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This instrument enables patients to claim Medicare Benefits if a participating rural generalist trainee has provided them a professional service.
Administered by: Health
Registered 22 Oct 2020
To be ceased 31 Dec 2024
Ceased by Self Ceasing

Ref No.    

 

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH

 

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefit Payable in Respect of Professional Services—Murrumbidgee Local Health District) Direction 2020

I, Paul McBride, First Assistant Secretary, Medical Benefits Division, Health Resourcing Group, delegate for the Minister for Health, acting under subsection 19(2) of the Health Insurance Act 1973, hereby:

DIRECT that Medicare Benefits shall be payable in respect of:

(a)    A professional service (as defined in Section 3 of the Health Insurance Act 1973) which has been agreed to be provided under the Memorandum of Understanding (MOU) between the Department of Health (ABN: 24 004 196 909) and the Murrumbidgee Local Health District (ABN: 71 172 428 618) (MLHD) in relation to the rural generalists innovative employment model trial within the Murrumbidgee region for which;

(i)     items specified in Schedule A of this Direction; and

of the general medical services table (means the table prescribed under subsection 4(1) of the Health Insurance Act 1973), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Health Insurance Act 1973) and pathology services table (means the table prescribed under subsection 4A(1) of the Health Insurance Act 1973) relates: and

(b)   Where the professional service is provided to:

(i)     an eligible person (as defined in Section 3 of the Health Insurance Act 1973); and

(ii)   a patient who is not receiving an episode of hospital treatment (as defined in Section 121-5 of the Private Health Insurance Act 2007); and

(c)    the professional services referred to in clause (a):

(i)     is professional attendance provided in a general practice (as defined in Section 7.1.1 of the general medical services table); and

(ii)   is provided at an approved Modified Monash Model 4-7 (as defined in Section 7.1.1 of the general medical services table) practice location specified in Schedule B; and

(iii)  is provided by a participating rural generalist trainee (as defined in the MOU mentioned in (a)):

                                                              i.      who is centrally employed, with a salary, by the MLHD for the provision of primary and acute care services: and

                                                            ii.      is registered in the rural generalists innovative employment model trial within the Murrumbidgee region.

DECLARED that this Direction shall have effect from the date of signature until
31 December 2024 inclusive unless earlier revoked.

Date this 19th day of October             2020

 

 

Paul McBride

First Assistant Secretary  

Medical Benefits Division

Health Resourcing Group

Department of Health 


 

SCHEDULE A

MEDICARE BENEFITS SCHEDULE ITEMS AS AGREED IN THE MEMORANDUM OF UNDERSTANDING BETWEEN THE DEPARTMENT OF HEALTH AND THE MURRUMBIDGEE LOCAL HEALTH DISTRICT

For services listed in the below tables, all provisions of the Health Insurance Act 1973 (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 apply.

General Medical Services Table

Group

Group Name

Subgroup

Subgroup Name

A1

General practitioner attendances to which no other item applies

A2

Other non-referred attendances to which no other item applies

A5

Prolonged attendances to which no other item applies

A6

Group therapy

A7

Acupuncture and non-specialist practitioner items

All

 

A11

Urgent attendances after-hours

A14

Health assessments

A15

GP Management plans, team care arrangements and multidisciplinary care plans and case

1

GP Management plans, team care arrangements and multidisciplinary care plans

2

Case conferences

A17

Domiciliary and residential medication management reviews

A18

Attendances associated with Practice Incentive Program payments

All

A19

Attendances associated with Practice Incentive Program payments

All

 

A20

Mental health Care

All

A22

General practitioner after-hours attendances to which no other item applies

A23

Other non-referred after-hour attendances to which no other item applies

A27

Pregnancy support counselling

A29

Early intervention services for children with autism, pervasive development disorder or disability

A30

Medical practitioner video conferencing consultation

1

Video conferencing consultation attendance at consulting rooms, home visit of other institution

2

Video conferencing consultation attendance at a residential aged care facility

3

Mental health and well-being video conferencing consultation

5

General practitioner video conferencing consultation attendance for patients in rural and remote areas

6

Other non-referred video conferencing consultation attendance for patients in rural and remote areas

7

Non-specialist practitioner video conferencing consultation for patients in rural and remote areas

A35

Non-referred attendance at a residential aged care facility

A36

Eating Disorder Services

1

GP and Medical Practitioner eating disorder treatment and management plans

3

Review of eating disorder treatment and management plan

4

GP and medical practitioner eating disorder s psychological treatment services

A39

Bushfire Recovery Access Initiative – GP and Medical Practitioner Focussed Psychological Strategies

A40

COVID-19 Services

1

COVID-19 general practice -  telehealth services

2

COVID-19 general practice - phone services

3

COVID-19 Focussed psychological strategies - telehealth services

10

COVID-19 Focussed psychological strategies - phone services

11

Health assessments for Aboriginal and Torres Strait Islander People - telehealth services

