Health Insurance (General Medical Services Table) Amendment (2016 Measures No. 1) Regulation 2016

I, General the Honourable Sir Peter Cosgrove AK MC (Retd), GovernorGeneral of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulation.

Dated 24 March 2016

Peter Cosgrove

GovernorGeneral

By His Excellencys Command

Sussan Ley

Minister for Health

 

 

 

Contents

1 Name

2 Commencement

3 Authority

4 Schedules

Schedule 1—Optometry service amendments

Health Insurance (General Medical Services Table) Regulation 2015

Schedule 2—Other service amendments

Part 1—General amendments

Health Insurance (General Medical Services Table) Regulation 2015

Part 2—Restricting services to inhospital services

Health Insurance (General Medical Services Table) Regulation 2015

1  Name

  This is the Health Insurance (General Medical Services Table) Amendment (2016 Measures No. 1) Regulation 2016.

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.  Sections 1 to 4 and anything in this instrument not elsewhere covered by this table

1 April 2016.

1 April 2016

2.  Schedule 1

1 April 2016.

1 April 2016

3.  Schedule 2

1 May 2016.

1 May 2016

Note: This table relates only to the provisions of this instrument as originally made.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 the Health Insurance Act 1973.

4  Schedules

  Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1Optometry service amendments

 

Health Insurance (General Medical Services Table) Regulation 2015

1  Subclause 1.2.3(1) of Schedule 1

Omit “10905 to 10929,”.

2  Clause 1.2.7 of Schedule 1

Omit “Items 3 to 10948”, substitute “Items 3 to 10816”.

3  Division 2.1 (heading)

Repeal the heading, substitute:

Division 2.1Groups A1 to A9

4  Division 2.1 (note to heading)

Repeal the note, substitute:

Note: Groups A1 to A9 include Groups A1, A2, A3, A4, A28, A5, A6, A7, A8, A12, A13, A21, A11, A14, A15, A17, A18, A19, A20, A24, A27, A22, A23, A26 and A9.

5  Clause 2.5A.1 of Schedule 1 (paragraph (c) of the definition of eligible allied health provider)

Repeal the paragraph, substitute:

 (c) an optometrist;

6  Clause 2.10.5 of Schedule 1 (paragraph (c) of the definition of eligible allied health provider)

Repeal the paragraph, substitute:

 (c) an optometrist;

7  Division 2.28 of Schedule 1

Repeal the Division.

8  Part 3 of Schedule 1 (definition of bulkbilled)

Repeal the definition, substitute:

bulkbilled, for Division 2.31, has the meaning given by clause 2.31.1.

Schedule 2Other service amendments

Part 1General amendments

Health Insurance (General Medical Services Table) Regulation 2015

1  Schedule 1 (items 30620 and 30621)

Repeal the items, substitute:

30620

Repair of symptomatic umbilical, epigastric or linea alba hernia requiring mesh or other formal repair of, in a person 10 years of age or over, other than a service to which item 30403 or 30405 applies (G) (H) (Anaes.) (Assist.)

299.45

30621

Repair of symptomatic umbilical, epigastric or linea alba hernia requiring mesh or other formal repair of, in a person 10 years of age or over, other than a service to which item 30403 or 30405 applies (S) (H) (Anaes.) (Assist.)

407.50

2  Schedule 1 (after item 30639)

Insert:

30640

Repair of large and irreducible scrotal hernia, where duration of surgery exceeds 2 hours, in a person 10 years of age or over, other than a service to which item 30403, 30405, 30614, 30615, 30620 or 30621 applies (H) (Anaes.) (Assist.)

914.95

3  Schedule 1 (after item 32087)

Insert:

32088

Fibreoptic colonoscopy—examination of the colon beyond the hepatic flexure, with or without biopsy, following a positive faecal occult blood test for a participant registered on the National Bowel Cancer Screening Program (Anaes.)

334.35

32089

Endoscopic examination of the colon beyond the hepatic flexure by fibreoptic colonoscopy for the removal of one or more polyps by argon plasma coagulation, following a positive faecal occult blood test for a participant registered on the National Bowel Cancer Screening Program (Anaes.)

469.20

4  Schedule 1 (item 34539)

Omit “in the operating theatre of a hospital”.

5  Schedule 1 (item 35306)

After “Transluminal stent insertion”, insert “, one or more stents,”.

6  Schedule 1 (item 35309)

After “Transluminal stent insertion”, insert “, one or more stents,”.

7  Schedule 1 (item 35646)

Omit “, if performed in the operating theatre of a hospital”.

8  Schedule 1 (after item 37038)

Insert:

37040

Bladder stress incontinence, sling procedure for, using a nonadjustable synthetic male sling system, with or without mesh, other than a service associated with a service to which item 30405, 35599 or 37042 applies (H) (Anaes.) (Assist.)

911.30

9  Schedule 1 (after item 37336)

Insert:

37338

Urethral synthetic male sling system, division or removal of, for urethral obstruction or erosion, following previous surgery for urinary incontinence, other than a service associated with a service to which item 37340 or 37341 applies (H) (Anaes.) (Assist.)

