Health Insurance (MRI for Patients 16 Years and Over and Capital Sensitivity Consequential Amendments) Determination 2013

Link to law: https://www.comlaw.gov.au/Details/F2013L01863

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Health Insurance (MRI for Patients 16 Years and Over and Capital Sensitivity Consequential Amendments) Determination 2013
 
I, RICHARD BARTLETT, delegate of the Minister for Health, make this determination under subsection 3C(1) of the Health Insurance Act 1973.
 
 
 
Dated                                            30th October 2013
 
 
 
 
____________________________________
 
Richard Bartlett
First Assistant Secretary
Medical Benefits Division
Department of Health
 
 
 

Contents
 
 
PART 1            PRELIMINARY   3
 
1           Name of Determination  3
2.          Commencement 3
3.          Authority  3
4.          Schedule                                                                                                3
 
 
Schedule – Amendments  4
 
 
Part 1        Preliminary
 
1.               Name of Determination
 
This Determination is the Health Insurance (MRI for Patients 16 Years and Over and Capital Sensitivity Consequential Amendments) Determination 2013.
 
2.               Commencement
 
This Determination commences as follows:
(a)        sections 1 to 4 and Schedule 1 on 1 November 2013;
(b)        Schedule 2 immediately after the cessation or earlier repeal of the Health Insurance (Diagnostic Imaging Services Table) Regulation 2012.
 
3.               Authority
 
This Determination is made under the Health Insurance Act 1973.
 
4.               Schedule
 
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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 to take effect 1 November 2013
 
Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service and Rockhampton, Bundaberg and Gladstone Mobile MRI Service) Determination 2012
 
1         Subsection 5(1), Interpretation (definition of RIL funding agreement)
 
Omit “Department of Health and Ageing as in force on 31 December 2011”, substitute “Department of Health as in force on 1 October 2013.”
 
2         Paragraph 6(1)(b)
 
After “items 63525 to 63530”, insert “and items 63584 to 63587”.
 
3         Paragraph 6AA(1)(b)
 
After “items 63525 to 63530”, insert “and items 63584 to 63587”.
 
4         Section 8
 
Repeal the section, substitute
8.      MRI and MRA services – meaning of scan
Clause 2.5.7 of Part 2 of Schedule 1 of the diagnostic imaging services table shall have effect as if the reference to “items 63001 to 63522” also included reference to items 63002 to 63483, items 63525 to 63530 and items 63584 to 63587 specified in the Schedule. 
 
5         Section 9
 
Repeal the section, substitute
9.      MRI and MRA services – related services that can be claimed in a 12 month period
 
Subclause 2.5.9(2) of Part 2 of Schedule 1 of the diagnostic imaging services table shall have effect as if the references to the items mentioned in column 1 of the table below (Existing references) include references to the items mentioned in column 2 of the following table (Additional references).
 

Existing references
Additional references

63040 to 63073
63041 to 63065

63101
63102

63125 to 63131
63126 to 63132

63161 to 63185
63163 to 63177

63219 to 63243
63220 to 63244

63271 to 63280
63272 to 63281

63322 to 63340
63323 to 63332

63361
63363

63385 to 63391
63386 to 63389

63401 and 63404
63402 and 63405

63416
63417

63425 and 63428
63426 and 63429

63461, 63464 and 63467
63463, 63466 and 63469

63482
63483

63507 to 63522
63525 to 63530 and 63584 to 63587

 
6         Schedule – Specified health services, after item 63530
 
Add
 
63584
Scan of head for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for any of the following:
(a) unexplained seizure(s);
(b) unexplained chronic headache with suspected intracranial pathology (R) (Contrast) (Anaes.)
403.20
Subgroup 34 – Scan of body-  for specified conditions

63585
Scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical radiculopathy (R) (Contrast) (Anaes.)
358.40
Subgroup 34 – Scan of body-  for specified conditions

63586
Scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical spinal trauma (R) (Contrast) (Anaes.)
492.80
Subgroup 34 – Scan of body-  for specified conditions

63587
Scan of knee following acute knee trauma, after referral by a medical practitioner (other than a specialist or consultant physician), for a patient 16 years or older with:
(a) inability to extend the knee suggesting the possibility of acute meniscal tear; or
(b) clinical findings suggesting acute anterior cruciate ligament tear (R) (Contrast) (Anaes.)
403.20
Subgroup 34 – Scan of body-  for specified conditions

 
 
Schedule 2 – Amendments to take effect on the cessation or earlier repeal of the Health Insurance (Diagnostic Imaging Services Table) Regulation 2012
 
 
Health Insurance (Gippsland and South Eastern New South Wales Mobile MRI Service and Rockhampton, Bundaberg and Gladstone Mobile MRI Service) Determination 2012
 
7         Section 6A
 
Omit “1.2.5A(1)(a)”, substitute “1.2.10(1)(a)”.
 
8         Section 8
 
Omit “63522”, substitute “63561”.
 
9         Section 9
 
Repeal the section, substitute:
9.      MRI and MRA services – related services that can be claimed in a 12 month period
Clause 2.5.9 of Part 2 of Schedule 1 of the diagnostic imaging services table shall have effect as if the references to the items mentioned in column 1 of the table below (Existing references) include references to the items mentioned in column 2 of the following table (Additional references).
 

Existing references
Additional references

63040 to 63085
63041 to 63065

63101 and 63104
63102

63125 to 63136
63126 to 63132

63161 to 63194
63163 to 63177

63219 to 63265
63220 to 63244

63271 to 63285
63272 to 63281

63322 to 63348
63323 to 63332

63361 and 63364
63363

63385 to 63394
63386 to 63389

63401 to 63408
63402 and 63405

63416 and 63419
63417

63425 to 63433
63426 and 63429

63455 to 63467
63463, 63466 and 63469

63482 and 63486
63483

63507 to 63561
63525 to 63530 and 63584 to 63587

 
 
Health Insurance (Poly Implant Prosthese MRI) Determination 2012
 
10       Subsection 3(1), Interpretation (definition of relevant provisions including the note)
 
Omit “1.2.7” (wherever occurring), substitute “1.2.12”.
 
11       Subsection 5(1)
 
Omit “1.2.5(1)(a)”, substitute “1.2.10(1)(a)”.
 
Health Insurance (Duplex Scanning for Erectile Dysfunction) Determination 2010 (No. 1)
 
12       Section 5
 
Repeal the section, substitute:
 
5         Treatment of a relevant service
 
Subject to section 6, for provisions of the Act and regulations made under the Act and the National Health Act 1953 and regulations made under that Act that relate to professional or medical services, a relevant service shall be treated as if:
 
(a)        it were both a professional service and a medical service; and
(b)        there were an item in Group I1 of the diagnostic imaging services table that related to the relevant service and specified in respect of the service a fee in relation to a State, being the fee specified in the Schedule in relation to the State specified.
 
13       Schedule 1, item 55208
 
After “(R)”, insert “(K)”.
 
14       Schedule 1, item 55211
 
After “(R)”, insert “(K)”.
 
15       Schedule 1, item 55209
 
Omit “Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011”, substitute “diagnostic imaging services table,”.
 
16       Schedule 1, item 55212
 
Omit “Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011”, substitute “diagnostic imaging services table,”.