12

Health assessments for Aboriginal and Torres Strait Islander People - phone Services

13

GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance 

14

GP management plans, team care arrangements and multidisciplinary care plans via phone attendance 

15

GP pregnancy support counselling - telehealth services

16

GP pregnancy support counselling - phone services

17

GP, Specialist and Consultant Physician autism service - telehealth services

18

GP, Specialist and Consultant Physician autism service - phone services

19

GP mental health treatment plan - telehealth services

20

GP mental health treatment plan - phone services

21

GP Eating Disorder Treatment and Management Plan – telehealth services

22

GP Eating Disorder Treatment and Management Plans - phone services

25

Review of an eating disorder Plan - telehealth services

26

Review of an Eating Disorder Plan – phone services

27

GP - Eating Disorder Focussed Psychological Strategies – telehealth services

28

GP - Eating Disorder Focussed Psychological Strategies – phone services

29

GP and Other Medical Practitioner - urgent after hours service in unsociable hours - telehealth services

30

GP and Other Medical Practitioner - urgent after hours service in unsociable hours - phone services

M1

Management of bulk billed services

M12

Services provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

1

Video conferencing consultation support service provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

2

Video conferencing consultation support service provided at a residential aged care facility on behalf of a medical practitioner

3

Services provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

D1

Miscellaneous diagnostic procedures and investigations

2

Ophthalmology

3

Otolaryngology

4

Respiratory

5

Vascular

6

Cardiovascular

8

Genito-urinary physiological investigations

9

Allergy testing

10

Other diagnostic procedures and investigations

D2

Nuclear Medicine (non-imaging)

T1

Miscellaneous therapeutic procedures

2

Dialysis

4

Paediatric and neonatal

5

Cardiovascular

8

Haematology

9

Procedures associated with intensive care and cardiopulmonary support

11

Chemotherapeutic procedures

13

Miscellaneous therapeutic procedures

T2

Radiation oncology

1

Superficial

T3

Therapeutic nuclear medicine

T4

Obstetrics

T6

Examination by anaesthetist

T7

Regional or field nerve blocks

T8

Surgical Operations

1

General

2

Colorectal

3

Vascular

4

Ear, nose and throat

5

Urological

6

Cardio-thoracic

7

Neurosurgical

8

Ear, nose and throat

9

Ophthalmology

11

Paediatric

12

Amputations

13

Plastic and reconstructive surgery

14

Hand surgery

15

Orthopaedic

T9

Assistance at operations

T10

Anaesthesia performed in connect with certain services (relative value guide)

All

 

 

 

Diagnostic Imaging Services Table

Group

Group Name

Subgroup

Subgroup Name

I1

Ultrasound

6

Musculoskeletal ultrasound

I3

 

 

Diagnostic Radiology

 

 

1

Radiographic examination of extremities

2

Radiographic examination of shoulder or pelvis

3

Radiographic examination of head

4

Radiographic examination of spine

5

Cardiovascular

6

Radiographic examination of thoracic region

7

Radiographic examination of urinary tract

8

Radiographic examination of alimentary tract and biliary system

12

Radiographic examination with opaque or contrast media

I6

Management of bulk billed Services

 

Pathology Services Table

Group

Group Name

P1

Haematology

P2

Chemical

P9

Simple Basic Pathology Tests

P12

Management of bulk billed services

 


 

SCHEDULE B

 

Approved Modified Monash 4-7 Practice Locations AS AGREED IN THE MEMORANDUM OF UNDERSTANDING BETWEEN THE DEPARTMENT OF HEALTH AND THE MURRUMBIDGEE LOCAL HEALTH DISTRICT

Approved primary care Modified Monash Model (MMM) 4 locations:

MMM 4 location

Practice Name

Street Address

Mailing Address

Young

Young District Medical Centre

16 Cloete Street

Young
NSW 2594

16 Cloete Street

Young
NSW 2594

Cootamundra

Cootamundra Medical Centre

44 Cooper Street

Cootamundra
NSW 2590

44 Cooper Street

Cootamundra
NSW 2590

Deniliquin

Deniliquin Clinic

409 George Street

Deniliquin
NSW 2710

409 George Street

Deniliquin
NSW 2710

Approved primary care Modified Monash Model (MMM) 5 locations:

MMM 5 location

Practice Name

Street Address

Mailing Address

Gundagai

Gundagai Medical Centre

95 Sheridan Street

Gundagai
NSW 2722

95 Sheridan Street

Gundagai
NSW 2722

Temora

Temora Medical Centre

296-298 Hoskins Street

Temora
NSW 2666

296-298 Hoskins Street

Temora
NSW 2666

Narrandera

Narrandera Medical   Centre

Victoria Square

Narrandera
NSW 2700

Victoria Square

Narrandera
NSW 2700

 

Note:     The name of this instrument was amended on registration as the instrument as lodged did not have a unique name (see subsection 10(2), Legislation Rule 2016).