Health Insurance Amendment Regulations 2003 (No. 1)1

Statutory Rules 2003 No. 872

I, GUY STEPHEN MONTAGUE GREEN, Administrator of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.

Dated 15 May 2003

G. S. M. GREEN

Administrator

By His Excellency’s Command

1 Name of Regulations

  These Regulations are the Health Insurance Amendment Regulations 2003 (No. 1).

2 Commencement

  These Regulations commence on gazettal.

3 Amendment of Health Insurance Regulations 1975

  Schedule 1 amends the Health Insurance Regulations 1975.

4 Transitional

  The amendments made by items 6 and 7 of Schedule 1 apply only to:

 (a) in relation to diagnostic imaging services — services described in item 12 of Schedule 1 to the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003; and

 (b) in relation to radiation oncology services — services described in item 13 of Schedule 2 to the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003.

Note 1   Item 12 of Schedule 1 to the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003 provides that certain amendments made by that Schedule (broadly amendments that enforce the registration provisions contained elsewhere in that Schedule) apply to diagnostic imaging services rendered using diagnostic imaging procedures carried out after the earlier of:

(a) a day fixed by proclamation; and

(b) the first day after the end of the period of 6 months beginning on the day on which the Act receives the Royal Assent.

Note 2   Item 13 of Schedule 2 to the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003 provides that certain amendments made by that Schedule (broadly amendments that enforce the registration provisions contained elsewhere in that Schedule) apply to radiation oncology services rendered after the earlier of:

(a) a day fixed by proclamation; and

(b) the first day after the end of the period of 6 months beginning on the day on which the Act receives the Royal Assent.

Schedule 1 Amendments

(regulation 3)

[1] Regulation 2, definition of requester number

omit

a chiropractor, a physiotherapist or a podiatrist.

insert

a chiropractor, osteopath, physiotherapist or podiatrist.

[2] Regulation 11, heading

substitute

11 Diagnostic imaging services that chiropractors, osteopaths, physiotherapists and podiatrists may request

[3] Subregulation 11 (1)

omit

16B (3) or (3A)

insert

16B (3), (3A) or (3C)

[4] After regulation 12A

insert

12B Definition of radiation oncology service

  For subsection 16F (2) of the Act, a radiation oncology service is a service to which an item in subgroup 3, 4 or 5 of Group T2 in the general medical services table relates.

[5] Subregulation 13 (15)

omit

a chiropractor, a physiotherapist or a podiatrist,

insert

a chiropractor, osteopath, physiotherapist or podiatrist,

[6] After subregulation 13 (17)

insert

 (17A) For subsection 19 (6) of the Act, if professional services to which an item in the diagnostic imaging services table relates are rendered in the circumstances mentioned in subsection 16B (10A) of the Act, the letters ‘SS’ (indicating that the services were substituted for a requested service) are a prescribed particular in relation to those services.

[7] After subregulation 13 (21)

insert

 (22) For subsection 19 (6) of the Act, in relation to professional services consisting of:

 (a) diagnostic imaging services rendered using a diagnostic imaging procedure carried out using diagnostic imaging equipment ordinarily located at registered diagnostic imaging premises or, when not in use, at a registered base for diagnostic imaging equipment; or

 (b) radiation oncology services rendered using radiation oncology equipment ordinarily located at registered radiation oncology premises or, when not in use, at a registered base for radiation oncology equipment;

the location specific practice number for the premises or base is a prescribed particular.

[8] Subparagraph 20 (2) (c) (i)

after

a chiropractor,

insert

an osteopath,

[9] Subparagraph 20 (2) (c) (iii)

omit

confirmation.

insert

confirmation; and

[10] After paragraph 20 (2) (c)

insert

 (d) if the service is rendered in the circumstances mentioned in subsection 16B (10A) of the Act:

 (i) words indicating that the providing practitioner has consulted with the requesting practitioner and the date of that consultation; or

 (ii) if the providing practitioner has not consulted with the requesting practitioner, sufficient information to demonstrate that he or she has taken all reasonable steps to do so.

[11] After regulation 20

insert

20A Diagnostic imaging — information to be included in application for registration

  For paragraph 23DZP (1) (d) of the Act, the other information to be included in an application for registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment is:

 (a) the nature of the practice; and

 (b) details of the diagnostic imaging equipment ordinarily located at the premises or base, including:

 (i) the quantity of equipment of each type mentioned in regulation 20C; and

 (ii) for equipment of a type mentioned in paragraph 20C (c), (d), (e), (i) or (j) — the age of the equipment; and

 (iii) the functionality of the equipment; and

 (iv) if the equipment has a serial number or other identifying number — that number.

Example for paragraph (a)

The practice might be a base for mobile equipment, a specialist diagnostic imaging practice (either on a stand-alone practice site or co-located with a primary care practice or group), a primary care practice, a sports medicine clinic or a public hospital.

20B Diagnostic imaging — information to be included on register

  For subparagraph 23DZQ (1) (b) (iv) of the Act, the other information to be included on the register is the information included in the application for registration.

