Health Insurance Legislation Amendment (2024 Measures No. 4) Regulations 2024

I, the Honourable Sam Mostyn AC, Governor‑General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulations.

Dated   26 September 2024

Sam Mostyn AC

Governor‑General

By Her Excellency’s Command

Mark Butler

Minister for Health and Aged Care

Contents

1 Name

2 Commencement

3 Authority

4 Schedules

Schedule 1—Diagnostic imaging services

Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020

Schedule 2—General medical services

Health Insurance (General Medical Services Table) Regulations 2021

Schedule 3—Pathology services

Health Insurance (Pathology Services Table) Regulations 2020

Schedule 4—Health Insurance Regulations 2018

Health Insurance Regulations 2018

1  Name

  This instrument is the Health Insurance Legislation Amendment (2024 Measures No. 4) Regulations 2024.

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.

i

Note: This table relates only to the provisions of this instrument as originally made.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  Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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 1—Diagnostic imaging services

Health Insurance (Diagnostic Imaging Services Table) Regulations (No. 2) 2020

1  Schedule 1 (after item 61612)

Insert:

2  Schedule 1 (cell at item 63476, column 2)

Repeal the cell, substitute:

3  Amendments of listed provisions—Group I2

The items of Schedule 1 listed in the following table are amended as set out in the table.

4  Amendments of listed provisions—Subgroup 1 of Group I4

The items of Schedule 1 listed in the following table are amended as set out in the table.

Schedule 2—General medical services

Health Insurance (General Medical Services Table) Regulations 2021

1  Subparagraph 1.1.5(1)(b)(i) of Schedule 1

Omit “735 to 758”, substitute “735, 739, 743, 747, 750, 758”.

2  At the end of clause 1.2.9 of Schedule 1

Add:

Note: Paragraph (h) does not apply to a service to which item 22002 applies.

3  Schedule 1 (items 231 and 232, column 2)

Omit “235 to 240 and 735 to 758”, substitute “235 to 240, 735, 739, 743, 747, 750 or 758”.

4  Schedule 1 (items 296, 297 and 299, column 2)

Omit “91839 and 92437”, substitute “91839, 92437 and 92478 to 92483”.

5  Schedule 1 (items 729 and 731, column 2)

Omit “items 735 to 758 apply”, substitute “item 735, 739, 743, 747, 750 or 758 applies”.

6  Subclauses 2.22.1(3) and (4) of Schedule 1

Omit “729”, substitute “792”.

7  Schedule 1 (item 90300, column 2, paragraphs (a) and (b))

Repeal the paragraphs, substitute:

(a) the service is:

(i) performed in conjunction with a service (the lead extraction service) to which item 38358 applies; or

(ii)  performed in conjunction with a service (the leadless pacemaker extraction service) to which item 38373 or 38374 applies; or

(iii) performed in conjunction with a service (the TAVI intermediate or low surgical risk service) to which item 38514 or 38522 applies); and

(b) the surgeon:

(i) is providing surgical backup for the provider (who is not a cardiothoracic surgeon) who is performing the lead extraction service, the leadless pacemaker extraction service or the TAVI intermediate or low surgical risk service; and

(ii) is present for the duration of the lead extraction service, the leadless pacemaker extraction service or the TAVI intermediate or low surgical risk service, other than during the low risk pre and post extraction or transcatheter aortic valve implantation phases; and

(iii) is able to immediately scrub in and perform a thoracotomy if major complications occur

8  Clause 5.3.1 of Schedule 1

Repeal the clause.

9  Schedule 1 (items 15906 and 15908, column 2, subparagraph (b)(ii))

Omit “(which must include multi‑leaf collimator‑based shaping to achieve target dose conformity and organs at risk avoidance or dose management or reduction)”.

10  Schedule 1 (items 15912, 15916 and 15922, column 2, paragraph (a))

After “plan”, insert “at a level that is equivalent to or higher than that”.

11  Schedule 1 (items 15930, 15932, 15934 and 15936, column 2)

Omit “Applicable once per plan per day”.

12  Schedule 1 (item 15938, column 2, paragraph (b))

After “plan”, insert “at a level that is equivalent to or higher than that”.

13  Schedule 1 (item 15938, column 2)

Omit “Applicable once per plan per day”.

14  Schedule 1 (item 15940, column 2, paragraph (b))

After “plan”, insert “at a level that is equivalent to or higher than that”.

