Health Insurance (Section 3C Diagnostic Imaging Services – Cardiac MRI for Myocarditis) Determination 2024

I, Mary Warner, delegate of the Minister for Health and Aged Care, make the following determination.

Dated  26 November 2024   

Mary Warner
Assistant Secretary
Diagnostic Imaging and Pathology Branch
Medicare Benefits and Digital Health Division
Health Resourcing Group

Department of Health and Aged Care

Contents

1  Name

2  Commencement

3  Authority

4  Definitions

5  Treatment of relevant services

6  Application of provisions of the diagnostic imaging services table

7  Application of contrast

Schedule 1—Relevant services

1  Name

  This instrument is the Health Insurance (Section 3C Diagnostic Imaging Services – Cardiac MRI for Myocarditis) Determination 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.

Note:  This table relates only to the provisions of this instrument as originally made.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

1.     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 subsection 3C(1) of the Health Insurance Act 1973.

4  Definitions

Note: A number of expressions used in this instrument are defined in subsection 3(1) of the Act, including the following:

1.      clinically relevant service;
2.      diagnostic imaging services table;
3.      general medical services table;
4.      item;
5.      professional service.

  In this instrument:

Act means the Health Insurance Act 1973.

(Anaes.) has the meaning given by subsection 5.9.4(1) of the general medical services table.

MRI has the meaning given by the diagnostic imaging services table.

(R) has the meaning given by subsection 1.2.15(1) of the diagnostic imaging services table.

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.

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.

1.     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

 (1) 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 diagnostic imaging service; and

 (b) there were an item in the diagnostic imaging services table that:

 (i) related to the service; and

 (ii) specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

Note: For this Determination, an internal Territory is deemed to form part of the State of New South Wales – see subsection 3C(7) of the Act.

6  Application of provisions of the diagnostic imaging services table

 (1) The item in the Schedule applies to an MRI service if all of the following apply:

 (a) it is performed in a permissible circumstance, as described in clause 2.5.3 of the diagnostic imaging services table;

 (b) it is performed by a person who is:

 (i) a specialist in diagnostic radiology; and satisfies the Chief Executive Medicare that the specialist is a participant in the Royal Australian and New Zealand College of Radiologists’ Quality and Accreditation Program; or

 (ii) a specialist in diagnostic radiology or a consultant physician; and is recognised by the Conjoint Committee for Certification in Cardiac MRI;

 (c) it is performed using equipment that is:

 (i) eligible equipment, as described in clause 2.5.5 of the diagnostic imaging services table; or

 (ii) partial eligible equipment, as described in clause 2.5.6 of the diagnostic imaging services table.

 (2) Subject to paragraph (1)(b), clause 2.5.4 of the diagnostic imaging services table shall have effect as if the item in the Schedule were also specified in column 1 of item 1 and 2 of table 2.5.4.

7  Application of contrast

 (1) If a service to which an item in the Schedule applies is performed using a contrast agent, the fee specified in that item applies in addition to the schedule fee in item 63491 of the diagnostic imaging services table.

Schedule 1—Relevant services