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Health Insurance (General Medical Services Table) Amendment Regulation 2012 (No. 1)

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Health Insurance (General Medical Services Table) Amendment Regulation 2012 (No. 1)1
Select Legislative Instrument 2012 No. 16
I, QUENTIN BRYCE, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulation under the Health Insurance Act 1973.
Dated 22 February 2012
QUENTIN BRYCE
Governor-General
By Her Excellency’s Command
TANYA PLIBERSEK
Minister for Health
1              Name of regulation
                This regulation is the Health Insurance (General Medical Services Table) Amendment Regulation 2012 (No. 1).
2              Commencement
                This regulation commences on 1 March 2012.
3              Amendment of Health Insurance (General Medical Services Table) Regulations 2011
                Schedule 1 amends the Health Insurance (General Medical Services Table) Regulations 2011.
Schedule 1        Amendments
(section 3)
 
[1]           Schedule 1, Division 2.4, table, item 109
substitute
109
Professional attendance by a specialist in the practice of his or her specialty of ophthalmology following referral of the patient to him or her — an attendance (other than a second or subsequent attendance in a single course of treatment) at which a comprehensive eye examination, including pupil dilation, is performed on:
   (a)  a patient aged 9 years or younger; or
  (b)  a patient aged 14 years or younger with developmental delay;
(other than a service to which any of items 104, 106 and 10801 to 10816 applies)
189.20
[2]           Schedule 1, subparagraph 2.20.3 (2) (c) (ii)
omit
who is qualified in the way mentioned in paragraph 57 (1) (b)
insert
mentioned in paragraph 2.20.7 (1) (b)
[3]           Schedule 1, subclauses 2.20.6 (3) to (5)
substitute
         (3)   Unless exceptional circumstances exist, items 2700, 2701, 2715 and 2717 cannot be claimed:
                (a)    with a service to which items 735 to 758, or item 2713 apply; or
               (b)    more than once in a 12 month period from the provision of any of the items for a particular patient; or
                (c)    within 3 months following the provision of a service to which item 2712, or item 2719 of the Health Insurance (Review of GP Mental Health Treatment Plan) Determination 2011 (as in force on 29 February 2012), applies; or
               (d)    more than once in a 12 month period from the provision of a service to which item 2702 or 2710 of the Health Insurance (General Medical Services Table) Regulations 2010 (as in force on 31 October 2011) applies for the patient.
         (4)   Item 2712 applies only if one of the following services has been provided to the patient in the previous 12 months:
                (a)    the preparation of a GP mental health treatment plan under:
                          (i)    items 2700, 2701, 2715 and 2717; or
                         (ii)    items 2702 and 2710 of the Health Insurance (General Medical Services Table) Regulations 2010 (as in force on 31 October 2011);
               (b)    a review of a GP mental health treatment plan under item 2712, or item 2719 of the Health Insurance (Review of GP Mental Health Treatment Plan) Determination 2011 (as in force on 29 February 2012);
                (c)    a psychiatrist assessment and management plan under item 291.
         (5)   Item 2712 does not apply:
                (a)    to a service to which items 735 to 758, or item 2713 apply; or
               (b)    unless exceptional circumstances exist for the provision of the service:
                          (i)    more than once in a 3 month period; or
                         (ii)    within 4 weeks following the preparation of a GP mental health treatment plan (item 2700, 2701, 2715 or 2717); or
                (c)    unless exceptional circumstances exist for the provision of the service to a patient within 3 months after the patient is provided a service to which item 2719 of the Health Insurance (Review of GP Mental Health Treatment Plan) Determination 2011 (as in force on 29 February 2012) applies.
[4]           Schedule 1, subparagraph 2.20.7 (2) (a) (i)
omit
calander
insert
calendar
[5]           Schedule 1, paragraph 2.20.7 (2) (b), except the note
substitute
               (b)    a service which:
                          (i)    for the period from 1 March 2012 to 31 December 2012 — is provided to a patient who has already been provided, in the calendar year, with 10 (or if exceptional circumstances exist — 16) other services to which any of the items in Subgroup 2, or items 80000 to 80015, 80100 to 80115, 80125 to 80140 or 80150 to 80165 apply; and
                         (ii)    for each subsequent calendar year — is provided to a patient who has already been provided, in the calendar year, with 10 other services to which any of the items in Subgroup 2, or items 80000 to 80015, 80100 to 80115, 80125 to 80140 or 80150 to 80165 apply.
[6]           Schedule 1, Division 2.44, table, item 42740
substitute
42738
Paracentesis of anterior chamber or vitreous cavity, or both, for the injection of therapeutic substances, or the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes, one or more of, as an independent procedure
295.15

42739
Paracentesis of anterior chamber or vitreous cavity, or both, for the injection of therapeutic substances, or the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes, one or more of, as an independent procedure, for a patient requiring anaesthetic services (Anaes.)
295.15

42740
Intravitreal injection of therapeutic substances, or the removal of vitreous humour for diagnostic purposes, one or more of, as a procedure associated with other intraocular surgery (Anaes.)
295.15

[7]           Dictionary, definition of non-medicare service, paragraph (b)
omit
Note
1.       All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See www.comlaw.gov.au.