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Health Insurance Amendment (100% Medicare Rebate and Other Measures) Bill 2004

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2004

 

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

 

 

HOUSE OF REPRESENTATIVES

 

 

 

 

 

 

 

 

 

 

HEALTH INSURANCE AMENDMENT (100% MEDICARE REBATE

AND OTHER MEASURES) BILL 2004

 

 

 

EXPLANATORY MEMORANDUM

 

 

 

 

 

 

 

 

 

 

 

 

 

(Circulated by authority of the Minister for Health and Ageing,

the Honourable Tony Abbott MP)

 



 

HEALTH INSURANCE AMENDMENT (100% MEDICARE REBATE

AND OTHER MEASURES) BILL 2004

 

 

OUTLINE

 

The measures in the Health Insurance Amendment (100% Medicare Rebate and Other Measures) Bill 2004 make medical services more affordable.  The Bill does this in two ways:

 

1.       Increasing the Medicare benefit from 85% to 100% of the schedule fee for services provided by general practitioners; and

 

2.       Ensuring that all families who are eligible for Family Tax Benefit Part A (FTB (A)) are also eligible for the lower $300 safety net threshold.

 

100% Medicare Rebate

 

From 1 January 2005, the Medicare benefit (or Medicare rebate) for general practitioner (GP) services will be increased from 85% to 100% of the Medicare schedule fee. 

 

All patients will benefit from this measure.  For a standard surgery consultation, this will mean an increase in the Medicare rebate of $4.60 for each patient visit.

 

The measure will be complemented by an increase in the fees paid by the Department of Veterans’ Affairs for GP services provided to eligible veterans and war widows.  The Government has announced that the fees paid to Local Medical Officers will be increased from 100% to 115% of the equivalent Medicare fee plus the Veterans Access Payment.  This will maintain the relativities between the Medicare and Department of Veterans’ Affairs fee scales.

 

The measure also builds on other recent Government initiatives aimed at making GP services more affordable such as the bulk billing incentives targeted at Commonwealth concession card holders and children aged under 16.

 



 

Eligibility for the extended Medicare safety net

 

The extended Medicare safety net covers 80% of the out-of-pocket costs for Medicare services provided outside hospital, once an annual threshold is met. The Health Insurance Act 1973 currently specifies that a $300 safety net threshold applies to concession card holders and families that fall within the definition of “FTB (A) family” in the Health Insurance Act 1973. It has become apparent that there are some families that are eligible for FTB(A) but who do not fall within the definition of FTB (A) family and are therefore not recognised by the legislation as eligible for the lower safety net threshold of $300 (unless they are also concessional). 

 

This amendment will allow the Minister for Health and Ageing to determine that additional families are FTB(A) families who are eligible for the lower safety net threshold.

 

 

FINANCIAL IMPACT STATEMENT

 

The measures in the Bill have a total cost over 2004-2005 and the following three years of $1,718 million.  There is no cost associated with the FTB (A) amendment as all FTB(A) families were included in the original costing. The costing for the 100% Medicare Rebate measure, which includes payments to patients and administrative costs, is set out in the following table:

 

 

2004-05

2005-06

2006-07

2007-08

100% Medicare rebate

$204.9m

$505.2m

$503.6m

$504.5m

 



HEALTH INSURANCE AMENDMENT (100% MEDICARE REBATE

AND OTHER MEASURES) BILL 2004

 

NOTES ON CLAUSES

 

Clause 1

Clause 1 provides for the short title of the Act to be cited as the Health Insurance Amendment (100% Medicare Rebate and Other Measures) Act 2004.

 

Clause 2

This clause details the commencement dates of the various amendments contained within the Bill:

 

·           Clauses 1 to 3 (inclusive) of the Bill, and any provisions not expressly provided for below, commence on Royal Assent.

·           Schedule 1 commences on 1 January 2005.

·           Schedule 2 commences on Royal Assent.

 

Clause 3

Clause 3 specifies that the Acts referred to in the Schedules are amended by the amendments set out in each of the Schedules.

