Health Insurance Legislation Amendment (Optometric Services and Other Measures) Regulation 2014

Link to law: https://www.comlaw.gov.au/Details/F2014L01715

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Health Insurance Legislation Amendment (Optometric Services and Other Measures) Regulation 2014
 
Select Legislative Instrument No. 195, 2014
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 regulation.
Dated 11 December 2014
Peter Cosgrove
Governor‑General
By His Excellency’s Command
Peter Dutton
Minister for Health
  
  
Contents
1............ Name................................................................................................... 1
2............ Commencement................................................................................... 1
3............ Authority............................................................................................. 1
4............ Schedules............................................................................................ 1
Schedule 1—Amendments                                                                                                2
Part 1—Optometric services                                                                                      2
Health Insurance (General Medical Services Table) Regulation 2014            2
Part 2—Other amendments                                                                                        9
Health Insurance (Diagnostic Imaging Services Table) Regulation 2014       9
Health Insurance Regulations 1975                                                                        9
 
1  Name
                   This is the Health Insurance Legislation Amendment (Optometric Services and Other Measures) Regulation 2014.
2  Commencement
                   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

Provisions
Commencement

1.  Sections 1 to 4 and anything in this instrument not elsewhere covered by this table
The day after this instrument is registered.

2.  Schedule 1, Part 1
1 January 2015.

3.  Schedule 1, Part 2
The day after this instrument is registered.

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—Amendments
Part 1—Optometric services
Health Insurance (General Medical Services Table) Regulation 2014
1  Subclause 1.2.3(1) of Schedule 1
Omit “10900”, substitute “10905”.
2  Clause 2.28.1 of Schedule 1 (heading)
Repeal the heading, substitute:
2.28.1  Applications of items 10940 and 10941
3  Subclause 2.28.1(1) of Schedule 1
Repeal the subclause.
4  Subclause 2.28.4(2) of Schedule 1
Repeal the subclause.
5  After clause 2.28.5 of Schedule 1
Insert:
2.28.6  Meaning of old item 10900
                   In the items in Group A10:
old item 10900 means item 10900 of the table as it was in force at any time before its repeal by Part 1 of Schedule 1 to the Health Insurance Legislation Amendment (Optometric Services and Other Measures) Regulation 2014.
6  Schedule 1 (item 10900)
Repeal the item.
7  Schedule 1 (cell at item 10905, column headed “Fee ($)”)
Repeal the cell, substitute:
 
66.80
8  Schedule 1 (items 10907 to 10914)
Repeal the items, substitute:
 
10907
Professional attendance of more than 15 minutes in duration, being the first in a course of attention if the patient has attended another optometrist for an attendance to which this item or item 10905, 10910, 10911, 10912, 10913, 10914 or 10915 applies, or to which old item 10900 applied:
(a) for a patient who is less than 65 years of age—within the previous 36 months; or
(b) for a patient who is at least 65 years of age—within the previous 12 months
33.45

10910
Professional attendance of more than 15 minutes in duration, being the first in a course of attention, if:
(a) the patient is less than 65 years of age; and
(b) the patient has not, within the previous 36 months, received a service to which:
(i) this item or item 10905, 10907, 10912, 10913, 10914 or 10915 applies; or
(ii) old item 10900 applied
66.80
 
10911
Professional attendance of more than 15 minutes in duration, being the first in a course of attention, if:
(a) the patient is at least 65 years of age; and
(b) the patient has not, within the previous 12 months, received a service to which:
(i) this item, or item 10905, 10907, 10910, 10912, 10913, 10914 or 10915 applies; or
(ii) old item 10900 applied
66.80
 
10912
Professional attendance of more than 15 minutes in duration, being the first in a course of attention, if the patient has suffered a significant change of visual function requiring comprehensive reassessment:
(a) for a patient who is less than 65 years of age—within 36 months of an initial consultation to which:
(i) this item, or item 10905, 10907, 10910, 10913, 10914 or 10915 at the same practice applies; or
(ii) old item 10900 at the same practice applied; or
(b) for a patient who is at least 65 years of age—within 12 months of an initial consultation to which:
(i) this item, or item 10905, 10907, 10910, 10911, 10913, 10914 or 10915 at the same practice applies; or
(ii) old item 10900 at the same practice applied
66.80

10913
Professional attendance of more than 15 minutes in duration, being the first in a course of attention, if the patient has new signs or symptoms, unrelated to the earlier course of attention, requiring comprehensive reassessment:
(a) for a patient who is less than 65 years of age—within 36 months of an initial consultation to which:
(i) this item, or item 10905, 10907, 10910, 10912, 10914 or 10915 at the same practice applies; or
(ii) old item 10900 at the same practice applied; or
(b) for a patient who is at least 65 years of age—within 12 months of an initial consultation to which:
(i) this item, or item 10905, 10907, 10910, 10911, 10912, 10914 or 10915 at the same practice applies; or
(ii) old item 10900 at the same practice applied
66.80