15  Schedule 1 (item 15940, column 2)

Omit “Applicable once per plan per day”.

16  Schedule 1 (item 15942, column, paragraph (b))

After “plan”, insert “at a level that is equivalent to or higher than that”.

17  Schedule 1 (item 15942, column 2)

Omit “Applicable once per day”.

18  Schedule 1 (item 15944, column 2, paragraph (b))

After “plan”, insert “at a level that is equivalent to or higher than that”.

19  Schedule 1 (item 15944, column 2)

Omit “Applicable once per day”.

20  Schedule 1 (item 15946, column 2)

Omit “Applicable once per plan per day”.

21  Schedule 1 (item 15948, column 2)

Omit “Applicable once per day”.

22  Schedule 1 (item 15952, column 2)

Omit “, other than a service to which item 15954 applies”.

23  Schedule 1 (item 15954)

Repeal the item, substitute:

24  Schedule 1 (item 15960, column 2)

Omit “to treat intracavitary, intraoral or intranasal site,”.

25  Schedule 1 (items 15970, 15972, 15974, 15976, 15978 and 15980, column 2)

Omit “Applicable once per course of treatment”.

26  After clause 5.9.4 of Schedule 1

Insert:

5.9.4A  Interaction of item 22002 with paragraph 1.2.9(h)

  Paragraph 1.2.9(h) does not apply in relation to a service to which item 22002 applies.

27  Schedule 1 (cell at item 22002, column 2)

Repeal the cell, substitute:

28  Schedule 1 (after item 31225)

Insert:

29  Schedule 1 (item 32135, column 2)

After “sclerotherapy”, insert “or topical energy therapies”.

30  Schedule 1 (item 32139, column 2)

Omit “haemorrhoids involving third‑degree or fourth‑degree haemorrhoids”, substitute “symptomatic haemorrhoids”.

31  Schedule 1 (cell at item 35401, column 2)

Repeal the cell, substitute:

32  Schedule 1 (item 45614, column 2)

Omit “(H)”.

33  Clause 7.1.1 of Schedule 1 (definitions of amount under clause 5.3.1, completes the minimum requirements for a cycle of care of a patient with established diabetes mellitus and completes the minimum requirements of the Asthma Cycle of Care)

Repeal the definitions.

Schedule 3—Pathology services

Health Insurance (Pathology Services Table) Regulations 2020

1  Schedule 1 (after item 66828)

Insert:

2  Schedule 1 (item 73343, column 2)

Omit “by fluorescence in situ hybridisation or genome wide micro‑array”.

3  Schedule 1 (item 73410, column 2, subparagraph (c)(i))

Omit “thalassemia”, substitute “thalassaemia”.

4  Schedule 1 (at the end of the cell at item 73420, column 2)

Add “, if the patient has not been previously alloimmunised against RhD”.

5  Schedule 1 (cell at item 73420, column 3)

Repeal the cell, substitute:

6  Schedule 1 (cell at item 73421, column 2)

Repeal the cell, substitute:

7  Schedule 1 (item 73422, column 2)

Omit “detected”, substitute “detectable”.

8  Schedule 1 (item 73424, column 2)

Omit “73422”, substitute “73422, 73434 or 73435”.

9  Schedule 1 (item 73429, column 2)

Omit “single gene panel”, substitute “gene panel”.

10  Schedule 1 (item 73434, column 2, paragraph (a))

Repeal the paragraph, substitute:

(a) a patient with a suspected neuromuscular disorder, being a neuromuscular disorder with signs and symptoms associated with variants that are not detectable by massively parallel sequencing;

11  Schedule 1 (item 73441, column 2, paragraph (b))

Omit “bilateral”.

12  Schedule 1 (cell at item 73451, column 2)

Repeal the cell, substitute:

Schedule 4—Health Insurance Regulations 2018

Health Insurance Regulations 2018

1  Section 4 (definition of hospital‑authorised medical practitioner)

Repeal the definition.

2  Section 4 (definition of obstetric medical practitioner)

Repeal the definition.

3  Divisions 1 and 2 of Part 2

Repeal the Divisions.

4  Section 44 (table item 1, column 2)

Omit “55036, 55066, 55070, 55071, 55076, 55600,”, substitute “55036, 55065, 55066, 55070, 55071, 55076, 55600, 55700, 55704,”.