Health Insurance Legislation Amendment (Services for Patients in Residential Aged Care Facilities) Regulations 2019
I, General the Honourable Sir Peter Cosgrove AK MC (Ret’d), Governor‑General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulations.
Dated 21 February 2019
Peter Cosgrove
Governor‑General
By His Excellency’s Command
Greg Hunt
Minister for Health
Contents
1 Name
2 Commencement
3 Authority
4 Schedules
Schedule 1—Amendments
Health Insurance (General Medical Services Table) Regulations 2018
Health Insurance Regulations 2018
This instrument is the Health Insurance Legislation Amendment (Services for Patients in Residential Aged Care Facilities) Regulations 2019.
(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 March 2019. | 1 March 2019 |
Note: This table relates only to the provisions of this instrument as originally made.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.
This instrument is made under the Health Insurance Act 1973.
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
Health Insurance (General Medical Services Table) Regulations 2018
1 Subclause 1.2.4(1) of Schedule 1
Omit “and 17609 to 17690”, substitute “, 17609 to 17690 and 90020 to 90096”.
2 Paragraph 1.2.4(3)(a) of Schedule 1
Omit “3 to 96 and 5000 to 5267”, substitute “3 to 65, 5000 to 5267 and 90020 to 90096”.
3 Subclause 1.2.5(1) of Schedule 1
Omit “and 16515 to 51318”, substitute “, 16515 to 51318 and 90020 to 90096”.
4 At the end of subclause 1.2.6(1) of Schedule 1
Add “and items 90020 to 90096”.
5 Clause 1.2.7 of Schedule 1
After “3 to 10816”, insert “and 90020 to 90096”.
6 Division 2.1 of Schedule 1 (heading)
Repeal the heading (including the note), substitute:
7 Clause 2.1.1 of Schedule 1 (table items 2, 4, 6, 8 and 13 to 16)
Repeal the items.
8 Schedule 1 (items 20, 35, 43, 51, 92, 93, 95 and 96)
Repeal the items.
9 After Division 2.30 of Schedule 1
Insert:
Division 2.30A—Group A35: Non‑referred attendance at a residential aged care facility
(1) For the first patient attended during one attendance by a general practitioner at one residential aged care facility on one occasion, the fee for the medical service described in whichever of items 90020, 90035, 90043 or 90051 applies is the amount listed in the item plus $55.
(2) For the first patient attended during one attendance by a medical practitioner at one residential aged care facility on one occasion, the fee for the medical service described in whichever of items 90092, 90093, 90095 or 90096 applies is the amount listed in the item plus $40.
Group A35—Non‑referred attendance at a residential aged care facility | ||
Column 1 Item | Column 2 Description | Column 3 Fee ($) |
90020 | Professional attendance (other than a service to which another item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex if the patient is accommodated in a residential aged care facility (other than accommodation in a self‑contained unit) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management—an attendance on one or more patients at one residential aged care facility on one occasion—each patient (subject to clause 2.30A.1) | 17.20 |
90035 | Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than a service to which another item applies), lasting less than 20 minutes and including any of the following that are clinically relevant: (a) taking a patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health‑related issues, with appropriate documentation—an attendance on one or more patients at one residential aged care facility on one occasion—each patient (subject to clause 2.30A.1) | 37.60 |
90043 | Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than a service to which another item applies), lasting at least 20 minutes and including any of the following that are clinically relevant: (a) taking a detailed patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health‑related issues, with appropriate documentation—an attendance on one or more patients at one residential aged care facility on one occasion—each patient (subject to clause 2.30A.1) | 72.80 |
90051 | Professional attendance by a general practitioner at a residential aged care facility to residents of the facility (other than a service to which another item applies), lasting at least 40 minutes and including any of the following that are clinically relevant: (a) taking an extensive patient history; (b) performing a clinical examination; (c) arranging any necessary investigation; (d) implementing a management plan; (e) providing appropriate preventive health care; for one or more health‑related issues, with appropriate documentation—an attendance on one or more patients at one residential aged care facility on one occasion—each patient (subject to clause 2.30A.1) | 107.15 |
90092 | Professional attendance (other than a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (that is not accommodation in a self‑contained unit) of not more than 5 minutes in duration—an attendance on one or more patients at one residential aged care facility on one occasion—each patient (subject to clause 2.30A.1), by: (a) a medical practitioner (who is not a general practitioner); or (b) a general practitioner to whom clause 2.3.1 applies | 8.50 |
90093 | Professional attendance (other than a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (that is not accommodation in a self‑contained unit) of more than 5 minutes in duration but not more than 25 minutes—an attendance on one or more patients at one residential aged care facility on one occasion—each patient (subject to clause 2.30A.1), by: (a) a medical practitioner (who is not a general practitioner); or (b) a general practitioner to whom clause 2.3.1 applies | 16.00 |
90095 | Professional attendance (other than a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (that is not accommodation in a self‑contained unit) of more than 25 minutes in duration but not more than 45 minutes—an attendance on one or more patients at one residential aged care facility on one occasion—each patient (subject to clause 2.30A.1), by: (a) a medical practitioner (who is not a general practitioner); or (b) a general practitioner to whom clause 2.3.1 applies | 35.50 |
90096 | Professional attendance (other than a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self‑contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (that is not accommodation in a self‑contained unit) of more than 45 minutes in duration—an attendance on one or more patients at one residential aged care facility on one occasion—each patient (subject to clause 2.30A.1), by: (a) a medical practitioner (who is not a general practitioner); or (b) a general practitioner to whom clause 2.3.1 applies | 57.50 |
Health Insurance Regulations 2018
10 Subsection 28(1) (note)
After “Group A7”, insert “and some items in Group A35”.
11 Subsection 28(1) (table item 1)
Repeal the item, substitute:
1 | A1 | 3, 4, 23, 24, 36, 37, 44, 47 |
12 Subsection 28(1) (table item 2)
Omit “, 92, 93, 95, 96”.
13 Subsection 28(1) (table item 6)
Repeal the item, substitute:
6 | Subgroup 2 of Group A7 | 179, 181, 185, 187, 189, 191, 203, 206 |
14 Subsection 28(1) (after table item 28)
Insert:
28A | A35 | 90020, 90035, 90043, 90051, 90092, 90093, 90095, 90096, 90183, 90188, 90202, 90212 |