Health Insurance (General Medical Services Table) Amendment Regulations 2009 (No. 3)1

Select Legislative Instrument 2009 No. 371

I, QUENTIN BRYCE, Governor-General 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 14 December 2009

QUENTIN BRYCE

Governor-General

By Her Excellency’s Command

NICOLA ROXON

Minister for Health and Ageing

1 Name of Regulations

  These Regulations are the Health Insurance (General Medical Services Table) Amendment Regulations 2009 (No. 3).

2 Commencement

  These Regulations commence on 1 January 2010.

3 Amendment of Health Insurance (General Medical Services Table) Regulations 2009

  Schedule 1 amends the Health Insurance (General Medical Services Table) Regulations 2009.

Schedule 1 Amendments

(regulation 3)

 

[1] Schedule 1, subrule 8 (1)

omit

6013 and 6015,

insert

6013, 6015, 16401 and 16404,

[2] Schedule 1, rule 10, heading

substitute

10 Interpretation of items 104 to 147, 289 to 388, 2801 to 2840, 3005 to 3028, 6007 to 6015, 16401, 16404, 17640, 17645, 17650 and 17655

[3] Schedule 1, subrule 10 (1)

after

6015,

insert

16401, 16404,

[4] Schedule 1, paragraph 48 (4) (c)

omit

an enhanced primary care

insert

a

[5] Schedule 1, subrule 55 (1)

substitute

 (1) For items 2702 and 2710, preparation of a GP mental health treatment plan means the preparation of a comprehensive written plan, in consultation with a patient (and, if subrule (6) applies, with the patient’s carer), that includes all of the following:

 (a) assessment of the patient’s mental disorder, including administration of an outcome measurement tool (except if considered clinically inappropriate);

 (b) formulation, including either provisional diagnosis or diagnosis, of the mental disorder;

 (c) treatment goals with which the patient agrees;

 (d) any actions to be taken by the patient;

 (e) a plan for crisis intervention or relapse prevention, or both;

 (f) referral and treatment options for the patient;

 (g) arrangements for providing the referral and treatment options mentioned in paragraph (f);

 (h) arrangements to review the plan.

[6] Schedule 1, subrule 55 (2)

omit

subparagraph (1) (a) (vi)

insert

paragraph (1) (f)

[7] Schedule 1, subparagraphs 55 (2) (c) (ii) and (iii)

omit

strategy

insert

strategies

[8] Schedule 1, subrule 55 (2), note

omit

2007.

insert

2009.

[9] Schedule 1, after subrule 55 (2)

insert

 (3) Preparation of the plan also includes all of the following:

 (a) explaining to the patient (and, if subrule (6) applies, the patient’s carer) the steps involved in preparing the plan;

 (b) recording the plan;

 (c) recording the patient’s agreement to the preparation of the plan;

 (d) offering the patient (and, if subrule (6) applies, the patient’s carer):

 (i) a copy of the plan; and

 (ii) suitable education about the mental disorder;

 (e) adding a copy of the plan to the patient’s medical records.

[10] Schedule 1, subrules 56 (1) and (2)

after

Items

insert

2702,

[11] Schedule 1, subrule 56 (4)

omit

item 2710 is

insert

items 2702 and 2710 are

[12] Schedule 1, paragraphs 56 (4) (b), (c) and (d)

substitute

 (b) more than once in a 12 month period of the provision of either item for a particular patient; or

 (c) within 3 months following the provision of a service to which item 2712 applies.

[13] Schedule 1, paragraphs 56 (5) (a) and (7) (b)

omit

(item 2710)

insert

(item 2702 or 2710)

[14] Schedule 1, paragraph 56 (8) (b)

omit

item

insert

item 2702,

[15] Schedule 1, after subrule 56 (8)

insert

 (9) Item 2710 applies only if the medical practitioner providing the service has successfully completed mental health skills training accredited by the General Practice Mental Health Standards Collaboration.

Note   The General Practice Mental Health Standards Collaboration operates under the auspices of the Royal Australian College of General Practitioners.

[16] Schedule 1, subrule 62 (2)

omit

13200, 13203,

insert

13200 to 13203,

[17] Schedule 1, rule 76, heading

substitute

76 Limitation of items 10943, 16590, 16591, 18360, 18364 and 50303

[18] Schedule 1, subrule 76 (2)

after

16590

insert

or 16591

[19] Schedule 1, rule 79

omit

13200 to 13221,

insert

13200, 13201 and 13203 to 13221,

[20] Schedule 1, rule 82, heading

substitute

82 Meaning of embryology laboratory services in items 13200, 13201 and 13206

[21] Schedule 1, rule 82

omit

13200

insert

13200, 13201

[22] Schedule 1, after item 2677, in Group A20, subgroup 1

insert

2702

Attendance by a medical practitioner (including a general practitioner who has not undertaken mental health skills training, but not including a specialist or consultant physician) for the preparation of a GP Mental Health Treatment Plan for a patient

