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Dental Benefits Amendment Bill 2016

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2016

 

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

 

 

HOUSE OF REPRESENTATIVES

 

 

 

 

 

 

 

 

 

 

 

DENTAL BENEFITS AMENDMENT BILL 2016

 

 

 

 

 

EXPLANATORY MEMORANDUM

 

 

 

 

 

 

 

 

 

 

 

 

(Circulated by authority of the Minister for Health, the Hon Sussan Ley MP)





DENTAL BENEFITS AMENDMENT BILL 2016

 

OUTLINE

 

This Bill amends the Dental Benefits Act 2008 to close the Child Dental Benefits Schedule (CDBS) from 30 June 2016, and establish a framework for agreements between the Commonwealth and the states and territories (“the states”) to underpin a Child and Adult Public Dental Scheme. 

 

The Child and Adult Public Dental Scheme will deliver better dental care to public patients. Both adults on concession cards and all children will be eligible to receive public dental services under the Scheme.

 

Under the Scheme the Commonwealth will provide funding to the states to improve access to public dental services from an ongoing capped special appropriation under the Dental Benefits Act 2008 .  Funding will be made available to the states under a National Partnership Agreement (NPA) to operate from1 July 2016 for an initial five year period.  After the fourth year, the program will be reviewed and the outcome of the review will inform the policy parameters of the next Agreement.

 

It is anticipated that this long term certainty of Commonwealth funding will enable the states to invest in infrastructure and improve dental service provision. The states will retain the ability to contract with private providers to deliver public dental services where required.

 

The Commonwealth contribution under the program will be set at 40 per cent of the efficient price of provision of dental services. The states will meet the balance of the costs of service provision. They will continue to manage their waiting lists through controls such as co-payment arrangements; will determine state-specific eligibility criteria (subject to the Commonwealth’s policy intent that all children will be eligible for public dental services); and will continue to provide services based on clinical need.

 

With the additional funding available, more services will be provided which should reduce waiting times. It is expected that the Commonwealth funding provided through the Child and Adult Public Dental Scheme will enable the states to treat an additional 600,000 patients annually.

 

The CDBS will be closed from 30 June 2016 (although benefits will still be paid for eligible services provided on or before that date).  The CDBS has been poorly utilised, with less than a third of eligible children accessing services since it began in 2014. 

 

Public dental patients are more likely to suffer from decay, tooth loss and gum disease than the general population. Financially disadvantaged Australians eligible for public dental services, namely pensioners and concession card holders, have a substantially reduced ability to access affordable and timely oral health care.  

 

The Child and Adult Public Dental Scheme will focus on improving dental services for all public dental patients, including an increasing focus on preventative dental care.

 

Financial Impact Statement

 

The Bill establishes a special appropriation to fund payments to the states for the Child and Adult Dental Scheme.  The appropriation is capped at $415.6 million for 2016-17, $415.6 million for 2017-18, and $420.2 million for 2018-19.  For 2019-20 and later years the appropriation is indexed by growth in population and the Consumer Price Index. 

 

Expenditure under the Child Dental Benefits Schedule, which will be closed by the amendments in the Bill, is estimated at $313.7 million in 2015-16. 



 

Regulation Impact Statement

Name of proposal: Child and Adult Public Dental Scheme

Office of Best Practice Regulation (OBPR) ID number: 20127

 

Child and Adult Public Dental Scheme

Regulation Impact Statement summary

Problem

Access to public dental services.

Recommended option

Option 2 - Child and Adult Public Dental Scheme

 

Poor oral health leads to poorer overall health outcomes such as visits to the GP or emergency department, hospitalisations that could have been prevented, and complications for other illnesses.

 

Good oral health involves ongoing maintenance for life but dental care in Australia can be very expensive. Thirty per cent of adults avoid seeking dental treatment due to cost.

 

Public dental services face great pressure in providing services to eligible people. 

 

The existing Commonwealth funded Child Dental Benefits Schedule is poorly targeted as children already had good visiting patterns prior to its commencement.  Utilisation has also been low at around 30 per cent of eligible children.

