Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis) Determination 2020
made under subsection 3C(1) of the
Health Insurance Act 1973
Compilation No. 2
Compilation date: 1 July 2022
Includes amendments up to: F2022L00553
Registered: 21 July 2022
About this compilation
This compilation
This is a compilation of the Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis) Determination 2020 that shows the text of the law as amended and in force on 1 July 2022 (the compilation date).
The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.
Uncommenced amendments
The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.
Application, saving and transitional provisions for provisions and amendments
If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.
Editorial changes
For more information about any editorial changes made in this compilation, see the endnotes.
Modifications
If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.
Self‑repealing provisions
If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
Contents
1. Name
3. Authority
4. Definitions
5. Treatment of relevant services
6. Application of provisions of the general medical services table
7. Indexation
Schedule 1 – relevant services
Endnotes
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
1. Name
This instrument is the Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis) Determination 2020.
3. Authority
This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.
4. Definitions
Act means the Health Insurance Act 1973.
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.
Pharmaceutical Benefits Scheme means the scheme for the supply of pharmaceutical benefits established under Part VII of the National Health Act 1953.
relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.
Schedule means a Schedule to this instrument.
Note: The following terms are defined in subsection 3(1) of the Act:
clinically relevant service;
general medical services table;
Treatment cycle for a patient, means a single day of treatment, or consecutive days of treatment that is required to deliver extracorporeal photopheresis.
(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
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 medical service; and
(b) there were an item in the general medical services table that:
- related to the service; and
- 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 general medical services table
(1) Clause 1.2.6 of the general medical services table shall have effect as if items 14247 and 14249 of this Determination were also specified in the clause.
(2) Clause 1.2.7 of the general medical services table shall have effect as if items 14247 and 14249 of this Determination were also specified in the clause.
(3) Clause 1.2.9 of the general medical services table shall have effect as if items 14247 and 14249 of this Determination were specified in the clause.
(4) Clause 1.2.10 of the general medical services table shall have effect as if items 14247 and 14249 of this Determination were specified in the clause.
(5) Clause 5.1.1 of the general medical services table shall have effect as if items 14247 and 14249 of this Determination were specified in the clause.
7. Indexation
(1) On 1 July 2022 (the indexation day), each amount covered by subsection (2) is replaced by the amount worked out using the following formula:
(2) The amounts covered by this subsection are the fee for each item in a Schedule of this Determination.
(3) An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).
Schedule 1 – relevant services
Group T1—Miscellaneous therapeutic procedures |
Subgroup 13 – Miscellaneous therapeutic procedures |
Column 1 Item | Column 2 Description | Column 3 Fee ($) |
14247 | Extracorporeal photopheresis for the treatment of erythrodermic stage III‑IVa T4 M0 cutaneous T‑cell lymphoma; if (a) the service is provided in the initial six months of treatment; and (b) the service is delivered using an integrated, closed extracorporeal photopheresis system; and (c) the patient is 18 years old or over; and (d) the patient has received prior systemic treatment for this condition and experienced either disease progression or unacceptable toxicity while on this treatment; and (e) the service is provided in combination with the use of Pharmaceutical Benefits Scheme‑subsidised methoxsalen; and (f) the service is supervised by a specialist or consultant physician in the speciality of haematology. Applicable once per treatment cycle | 1,925.55 |
14249 | Extracorporeal photopheresis for the continuing treatment of erythrodermic stage III‑IVa T4 M0 cutaneous T‑cell lymphoma; if (a) in the preceding 6 months: (i) a service to which item 14247 applies has been provided; and (ii) the patient has demonstrated a response to this service; and (iii) the patient requires further treatment; and (b) the service is delivered using an integrated, closed extracorporeal photopheresis system; and (c) the patient is 18 years old or over; and (d) the service is provided in combination with the use of Pharmaceutical Benefits Scheme‑subsidised methoxsalen; and (e) the service is supervised by a specialist or consultant physician in the speciality of haematology. Applicable once per treatment cycle | 1,925.55 |
Endnotes
Endnote 1—About the endnotes
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history
Abbreviation key—Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.
If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to the amendment history.
Endnote 2—Abbreviation key
ad = added or inserted | o = order(s) |
am = amended | Ord = Ordinance |
amdt = amendment | orig = original |
c = clause(s) | par = paragraph(s)/subparagraph(s) |
C[x] = Compilation No. x | /sub‑subparagraph(s) |
Ch = Chapter(s) | pres = present |
def = definition(s) | prev = previous |
Dict = Dictionary | (prev…) = previously |
disallowed = disallowed by Parliament | Pt = Part(s) |
Div = Division(s) | r = regulation(s)/rule(s) |
ed = editorial change | reloc = relocated |
exp = expires/expired or ceases/ceased to have | renum = renumbered |
effect | rep = repealed |
F = Federal Register of Legislation | rs = repealed and substituted |
gaz = gazette | s = section(s)/subsection(s) |
LA = Legislation Act 2003 | Sch = Schedule(s) |
LIA = Legislative Instruments Act 2003 | Sdiv = Subdivision(s) |
(md) = misdescribed amendment can be given | SLI = Select Legislative Instrument |
effect | SR = Statutory Rules |
(md not incorp) = misdescribed amendment | Sub‑Ch = Sub‑Chapter(s) |
cannot be given effect | SubPt = Subpart(s) |
mod = modified/modification | underlining = whole or part not |
No. = Number(s) | commenced or to be commenced |
Endnote 3—Legislation history
Name | Registration | Commencement | Application, saving and transitional provisions |
Health Insurance (Section 3C General Medical Services – Extracorporeal Photopheresis) Determination 2020 | 28 Oct 2020 (F2020L01351) | 1 Nov 2020 (s 2(1) item 1) | |
Health Insurance Legislation Amendment (Section 3C General Medical and Diagnostic Imaging Services – Medicare Indexation) Determination 2021 | 8 Apr 2021 (F2021L00426) | Sch 1 (items 355, 356): 1 July 2021 (s 2(1) item 1) | — |
Health Insurance Legislation Amendment (Indexation) Determination 2022 | 7 Apr 2022 (F2022L00553) | Sch 1 (item 9): 1 July 2022 (s 2(1) item 1) | — |
Endnote 4—Amendment history
Provision affected | How affected |
s 2..................... | rep LA s 48D |
s 7..................... | ad F2022L00553 |
Schedule 1 | |
Schedule 1................ | am F2021L00426 |