911.30

10  Schedule 1 (items 47300 to 47345)

Repeal the items, substitute:

47301

Phalanx, middle or proximal, treatment of fracture of, by closed reduction, requiring anaesthesia, not provided on the same occasion as a service described in item 47304, 47307, 47310, 47313, 47316 or 47319 (Anaes.)

86.80

47304

Metacarpal, treatment of fracture of, by closed reduction, requiring anaesthesia, not provided on the same occasion as a service described in item 47301, 47307, 47310, 47313, 47316 or 47319 (H) (Anaes.)

98.90

47307

Phalanx or metacarpal, treatment of fracture of, by closed reduction with percutaneous Kwire fixation (H) (Anaes.) (Assist.)

200.00

47310

Phalanx or metacarpal, treatment of fracture of, by open reduction with fixation (H) (Anaes.) (Assist.)

330.00

47313

Phalanx or metacarpal, treatment of intraarticular fracture of, by closed reduction with percutaneous Kwire fixation (H) (Anaes.) (Assist.)

320.00

47316

Phalanx or metacarpal, treatment of intraarticular fracture of, by open reduction with fixation, not provided on the same occasion as a service to which item 47319 applies (H) (Anaes.) (Assist.)

635.00

47319

Middle phalanx, proximal end, treatment of intraarticular fracture of, by open reduction with fixation, not provided on the same occasion as a service to which item 47316 applies (H) (Anaes.) (Assist.)

650.00

11  Schedule 1 (items 47360 to 47375)

Repeal the items, substitute:

47361

Radius or ulna, or radius and ulna, distal end of, treatment of fracture of, by cast immobilisation, other than a service associated with a service to which item 47362, 47364, 47367, 47370 or 47373 applies

131.85

47362

Radius or ulna, or radius and ulna, distal end of, treatment of fracture of, by closed reduction, requiring general or major regional anaesthesia, but excluding local infiltration, other than a service associated with a service to which item 47361, 47364, 47367, 47370 or 47373 applies (Anaes.)

197.60

47364

Radius or ulna, distal end of, not involving joint surface, treatment of fracture of, by open reduction with fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.)

280.00

47367

Radius, distal end of, treatment of fracture of, by closed reduction with percutaneous fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.)

223.60

47370

Radius, distal end of, treatment of intraarticular fracture of, by open reduction with fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.)

406.00

47373

Ulna, distal end of, treatment of intraarticular fracture of, by open reduction with fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.)

290.00

Part 2Restricting services to inhospital services

Health Insurance (General Medical Services Table) Regulation 2015

12  Schedule 1 (item 31551)

After “aftercare”, insert “(H)”.

13  Schedule 1 (item 32145)

After “hospital”, insert “(H)”.

14  Schedule 1 (item 32212)

After “aftercare”, insert “(H)”.

15  Schedule 1 (item 35103)

After “only”, insert “(H)”.

16  Schedule 1 (item 35630)

After “applies”, insert “(H)”.

17  Schedule 1 (item 39135)

After “hospital”, insert “(H)”.

18  Schedule 1 (item 45020)

After “period”, insert “(H)”.

19  Schedule 1 (item 45823)

After “hospital”, insert “(H)”.

20  Schedule 1 (item 45851)

After “applies”, insert “(H)”.

21  Schedule 1 (item 46486)

After “hospital”, insert “(H)”.

22  Schedule 1 (item 46489)

After “hospital”, insert “(H)”.

23  Schedule 1 (item 46516)

After “hospital”, insert “(H)”.

24  Schedule 1 (item 47381)

After “hospital”, insert “(H)”.

25  Schedule 1 (item 47385)

After “hospital”, insert “(H)”.

26  Schedule 1 (item 47426)

After “hospital”, insert “(H)”.

27  Schedule 1 (item 47456)

After “hospital”, insert “(H)”.

28  Schedule 1 (item 47696)

After “hospital”, insert “(H)”.

29  Schedule 1 (item 47906)

After “hospital”, insert “(H)”.

30  Schedule 1 (item 48603)

After “applies”, insert “(H)”.

31  Schedule 1 (item 50115)

After “applies”, insert “(H)”.

32  Schedule 1 (item 50330)

After “applies”, insert “(H)”.

33  Schedule 1 (item 50348)

After “hospital”, insert “(H)”.

34  Schedule 1 (item 50390)

After “hospital”, insert “(H)”.

35  Schedule 1 (item 50516)

After “hospital”, insert “(H)”.

36  Schedule 1 (item 50524)

After “hospital”, insert “(H)”.

37  Schedule 1 (item 50552)

After “hospital”, insert “(H)”.

38  Schedule 1 (item 50568)

After “hospital”, insert “(H)”.

39  Schedule 1 (item 50600)

After “hospital”, insert “(H)”.

40  Schedule 1 (item 52097)

After “hospital”, insert “(H)”.

41  Schedule 1 (item 52106)

After “hospital”, insert “(H)”.

42  Schedule 1 (item 52135)

After “hospital”, insert “(H)”.

43  Schedule 1 (item 53206)

After “applies”, insert “(H)”.