20C Primary information — types of diagnostic imaging equipment

  For subsection 23DZR (2) of the Act, the following types of diagnostic imaging equipment are prescribed:

 (a) ultrasound equipment – non-musculoskeletal — that is, equipment that:

 (i) is used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in Group I1 in the diagnostic imaging services table, except subgroup 6; and

 (ii) does not include a transducer capable of operation at a frequency of 7.5 megahertz or higher;

 (b) ultrasound equipment – musculoskeletal — that is, equipment that:

 (i) is used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 6 of Group I1 in the diagnostic imaging services table; and

 (ii) includes a transducer capable of operation at a frequency of 7.5 megahertz or higher;

 (c) computed tomography equipment – K-type — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in an item in Group I2 in the diagnostic imaging services table in which the designation ‘(K)’ appears;

 (d) computed tomography equipment – NK-type — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in Group I2 in the diagnostic imaging services table in which the designation ‘(NK)’ appears;

 (e) magnetic resonance imaging equipment — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in Group I5 in the diagnostic imaging services table;

 (f) nuclear medicine imaging equipment for positron emission tomography — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service of the kind described in Health Insurance Determination HS/6/01 or Health Insurance Determination HS/3/1997, as in force on 15 May 2003;

 (g) nuclear medicine imaging equipment for other services — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in Group I4 in the diagnostic imaging services table;

 (h) diagnostic radiology equipment for mammography — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 10 of Group I3 in the diagnostic imaging services table;

 (i) diagnostic radiology equipment for angiography – K‑type — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 13 of Group I3 in the diagnostic imaging services table in which the designation ‘(K)’ appears;

 (j) diagnostic radiology equipment for angiography – NK‑type — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 13 of Group I3 in the diagnostic imaging services table in which the designation ‘(NK)’ appears;

 (k) diagnostic radiology equipment for fluoroscopy — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 15 or 17 of Group I3 in the diagnostic imaging services table;

 (l) diagnostic radiology equipment for orthopantomography — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in an item in subgroup 3 of Group I3 in the diagnostic imaging services table in which the word ‘orthopantomography’ appears;

 (m) diagnostic radiology equipment – x-ray — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in an item in Group I3 in the diagnostic imaging services table not mentioned in any of the preceding paragraphs of this regulation (except in subgroup 16 of that Group).

20D Radiation oncology — information to be included in application for registration

  For paragraph 23DZZO (1) (d) of the Act, the other information to be included in an application for registration of radiation oncology premises or a base for radiation oncology equipment is:

 (a) the nature of the practice; and

 (b) details of the radiation oncology equipment ordinarily located at the premises or base, including:

 (i) the quantity of equipment of each type mentioned in regulation 20F; and

 (ii) the functionality of the equipment; and

 (iii) if the equipment has a serial number or other identifying number — that number.

Examples for paragraph (a)

The practice might be a base for mobile equipment, a specialist radiation oncology practice (either on a stand-alone practice site or co-located with a primary care practice or group), a primary care practice, a sports medicine clinic or a public hospital.

20E Radiation oncology — information to be included on register

  For subparagraph 23DZZP (1) (b) (iv) of the Act, the other information to be included on the register is the information included in the application for registration.

20F Primary information — types of radiation oncology equipment

  For subsection 23DZZQ (2) of the Act, the following types of radiation oncology equipment are prescribed:

 (a) megavoltage equipment — that is, equipment used in the rendering of a radiation oncology service described in subgroup 3 of Group T2 in the general medical services table;

 (b) planning equipment — that is, equipment used in the rendering of a radiation oncology service described in subgroup 5 of Group T2 in the general medical services table;

 (c) brachytherapy equipment — that is, equipment used in the rendering of a radiation oncology service described in subgroup 4 of Group T2 in the general medical services table.

1. These Regulations amend Statutory Rules 1975 No. 80, as amended by 1975 Nos. 118, 125 and 135 (disallowed by the Senate on 4 September 1975); 1976 Nos. 202, 214 and 215; 1977 Nos. 26 and 44; 1978 Nos. 95 and 177; 1979 No. 230; 1981 Nos. 198 and 317; 1982 Nos. 157, 251 and 287; 1983 Nos. 106, 231, 253 and 255; 1984 Nos. 5 and 162; 1985 Nos. 36, 50, 95, 205 and 290 (disallowed by the Senate at the expiration of 10 April 1986); 1986 Nos. 19, 20, 87 and 326; 1987 Nos. 32, 163 and 166; 1988 No. 314; 1989 Nos. 6, 54, 117 and 293; 1990 No. 25; 1991 Nos. 82, 314, 365 and 441; 1992 Nos. 42, 111, 239, 335 and 431; 1993 Nos. 106, 130 and 154; 1994 Nos. 20, 27, 111, 137, 138, 328 and 413; 1995 Nos. 9, 25, 287, 300 and 409; 1996 Nos. 231, 234, 235, 335 and 336; 1997 Nos. 61, 287, 300, 319 and 395; 1998 Nos. 44, 125, 138, 204, 220, 253, 268, 370, 371 and 372; 1999 Nos. 48, 88, 157, 176, 254, 343 and 344; 2000 Nos. 146 and 290; 2001 Nos. 272, 273, 274, 275, 290 and 342; 2002 Nos. 246 and 261.

2. Notified in the Commonwealth of Australia Gazette on 16 May 2003.