Federal Register of Legislation - Australian Government

Primary content

Determinations/Health as amended, taking into account amendments up to Health Insurance (General Practice COVID-19 Treatment) Amendment Determination (No. 1) 2022
This instrument inserts two items for general practitioners (GPs) or other medical practitioners (OMPs) to determine a patient’s eligibility to receive oral antiviral medication for the effective treatment of COVID-19.
Administered by: Health and Aged Care
Registered 23 Aug 2022
Start Date 10 Aug 2022
End Date 29 Sep 2022
To be ceased 31 Dec 2022 23:59
Ceased by Self Ceasing
Table of contents.

Commonwealth Coat of Arms of Australia

Health Insurance (General Practice COVID-19 Treatment) Determination 2022

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 1

Compilation date:                              10 August 2022

Includes amendments up to:            F2022L01051

Registered:                                         23 August 2022

About this compilation

This compilation

This is a compilation of the Health Insurance (General Practice COVID-19 Treatment) Determination 2022 that shows the text of the law as amended and in force on 10 August 2022 (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............................................................................................................................. 1

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

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

4............ Cessation....................................................................................................................... 1

5............ Definitions..................................................................................................................... 1

6............ Treatment of relevant service......................................................................................... 2

7............ Application of COVID‑19 Treatment Items.................................................................. 3

8............ Limitation of COVID‑19 Treatment.............................................................................. 3

Schedule – relevant services......................................................................................................... 4

Endnotes                                                                                                                                                                 5

Endnote 1—About the endnotes                                                                                                        5

Endnote 2—Abbreviation key                                                                                                            6

Endnote 3—Legislation history                                                                                                         7

Endnote 4—Amendment history                                                                                                       8

 


1.  Name

              This instrument is the Health Insurance (General Practice COVID-19 Treatment) Determination 2022.

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

19 July 2022

 

                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.  Cessation

Unless earlier revoked, this instrument ceases as if revoked on 31 October 2022 at 11.59pm.

5.  Definitions

(1)     In this instrument:

Act means the Health Insurance Act 1973.

admitted patient means a patient who is receiving a service that is provided:

(a)  as part of an episode of hospital treatment; or

(b) as part of an episode of hospital‑substitute treatment in respect of which the person to whom the treatment is provided chooses to receive a benefit from a private health insurer.

COVID-19 oral antiviral treatment means an oral antiviral treatment for the treatment of COVID-19 infection which has been approved for supply in Australia by the Therapeutic Goods Administration.

general medical services table means the table prescribed under section 4 of the Act as in force from time to time.

phone attendance means a professional attendance by telephone where the health practitioner:

(a)  has the capacity to provide the full service through this means safely and in accordance with professional standards; and

(b) is satisfied that it is clinically appropriate to provide the service to the patient; and

(c)  maintains an audio link with the patient.

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 instrument.

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

·         clinically relevant service;

·         general medical services table;

·         hospital‑substitute treatment;

·         hospital treatment;

·         item;

·         medical practitioner;

·     professional service.

(2)    Unless the contrary intention appears, a reference in this instrument 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.

(3)    In this instrument, general practitioner includes a kind of medical practitioner specified in clause 1.1.3 of the general medical services table.

6.  Treatment of relevant service

For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument 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 COVID‑19 Treatment Items

(1)     An item in a Schedule of this Determination only applies to a service mentioned in the item if the patient’s COVID-19 infection has been confirmed by either:

(a)        laboratory testing; or

(b)        a COVID-19 rapid antigen self test which has been approved for supply in Australia by the Therapeutic Goods Administration, where:

(i)      the treating practitioner makes a record in the patient’s notes that the relevant state and territory reporting requirements have been met, if applicable, and either:

A.    confirms the patient has reported the positive test result to the relevant state or territory public health unit where reporting requirements are in place from time to time; or

B.    assists the patient to report the positive result to the relevant state or territory public health unit where reporting requirements are in place from time to time.

(2)     An item in a Schedule of this Determination only applies to a service performed by a medical practitioner who:

               (a)     is located at a medical practice with capacity for in person assessment
    where appropriate; or

   (b)    has a formal agreement with a medical practice to provide personal attendance services.

8.  Limitation of COVID‑19 Treatment

(1)     An item in a Schedule of this Determination does not apply to a service mentioned in the item if the person is an admitted patient.

(2)     An item in a Schedule of this Determination does not apply to a service if it is performed in association with any other attendance service on the same occasion by the same medical practitioner.

 


Schedule – relevant services

Group A46— COVID‑19 management support service

Item

Description

Fee ($)

93716

Phone attendance by a general practitioner lasting at least 20 minutes for the assessment and management of a person with COVID‑19 infection of recent onset, for the purposes of determining the patient’s eligibility for receiving a COVID-19 oral antiviral treatment, where the service includes any of the following that are clinically relevant:

(a)     taking a detailed patient history;

(b)     arranging any necessary investigation;

(c)     implementing a management plan, including follow up arrangements;

(d)     providing any necessary treatment, including prescribing a COVID-19 oral antiviral treatment;

(e)     providing appropriate preventive health care for one or more related issues;

with appropriate documentation

90.50

93717

Phone attendance by a medical practitioner (other than a general practitioner) lasting at least 25 minutes for the assessment and management of a person with COVID‑19 infection of recent onset, for the purposes of determining the patient’s eligibility for receiving a COVID-19 oral antiviral treatment, where the service includes any of the following that are clinically relevant:

(a)     taking a detailed patient history;

(b)     arranging any necessary investigation;

(c)     implementing a management plan, including follow up arrangements;

(d)     providing any necessary treatment, including prescribing a COVID-19 oral antiviral treatment;

(e)     providing appropriate preventive health care for one or more related issues;

with appropriate documentation

44.70


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 how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.

If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to 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 (General Practice COVID-19 Treatment) Determination 2022

18 July 2022 (F2022L00992)

19 July 2022 (s 2(1) item 1)

 

Health Insurance (General Practice COVID-19 Treatment) Amendment Determination (No. 1) 2022

9 Aug 2022 (F2022L01051)

10 Aug 2022 (s 2(1) item 1)

 

Endnote 4—Amendment history

 

Provision affected

How affected

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

rep LA s 48D

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

am F2022L01051