Save Search

Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2010

Bill home page  


Download WordDownload Word


Download PDFDownload PDF

 

 

 

 

 

2008-2009

 

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

 

 

HOUSE OF REPRESENTATIVES

 

 

 

 

 

 

 

 

 

 

 

HEALTH INSURANCE AMENDMENT (DIAGNOSTIC IMAGING ACCREDITATION) BILL 2009

 

 

 

 

 

EXPLANATORY MEMORANDUM

 

 

 

 

 

 

 

 

 

 

 

 

(Circulated by authority of the Minister for Health and Ageing, the Hon. Nicola Roxon, MP)





HEALTH INSURANCE AMENDMENT (DIAGNOSTIC IMAGING ACCREDITATION) BILL 2009

 

OUTLINE

 

The Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2009 (the Bill) will make amendments to the Health Insurance Amendment (Diagnostic Imaging Accreditation) Act 2007 (the DIA Act) to broaden the scope of the Diagnostic Imaging Accreditation Scheme (the Scheme). 

 

The Scheme is set out in the Health Insurance Act 1973 (the HIA) and provides for the accreditation of diagnostic imaging premises and bases for mobile diagnostic imaging equipment.  The framework for the Scheme is set out in section 16EA and Division 5, Part IIB, of the HIA.  Specific provisions of the Scheme are provided by regulations and other subordinate legislation.

 

The Scheme is being implemented in two stages.  Under the Stage I Scheme, which commenced on 1 July 2008, practices providing radiology services are required to be accredited for those services to attract Medicare benefits.  Under the Stage II Scheme, which will commence on 1 July 2010, practices providing non-radiology services, or a combination of radiology and non-radiology services, will need to be accredited, or hold ‘deemed accreditation’, to provide Medicare eligible diagnostic imaging services. 

 

Non-radiology diagnostic imaging services are cardiac ultrasound and angiography, obstetric and gynaecological ultrasound, and nuclear medicine imaging services.

 

The Bill will amend the DIA Act to provide transitional arrangements for premises  and bases which are in operation prior to 1 July 2010, which are not accredited under the Stage I Scheme and which provide either non-radiology services or a combination of non-radiology and radiology services, to register for ‘deemed accreditation’ under the Stage II Scheme.  This will enable those practices to continue to provide Medicare eligible services following the commencement of the Stage II Scheme on 1 July 2010.  There will be around 1,400 practices eligible to register for ‘deemed accreditation’ under the transitional arrangements.    

 

The registration period for ‘deemed accreditation’ will operate from 1 April 2010 up to and including 30 June 2010.  ‘Deemed accreditation’ will cease on 1 July 2011, or earlier if a practice providing non-radiology services obtains accreditation prior to that date.  Practices with ‘deemed accreditation’ will need to obtain accreditation by demonstrating compliance with three entry level standards under the Scheme, the full suite of standards under the Scheme or accreditation based on recognition of accreditation under the Medical Imaging Accreditation Program before 1 July 2011. 

 

Accreditation arrangements for practices accredited under the Stage I Scheme for radiology services will continue under the Stage II Scheme. 

 



Financial Impact Statement

The measure to broaden the scope of the Scheme is being developed and implemented within the Department of Health and Ageing’s existing program budget including the cost of $649,000 (GST exclusive) for 2009-10 to 2013-14 of modifying the Medicare Australia payment systems.  The costs of participating in the Scheme and becoming accredited will be met by the practices which provide non-radiology services under Medicare.

 



Regulation Impact Statement

 

A Business Cost Calculator (BCC) has been undertaken in respect of Stage II of the Diagnostic Imaging Accreditation Scheme.  The BCC report (Office of Best Practice Regulation reference number 10411) is set out below.

 



 

 



 

 



 

 

 



HEALTH INSURANCE AMENDMENT (DIAGNOSTIC IMAGING ACCREDITATION) BILL 2009

 

NOTES ON CLAUSES

 

Clause 1 - Short Title

This clause provides for the Bill, once enacted, to be cited as the Health Insurance Amendment (Diagnostic Imaging Accreditation) Act 2009 .

 

Clause 2 - Commencement

This clause provides that clauses 1 to 3 to commence on Royal Assent. 

 

The Schedule, which provides for the transition of practices providing non-radiology services into the Stage II Diagnostic Imaging Accreditation Scheme (the Stage II Scheme), will commence on start of the day of Royal Assent or 1 April 2010, whichever is the later.  This will allow existing practices providing non-radiology services, or a combination of non-radiology and radiology services, not accredited under the Scheme, to register for ‘deemed accreditation’ before 1 July 2010, thereby ensuring the continuation of Medicare benefits for these types of services from 1 July 2010.

 

Clause 3 - Schedule(s)

This clause provides that each Act that is specified in a Schedule to this Bill is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item has effect according to its terms.  In this Bill the Schedule amends the Health Insurance Amendment (Diagnostic Imaging Accreditation) Act 2007 to include new transitional arrangements for practices providing non-radiology services.