10914
Professional attendance of more than 15 minutes in duration, being the first in a course of attention, if the patient has a progressive disorder (excluding presbyopia) requiring comprehensive reassessment:
(a) for a patient who is less than 65 years of age—within 36 months of an initial consultation to which:
(i) this item, or item 10905, 10907, 10910, 10912, 10913 or 10915 applies; or
(ii) old item 10900 applied; or
(b) for a patient who is at least 65 years of age—within 12 months of an initial consultation to which:
(i) this item, or item 10905, 10907, 10910, 10911, 10912, 10913 or 10915 applies; or
(ii) old item 10900 applied
66.80

9  Schedule 1 (cell at item 10915, column headed “Fee ($)”)
Repeal the cell, substitute:
 
66.80
10  Schedule 1 (cells at items 10916 and 10918, column headed “Fee ($)”)
Repeal the cells, substitute:
 
33.45
11  Schedule 1 (items 10921 to 10929)
Repeal the items, substitute:
 
10921
All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention for which the first attendance is a service to which:
(a) item 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915 or 10916 applies; or
(b) old item 10900 applied
For patients with myopia of 5.0 dioptres or greater (spherical equivalent) in one eye
165.80

10922
All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention for which the first attendance is a service to which:
(a) item 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915 or 10916 applies; or
(b) old item 10900 applied
For patients with manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in one eye
165.80

10923
All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention for which the first attendance is a service to which:
(a) item 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915 or 10916 applies; or
(b) old item 10900 applied
For patients with astigmatism of 3.0 dioptres or greater in one eye
165.80

10924
All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention for which the first attendance is a service to which:
(a) item 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915 or 10916 applies; or
(b) old item 10900 applied
For patients with irregular astigmatism in either eye, being a condition the existence of which has been confirmed by keratometric observation, if the maximum visual acuity obtainable with spectacle correction is worse than 0.3 logMAR (6/12) and if that corrected acuity would be improved by an additional 0.1 logMAR by the use of a contact lens
209.20

10925
All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention for which the first attendance is a service to which:
(a) item 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915 or 10916 applies; or
(b) old item 10900 applied
For patients with anisometropia of 3.0 dioptres or greater (difference between spherical equivalents)
165.80

10926
All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention for which the first attendance is a service to which:
(a) item 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915 or 10916 applies; or
(b) old item 10900 applied
For patients with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes, being patients for whom a contact lens is prescribed as part of a telescopic system
165.80

10927
All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention for which the first attendance is a service to which:
(a) item 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915 or 10916 applies; or
(b) old item 10900 applied
For patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by pathological mydriasis, aniridia, coloboma of the iris, pupillary malformation or distortion, significant ocular deformity or corneal opacity—whether congenital, traumatic or surgical in origin
209.20

10928
All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention for which the first attendance is a service to which:
(a) item 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915 or 10916 applies; or
(b) old item 10900 applied
For patients who, because of physical deformity, are unable to wear spectacles
165.80

10929
All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention for which the first attendance is a service to which:
(a) item 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915 or 10916 applies; or
(b) old item 10900 applied
For patients who have a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia or a condition to which item 10926, 10927 or 10928 applies) requiring the use of a contact lens for correction, if the condition is specified on the patient’s account
209.20

12  Schedule 1 (cell at item 10930, column headed “Fee ($)”)
Repeal the cell, substitute:
 
165.80
13  Schedule 1 (cell at item 10931, column headed “Fee ($)”)
Repeal the cell, substitute:
 
23.30
14  Schedule 1 (cell at item 10932, column headed “Fee ($)”)
Repeal the cell, substitute:
 
11.60
15  Schedule 1 (cell at item 10933, column headed “Fee ($)”)
Repeal the cell, substitute:
 
7.70
16  Schedule 1 (cell at item 10940, column headed “Fee ($)”)
Repeal the cell, substitute:
 
63.75
17  Schedule 1 (cell at item 10941, column headed “Fee ($)”)
Repeal the cell, substitute:
 
38.45
18  Schedule 1 (cells at items 10942 and 10943, column headed “Fee ($)”)
Repeal the cells, substitute:
 
33.45
Part 2—Other amendments
Health Insurance (Diagnostic Imaging Services Table) Regulation 2014
19  Clause 2.2.6 of Schedule 1
Repeal the clause, substitute:
2.2.6  Cone bean computed tomography—items 57362 and 57363
                   Item 57362 or 57363 applies to the service mentioned in that item only if the service is performed with diagnostic imaging equipment that is not used to perform any other diagnostic imaging service.
20  Part 3 of Schedule 1 (definition of dental specialist)
Repeal the definition.
Health Insurance Regulations 1975
21  Paragraph 10(1)(b)
After “56068”, insert “, 57362, 57363”.
22  Paragraph 10(1)(d)
After “57345”, insert “, 57362, 57363”.