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House: House of Representatives Presented by: Mr A. Webster, MP

Purpose To provide that Medicare benefits will not be payable for certain pregnancy termination procedures.

Background The Commonwealth's main involvement with pregnancy termination is through Medicare subsidies of certain termination procedures. Items 274, 275 and 6469 of the Schedule to the Health Insurance Act 1973 (the Principal Act) are Medicare subsidised medical procedures that may result in the termination of pregnancy. Basically, Items 274 and 275 are medical procedures whereby a practitioner injects a miscarriage causing solution through the abdomen into the amniotic sac and uterine contractions expel the foetus. Generally, this medical procedure is used in the second trimester of pregnancy (i.e. sixteen to twenty four weeks of pregnancy). Item 6469 is a medical procedure that provides for the removal of the contents of the pregnant uterus by curettage or aspiration curettage (i.e. by medical instruments which scrape, or having scraped tissue from the wall of the uterus, pick it up by suction). Generally, this medical procedure is used in the first trimester of pregnancy (i.e. first to sixteen weeks of pregnancy). 1

Item 6469 was introduced on 1 April 1975 and Items 274 and 275 on 1 October 1976. In 1990- 91, the number of medical services performed under Items 274 and 275 was 950 (compared to 844 in 1989- 90). In 1990- 91, the number of medical services performed under Item 6469 was 69 378 (compared to 68 743). Benefits paid for Item 6469 in 1990- 91 totalled $8 172 464 (compared to $7 712 364 in 1989- 90).

Main Provisions This Bill will operate six months after the day it receives the Royal Assent (clause 2).

A new section 19C will be inserted into the Principal Act by clause 3 that provides that Medicare benefits will not be payable for medical services under Items 274, 275 and 6469 unless accompanied by a proposed Schedule 1AA certificate.

A new Schedule 1AA will be inserted into the Principal Act by clause 4 that sets out the certificate that will have to accompany a Medicare benefits claim for medical services provided under Items 274, 275 or 6469. Basically the proposed certificate will require a medical practitioner to certify that they performed a medical service under Items 274, 275 and 6469 because the life of their patient was threatened; or to treat another medical condition, but without knowledge, or reasonable expectation that the service would terminate the existence of a foetus.

References 1. Boston Women's Health Book Collective, The New Our Bodies, Ourselves, Penguin Books, 1985, pp. 291- 314.

Bills Digest Service 24 August 1992 Parliamentary Research Service This Digest does not have any official legal status. Other sources should be consulted to determine the subsequent official status of the Bill.

Commonwealth of Australia 1992.

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Published by the Department of the Parliamentary Library, 1992.