 

This proposal closes the Child Dental Benefits Schedule to fund the proposed new Scheme in part.  As private dentists will not have direct access to the new Scheme there will be deregulation offsets achieved through the closure of the Child Dental Benefits Schedule .

 

This measure will provide funding to the states and territories to improve access to public dental services by establishing an ongoing capped special appropriation under the Dental Benefits Act 2008 .  Funding will be made available to the states under a National Partnership Agreement (NPA) to operate from1 July 2016 for an initial five year period.

 

The Commonwealth contribution under the program will be set at 40 per cent of the efficient price of the dental service, with states contributing the remaining costs.

 

With the additional Commonwealth funding available, more services will be provided which will have a positive impact on waiting lists.

 

The intention is that both adults on concession cards and all children will be eligible  to receive public dental services under the program.

 

The Dental Benefits Act 2008 will be amended to close the Child Dental Benefits Schedule and to implement the Child and Adult Public Dental Scheme. The new scheme will commence on 1 July 2016.

Background

The Government has proposed a new national Child and Adult Public Dental Scheme to be introduced from 1 July 2016.  The Scheme is to be implemented through a new five year National Partnership Agreement (NPA) that will provide funding to the states and territories (the states) to assist them with the delivery of public dental services to children and concession card holder adults, supported by an ongoing special appropriation.  Funding for the Scheme is offset by ceasing the existing Child Dental Benefits Schedule (CDBS) and from not continuing with the current NPA on Adult Public Dental Services.

 

The Commonwealth would pay 40 per cent of the national “efficient” price of dental services provided or purchased by the states. The high level principles underlying the Scheme will be set out in a NPA.

 

The closure of the CDBS and the establishment of the new scheme will require amendment of the Dental Benefits Act 2008 before 1 July 2016. 

Problem Definition

·            Although Australians’ oral health has improved over the past three decades, largely through the introduction of fluoridation in the 1960s, poor oral health among adult Australians is still widespread.  Across the population as a whole three out of 10 adults have untreated tooth decay.  The rate is more than twice this among adults on low incomes and Aboriginal and Torres Strait Islander people.  Rural and remote populations are also at greater risk of poor dental health. 

 

·            Poor oral health leads to poorer overall health outcomes such as visits to the GP or emergency department and complications for other illnesses. This also leads to greater costs to the health system.

 

·            Good oral health involves ongoing maintenance for life. However, dental care in Australia can be very expensive.  Thirty per cent of adults avoid seeking dental treatment due to cost.

 

·            Public dental services face great pressure in providing services to eligible people. 

 

·            The CDBS is significantly underutilised, with only around 30 per cent of eligible children having accessed the scheme.   The CDBS is also a poorly targeted use of Commonwealth funding, in that it is substituting Commonwealth expenditure for other sources of funding. Before the introduction of the CDBS, around 80 per cent of children visited a dental practitioner in a 12 month period.

Objective of Government Action

·            The Scheme will better utilise existing Commonwealth dental funding.

·            The Scheme will consolidate Commonwealth effort to target funding where it is most needed, to assist the states to provide more services to children and concession card holder adults, irrespective of where people reside.

Policy Options

Given the overall fiscal circumstances facing the Commonwealth, the only options considered were those that did not increase the Commonwealth’s fiscal exposure.

Option 1 (Status Quo)

Option Overview

The current Commonwealth funding arrangements for dental services are provided through the Child Dental Benefits Schedule (CDBS) and the National Partnership Agreement (NPA) on Adult Public Dental Services.  Under the CDBS, eligible children can receive up to $1,000 worth of dental treatment, capped over two calendar years.  Under the NPA, $155.0 million is being provided to the states and territories during 2015-16 for the treatment of 178,000 additional public dental patients.

 

Impacted Parties

·            state and territory governments; and

·            private dentists.

 

Impact Analysis

As these programs are already in place, there will be no change to the regulatory burden. Under the CDBS, the dentists will continue to be required to obtain financial consent and to train staff in the processing of claims under the program.