125.95

[23] Schedule 1, item 2710

omit

practitioner,

insert

practitioner who has undertaken mental health skills training,

[24] Schedule 1, items 13200 to 13251

substitute

13200

Assisted reproductive technologies superovulated treatment cycle proceeding to oocyte retrieval, involving the use of drugs to induce superovulation and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services but excluding artificial insemination, transfer of frozen embryos or donated embryos or ova or a service to which item 13201, 13202, 13203, 13206 or 13218 applies, being services rendered during 1 treatment cycle  initial cycle in a single calendar year

2 940.00

13201

Assisted reproductive technologies superovulated treatment cycle proceeding to oocyte retrieval, involving the use of drugs to induce superovulation and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services but excluding artificial insemination, transfer of frozen embryos or donated embryos or ova or a service to which item 13200, 13202, 13203, 13206 or 13218 applies, being services rendered during 1 treatment cycle — each cycle after the first in a single calendar year

2 750.00

13202

Assisted reproductive technologies superovulated treatment cycle that is cancelled before oocyte retrieval, involving the use of drugs to induce superovulation and including quantitative estimation of hormones and ultrasound examinations, but excluding artificial insemination, transfer of frozen embryos or donated embryos or ova or a service to which item 13200, 13201, 13203, 13206 or 13218 applies, being services rendered during 1 treatment cycle

440.00

13203

Ovulation monitoring services for artificial insemination, including quantitative estimation of hormones and ultrasound examinations, being services rendered during 1 treatment cycle but excluding a service to which item 13200, 13201, 13202, 13206, 13212, 13215 or 13218 applies

460.00

13206

Assisted reproductive technologies treatment cycle using the natural cycle or oral medication only to induce oocyte growth and development, including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services but excluding artificial insemination, frozen embryo transfer, donated embryos or ova or treatment involving the use of injectable drugs to induce superovulation, being services rendered during 1 treatment cycle  only if rendered in conjunction with a service to which item 13212 applies

440.00

13209

Planning and management of a referred patient by a specialist for the purpose of treatment by assisted reproductive technologies or for artificial insemination payable once only during 1 treatment cycle

80.00

13212

Oocyte retrieval for the purpose of assisted reproductive technologies  only if rendered in conjunction with a service to which item 13200, 13201 or 13206 applies (Anaes.)

335.00

13215

Transfer of embryos or both ova and sperm to the female reproductive system, excluding artificial insemination  only if rendered in conjunction with a service to which item 13200, 13201, 13206 or 13218 applies, being services rendered in 1 treatment cycle (Anaes.)

105.00

13218

Preparation of frozen or donated embryos or donated oocytes for transfer to the female reproductive system, by any means and including quantitative estimation of hormones and all treatment counselling but excluding artificial insemination services rendered in 1 treatment cycle and excluding a service to which item 13200, 13201, 13202, 13203, 13206 or 13212 applies (Anaes.)

750.00

13221

Preparation of semen for the purpose of artificial insemination  only if rendered in conjunction with a service to which item 13203 applies

48.00

13251

Intracytoplasmic sperm injection for the purpose of assisted reproductive technologies, for male factor infertility, excluding a service to which item 13203 or 13218 applies

395.00

[25] Schedule 1, item 16400

omit

23.45

insert

25.80

[26] Schedule 1, after item 16400

insert

16401

Professional attendance at consulting rooms or a hospital by a specialist in the practice of his or her specialty of obstetrics after referral of the patient to him or her each attendance, other than a second or subsequent attendance in a single course of treatment

80.85

16404

Professional attendance at consulting rooms or a hospital by a specialist in the practice of his or her specialty of obstetrics after referral of the patient to him or her — each attendance after the first attendance in a single course of treatment

40.60

[27] Schedule 1, items 16500, 16502, 16504, 16505, 16508 and 16509

omit

40.45

insert

44.55

[28] Schedule 1, items 16515 and 16518

omit

327.60

insert

425.95

[29] Schedule 1, item 16519

omit

504.50

insert

655.85

[30] Schedule 1, item 16520

omit

589.60

insert

766.55

[31] Schedule 1, item 16522

omit

1 184.55

insert

1 539.90

[32] Schedule 1, item 16525

omit

279.45

insert

363.25

[33] Schedule 1, item 16590

omit

122.50

insert

306.30

[34] Schedule 1, after item 16590

insert

16591

Planning and management of a pregnancy that has progressed beyond 20 weeks, excluding management of the labour and delivery if the care of the patient will be transferred to another medical practitioner for the labour and delivery

(Item is subject to rule 76)

134.80

[35] Schedule 1, item 22051

omit

transoesophogeal echocardiograpy

insert

transoesophageal echocardiography

Note

1. All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See http://www.frli.gov.au.