to olaparib to patients who have BRCA variants detected, regardless of whether the BRCA variants are the result of germline variant/s or not.
Administered by: Health
Registered 23 Jul 2020
Table of contents.

Commonwealth Coat of Arms of Australia

 

Health Insurance (Section 3C Co-Dependent Pathology Services) Amendment Determination (No. 5) 2020

I, Mary Warner, delegate of the Minister for Health, make the following Determination.

Dated     20 July 2020                        

Mary Warner

Acting Assistant Secretary

MBS Policy and Specialist Services Branch

Medical Benefits Division

Health Financing Group

Department of Health

 

 

 


Contents

1  Name........................................................................................................................................ 1

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

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

4  Schedules................................................................................................................................. 1

Schedule 1— Amendments                                                                                          2

Health Insurance (Section 3C Co-Dependent Pathology Services) Determination 2018                          2

 

 


1  Name

                        This instrument is the Health Insurance (Section 3C Co-Dependent Pathology Services) Amendment Determination (No. 5) 2020.

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 August 2020

 

                Note:        This table relates only to the provisions of this instrument as originally made.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 instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4  Schedules

                        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 1— Amendments

 

Health Insurance (Section 3C Co-Dependent Pathology Services) Determination 2018

1 Schedule 1 (item 73295)

Repeal the item, substitute:

 

73295

Detection of germline BRCA1 or BRCA2 pathogenic or likely pathogenic gene variants, in a patient with advanced (FIGO III-IV) high-grade serous or high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer for whom testing of tumour tissue is not feasible, requested by a specialist or consultant physician, to determine eligibility for olaparib under the Pharmaceutical Benefits Scheme (PBS)

Maximum of one test per patient’s lifetime

1,200.00

 

2 Schedule 1 (immediately after item 73295)

Insert:

 

73301

A test of tumour tissue from a patient with advanced (FIGO III-IV), high grade serous or high grade epithelial ovarian, fallopian tube or primary peritoneal cancer, requested by a specialist or consultant physician, to determine eligibility relating to BRCA status for access to olaparib under the Pharmaceutical Benefits Scheme (PBS)

Applicable once per primary tumour diagnosis

1,200.00

73302

Characterisation of germline gene variants including copy number variants, in BRCA1 or BRCA2 genes, in a patient who has had a pathogenic or likely pathogenic variant identified in either gene by tumour testing and who has not previously received a service to which items 73295, 73296 or 73297 applies, requested by a specialist or consultant physician

Applicable once per primary tumour diagnosis

Note: Items 73296 and 73297 are in the pathology services table.

400.00

 

3 Schedule 1 (item 73344, column 2)

Omit “crizotinib”, substitute “crizotinib or entrectinib”