 

The states are responsible for the delivery of public dental services and would continue to deliver services to concession card holder adults and children.

Option 2 - Child and Adult Public Dental Scheme

Option Overview

This measure will provide funding to the states and territories to improve access to public dental services by establishing an ongoing capped special appropriation under the Dental Benefits Act 2008 .  Funding will be made available to the states under a National Partnership Agreement (NPA) to operate from1 July 2016 for an initial five year period. After the fourth year, the program will be reviewed and the outcome of the review will inform the policy parameters of the next Agreement.

 

The Commonwealth contribution under the program will be set at 40 per cent of the efficient price of the dental service. With the additional funding available, more services will be provided which should reduce waiting times.

 

Both adults on concession cards and all children will be eligible to receive public dental services under the program.

 

The CDBS will be closed from 30 June 2016 (although benefits will still be paid for eligible services provided on or before that date).

 

Impacted Parties

·            state and territory governments and individuals seeking public dental care; and

·            private dentists.

 

Impact Analysis

There will be an impact on state and territory governments which are responsible for the provision of public dental services, as the amount of Commonwealth assistance will increase from an estimated $200 million in 2015-16 to over $400 million each year over the forward estimates. Under this option, the additional Commonwealth funding will enhance the existing mechanisms in place to provide additional services with the increase in funding.

 

The states will continue to manage their waiting lists through controls such as co-payment arrangements; will determine state-specific eligibility criteria (subject to the Commonwealth’s policy intent that all children will be eligible for public dental services); and will continue to provide services based on clinical need.

 

Low income adults (predominantly concession card holders) who can generally only afford to receive dental care from public dental services have poor oral health and poor dental visiting patterns.  About half do not attend a dentist annually, and of those who do about half attend only to address an urgent problem. 

 

Before the National Partnership Agreement (NPA) on Treating More Public Dental Patients that began in 2012-13 national average waiting times for adults for general treatment were over two years.   The Commonwealth investment under that NPA of $344 million over three years saw an additional 400,000 average complexity patients treated and national average waiting times for adults for general treatment reduced from 20 months to less than one year.

 

The states achieved this through a range of measures including employing additional temporary staff, extending opening hours for clinics, and increasing the contracted use of private sector dentists to deliver services to public dental patients. 

 

Under the new Scheme, which will see a Commonwealth contribution of over $400 million a year, a sustained ongoing reduction in waiting times should be achievable.  The Commonwealth estimates that services should be available to an additional 600,000 average complexity patients who could not afford services in the private sector. 

 

In the short term under the new Scheme it is expected that the states will continue the range of measures introduced under the NPA to increase service volumes and hence reduce waiting times.  In the medium term the assured source of funding made available through the special appropriation under the new Scheme should allow them to expand infrastructure and workforce and reduce their reliance on contracting with the private sector.  The final impact on the distribution of public service provision between the public and private sectors is uncertain.

 

The closure of the CDBS is not expected to have a significant impact on private sector dentists.  While the CDBS has been in operation for almost two and a half years, only thirty per cent of eligible families (or around 750,000 children annually) have made use of the scheme. 

 

Before the introduction of the CDBS around 80 per cent of children - or about 4.4 million children - visited a dental practitioner annually.  This proportion has been stable for many years.  

 

Of the children who visited a dentist annually before the CDBS began in 2014 some 3.7 million were treated in the private sector using private health insurance or families’ own resources.  This strongly suggests that the CDBS simply substituted Commonwealth funding for other sources of funding for dental services for children.  The Commonwealth expects that closure of the CDBS will see a return to the service and funding patterns that applied up until the end of 2013.

 

Given the low utilisation of the CDBS, the direct financial impact on private sector dentists is expected to be minimal. The government will continue to subsidise the cost of private health insurance, which pays benefits for many private sector dental services, through the private health insurance premium rebate.  There will, however, be a reduction in the regulatory burden on private sector dentists due to the closure of the CDBS, as set out in Appendix 1.

 

In summary the new Scheme will more effectively target Commonwealth assistance at low income adults with poor oral health and poor dental visiting patterns who attend public dental services. 

