Federal Register of Legislation - Australian Government

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Determinations/Health as made
This instrument creates a new item to enable patient access to an alternative positron emission tomography (PET) imaging service during supply disruptions of the radiopharmaceutical gallium-67 (Ga-67).
Administered by: Health and Aged Care
Registered 21 Jul 2022
Tabling HistoryDate
Tabled HR26-Jul-2022
Tabled Senate27-Jul-2022
Table of contents.

Commonwealth Coat of Arms of Australia

 

Health Insurance (Section 3C Diagnostic Imaging Services – PET and Gallium-67 Services) Determination 2022

I, Travis Haslam, delegate of the Minister for Health and Aged Care, make the following Determination.

Dated               21 July 2022

Travis Haslam

Acting First Assistant Secretary

Medical Benefits Division

Health Resourcing Group

Department of Health and Aged Care

 

 

 


Contents

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

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

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

4  Definitions................................................................................................................................ 1

5  Treatment of relevant services.................................................................................................. 2

6 Application of provisions of the diagnostic imaging services table........................................... 2

7  Restriction on items  - services connected with the provision of PET nuclear

    scanning during Gallium-67 interruptions................................................................................ 3

Schedule 1 — Relevant services................................................................................................... 4

 

 


1  Name

                        This instrument is the Health Insurance (Section 3C Diagnostic Imaging Services – PET and Gallium-67 Services) 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

1 August 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  Definitions

 (1)        In this instrument:

Act means the Health Insurance Act 1973.

PET means positron emission tomography.

(R) has the meaning given by clause 1.2.15 of the diagnostic imaging services table.

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.

report means a report prepared by a medical practitioner.

Schedule means a Schedule to this instrument.


 

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

·         clinically relevant service;

·         diagnostic imaging services table;

·         item; and

·         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.

5  Treatment of relevant services

 (1)        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 diagnostic imaging   service; and

(b)                   there were an item in the diagnostic imaging 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 provisions of the diagnostic imaging services table

(1)     Clause 1.2.17 of the diagnostic imaging services table shall have effect as if the items in Schedule 1 of this instrument were specified for the purpose of that clause.

(2)     Clause 2.4.2 of the diagnostic imaging services table shall have effect as if the items in Schedule 1 of this instrument were specified in subclause 2.4.2(1).

 

 


 

7  Restriction on items – services connected with provision of PET nuclear scanning during Gallium-67 interruptions

 

(1)       An item in Schedule 1 of this instrument only applies to a service described in the item, if:

(a)    the patient’s clinical condition requires the service to be performed before the resumption of normal gallium-67 (Ga-67) supply is anticipated by the practitioner who provides the service; and

(b)   the report of the service performed includes a justification for the substitute service, which describes the unavailability of a service to which item 61429, 61430, 61442, 61450 or 61453 applies.

 


(1)    

Schedule 1 — Relevant services

  

Group I4 – Nuclear Medicine Imaging

Column 1

Item

Column 2

Description

Column 3

Fee ($)

Subgroup 2– PET

61527

Whole body study using PET, if the service is performed because the services to which items 61429, 61430, 61442, 61450 or 61453 apply cannot be performed due to unavailability of gallium-67  (R)

752.35