 

 



SCHEDULE 1 AMENDMENT OF THE HEALTH INSURANCE AMENDMENT (DIAGNOSTIC IMAGING ACCREDITATION) ACT 2007

 

Item 1 - After item 12 of Schedule 1

This item inserts new section 12A into Schedule 1 of the DIA Act, which provides transitional provisions applying to proprietors of practices providing non-radiology diagnostic imaging services which have never been accredited under the Diagnostic Imaging Accreditation Scheme (the Scheme).

 

In summary, the transitional arrangements provide that as long as a practice providing non-radiology services, or a combination of non-radiology and radiology services, has lodged a notice with a person designated by the Minister before 1 July 2010, services rendered from the diagnostic imaging premises or base will continue to be eligible for Medicare benefits until 30 June 2011, by which time the practice will need to be accredited. 

 

Subitem 1 sets out the conditions under which the transitional provisions apply to proprietor’s of diagnostic imaging premises or a base for mobile diagnostic imaging equipment providing non-radiology diagnostic imaging procedures.  The transitional provisions for providers of non-radiology services will apply to a proprietor of diagnostic imaging premises or a base for mobile diagnostic imaging equipment if the premises or base has been in operation before 30 June 2010, provides non-radiology services and has not been accredited under the Scheme.

 

Subitem 2 provides that a non-radiology diagnostic imaging procedure means a procedure described in the following items in the Health Insurance (Diagnostic Imaging Services Table) Regulations:

·          subgroup 2 of Group 11 (cardiac ultrasound);

·          subgroup 5 of Group 11 (obstetric and gynaecological ultrasound);

·          items 59903-59925 (inclusive) (cardiac angiography);

·          items 59971-59973 (inclusive) (cardiac angiography);

·          subgroup 16 of Group 13 (cardiac procedure); and

·          Group 14 (nuclear medicine imaging).

 

Subitem 3 provides for the type of diagnostic imaging services a proprietor may register.  That is, a proprietor may register premises or a base for:

·          one or more non-radiology diagnostic imaging procedures (i.e. diagnostic imaging practices providing only non-radiology services); or

·          one or more non-radiology procedures and one or more other diagnostic imaging procedures (i.e. diagnostic imaging practices not accredited under the Scheme providing a combination of non-radiology and radiology services). 

 

Subitem 4 provides that a proprietor of diagnostic imaging premises or a base may lodge a notice with the person designated by the Minister no later than 30 June 2010.  After 30 June 2010 diagnostic imaging premises or a base requiring accreditation will need to obtain accreditation against entry level standards or full suite standards under the Scheme, or accreditation based on recognition of accreditation under the Medical Imaging Accreditation Program if the practice wants to provide Medicare eligible diagnostic imaging services after 1 July 2011.

 

Subitem 5 provides that if a person designated by the Minister approves a form for the notice to register diagnostic imaging premises or a base for deemed accreditation, the notice, lodged by the proprietor of the premises or base must be in that form.

 

Subitem 6 provides that a person designated by the Minister may charge a fee for lodgement of the notice for deemed accreditation. 

 

Subitem 7 deems premises or a base for mobile diagnostic imaging equipment to be accredited for the purpose of subsection 16EA(1) of the HIA once the proprietor of that premises or base registers the premises or base in accordance with subitems (3) to (6) no later than 30 June 2010. 

 

Subitem 8 provides that a proprietor may add one or more diagnostic imaging procedures to the deemed accreditation by lodging a notice, no later than 30 June 2011 with the person designated by the Minister. 

 

Subitem 9 provides thatdeemed accreditation only applies to diagnostic imaging premises or a base identified in the notice.  The deemed accreditation is location specific and cannot be transferred to another diagnostic imaging premises or base.

 

Subitem 10 provides that deemed accreditation is not affected if there is a change to the proprietor of a diagnostic imaging premises or base during the deemed accreditation.

 

Subitem 11 provides for the cessation of deemed accreditation.  Deemed accreditation ceases:

(a)            on the day a diagnostic imaging premises or a base has been granted accreditation under the Scheme; or

(b)           if accreditation has been refused:

(i)      on the day the proprietor’s rights to have the decision reconsidered are exhausted or have expired: or

(ii)     on 30 June 2011;

whichever is the later; or

(c)            on 30 June 2011 in any other cases which may include, but are not limited to, the following circumstances:

(i)      where a proprietor of diagnostic imaging premises or a base fails to apply for accreditation for the diagnostic imaging procedures that are covered by the deemed accreditation before 1 July 2011; or

(ii)     where a proprietor of a diagnostic imaging premises or a base applies for accreditation before 1 July 2011 and the approved accreditor has not made a decision in relation to their application.

 

Subitem 12 provides that the Minister may, by legislative instrument, designate a person with whom the notice under subitem (4) is to be lodged.  The legislative instrument will be subject to the Legislative Instruments Act 2003 which means it must be registered on the Federal Register of Legislative Instruments, tabled in Parliament and is subject to disallowance.

 

 

 

Subitem 13 allows the Minister to delegate to the Secretary of the Department, or to an SES employee in the Department, his or her power under subitem (12) to designate the persons who will be able to accept notices for deemed accreditation pursuant to subitem (4).

 

Subitem 14 provides that any term defined in the HIA that is used in this item 12A has the same meaning as defined in the HIA.