 

 

 

 



 

Schedule 1 - Amendments relating to 100% Medicare benefit for certain services

 

Schedule 1 of the Health Insurance Amendment (100% Medicare Rebate and Other Measures) Bill 2004 (the Bill) amends the Health Insurance Act 1973 to enable a Medicare benefit of 100% of the schedule fee to be paid for certain services, as prescribed in regulations.

 

The regulations will prescribe the range of services that will attract a Medicare benefit of 100% of the schedule fee.   It is intended that the 100% Medicare benefit will apply to non-referred attendances provided by vocationally and non-vocationally registered GPs.  This includes consultations provided in GP surgeries, after-hours consultations, home and  aged facility visits, and services provided by GPs to their unadmitted patients in a hospital.  Services provided by a practice nurse on behalf of a GP will also attract the 100% Medicare benefit.

 

 

  NOTES ON CLAUSES

 

Item 1:  After paragraph 10(2)(a)

This item introduces a new paragraph 10(2)(aa). 

 

The effect of this item is to allow a Medicare benefit of 100% of the schedule fee to be paid for services, other than those covered by paragraph 10(2)(a), that are prescribed in regulations. 

 

Paragraph 10(2)(a) provides that where a service is provided to a patient admitted to a hospital and the patient elects to be treated as a private patient, the Medicare benefit is 75% of the schedule fee.

 

Item 2:  After subsection 10(2)

This item inserts a new subsection 10(2A).

 

The effect of this item is to allow the services to be prescribed in the regulations creating the General Medical Services Table, the Pathology Services Table or the Diagnostic Imaging Services Table. 

 

Item 3:   Application

This item provides for the amendments in Schedule 1 to apply to professional services that commence on or after 1 January 2005.

 



 

Schedule 2 - Amendments to eligibility for the Medicare safety net

 

The extended Medicare safety net covers 80% of the out-of-pocket costs for Medicare services provided outside hospital, once an annual threshold is met. Section 8(1A) of the Health Insurance Act 1973 specifies that, for the purposes of the extended Medicare safety net, a $300 safety net threshold will apply to concession card holders and Family Tax Benefit Part (A) (FTB(A)) families.

 

The legislation defines an FTB(A) family as one that is registered for the safety net and in receipt of an FTB(A) payment either through fortnightly instalment payments under s 23 of the A New Tax System (Family Assistance) (Administration) Act 1999 (Administration Act) or a lump sum at the end of the financial year under  s 24 of the Administration Act.

It has become apparent that there are some families that are eligible for FTB(A) but who do not receive payments under ss 23 or 24 of the Administration Act, including families who defer their entire entitlement to s 23 payments in a calendar year to avoid incurring a debt to Centrelink. These families do not fall within the definition of FTB (A) family and are therefore not recognised by the legislation as eligible for the lower safety net threshold of $300 (unless they are also concessional).

The amendment will enable the Minister for Health and Ageing to determine that other registered families fall within the definition of FTB (A) family for the purposes of the extended Medicare safety net. The purpose of the amendment is to ensure that all families who are eligible for FTB (A), are also eligible for the lower safety net threshold. This was the original policy intention.

 

NOTES ON CLAUSES

 

Item 1

This item adds a new paragraph to the definition of “FTB (A) family” to include those families determined by the Minister to be FTB(A) families under new section 8A in the definition.

 

Item 2

This item makes a technical amendment to a note in the Act to replace the incorrect reference to the A New Tax System (Family Assistance) (Administration) Act 1999 with a reference to the A New Tax System (Family Assistance) Act 1999.

 

Item 3

This item introduces a new paragraph 8A. 

 



This item gives the Minister the power to determine that a registered family is an FTB(A) family for the purposes of paragraph (c) of the definition of FTB(A) family in subsection 8(1A).  T he Minister will be able to identify each family by reference to a class of families as permitted by subsection 46(2) of the Acts Interpretation Act 1901.   The item specifies the requirements for a determination under section 8A and provides that a determination under section 8A is a disallowable instrument.