Consultation

Consultations have taken place with jurisdictions, the Australian Dental Association (ADA), Consumers’ Health Forum (CHF), the Australian Healthcare and Hospitals Association (AHHA) and Private Healthcare Australia (PHA).  While discussions focused on an alternative public sector model to the option agreed by Government, the discussions covered principles which were broadly consistent with the new Scheme.  This included discussions on consolidating existing funding arrangements and developing a new legislatively based proposal to support states in the provision of public dental services.

 

Nature of consultation

Teleconferences and face to face meetings were held with the jurisdictions, ADA, CHF, AHHA and PHA.

 

Impacted parties

The ADA does not support the exclusion of the private sector from accessing direct Commonwealth funding.  The ADA also seeks further Commonwealth expansion of items and increased schedule fees under the CDBS. 

 

AHHA was concerned that increasing funding for states would not result in a universal scheme, and would entrench differences between the states in how services are provided. 

 

Other groups, including states and territories, were broadly supportive of the proposal.

Preferred Option

The Government’s preferred option is option 2. 

 

It considers that providing increased support to the states for public dental services which provide treatment for low income adults and children is a more effective use of taxpayers’ funds than the CDBS, noting that only 30 per cent of eligible children utilised the CDBS and 80 per cent of children were already receiving dental treatment annually before the CDBS began.

 

By focusing additional resources on improving access for concession card holders and children, the ongoing NPA will fill a key gap in the dental system.  The ongoing nature of the measure will provide the states with long term funding certainty, which will allow for the development of innovative models of care and will stabilize and improve waiting times.

Implementation

The broader principles of the Scheme will be established under a NPA, which operates under the Federal Financial Relations framework, with payments based in statute and paid via the Treasury through a specific purpose payment.

 

The states will provide information on the services they provide to the Department of Health, which will calculate the amount of funding payable.  The Department will then recommend that payment be made by the Treasury.

 

The new Scheme will allow the states to maintain existing private sector arrangements in place and build on these where necessary.

 

It is proposed that the CDBS will close on 30 June 2016 and that the Scheme will commence on 1 July 2016.  The closure of the CDBS would be communicated in writing to eligible patients and dentists by the Department of Human Services.

 

 



 

RIS Appendix 1

Regulatory Burden and Cost Offset (RBCO) Estimate Table

Average Annual Compliance Costs (from Business as usual)

Change in Costs ($m)

Business

Community Organisations

Individuals

Total change in Cost

Total by Sector

-$5.254

$

-$3.671

-$8.925

 

Cost offset ($m)

Business

Community Organisations

Individuals

Total by Source

Agency

$

$

$

$

 

Are all new costs offset?

q Yes, costs are offset, please provide information below

q No, costs are not offset

ü Deregulatory, no offsets required

Total (Change in costs - Cost offset) ($million): $

 

The RBM calculations focus on closure of the CDBS.  They assume that closing the CDBS will lead to savings which are exactly equivalent to the regulatory costs associated with participating in the program.

The costing only relates to private sector regulatory costs: public sector dental services were excluded.  The regulatory costs of participating in the CDBS apply to dental practices and patients and there are no costs for community organisations.

There is no up-to-date data on the number of private dental practices operating in Australia. The number of private dental practices involved in the CDBS was estimated using Australian Institute of Health and Welfare (AIHW) workforce data, advice from the Department’s dental advisers about the structure of the industry and the likely ratio of employed dentists to dental practices, and departmental data on the number of dentists participating in the program. As of 2012, there were 10,254 employed private dentists in Australia.  The calculations assumed the number of private dental practices in operation is 60% of this figure, i.e. 6152.  88% of dental practitioners participated in CDBS in 2015.  By applying the same percentage to the number of practices it was calculated that there are 5414 private practices participating in the program.  Public dental services were excluded.

In 2015, 780,150 children utilised the CDBS as private patients which we used as the basis for calculating the regulatory costs to the individual.  Public patients using the program were excluded.

The key requirement for participating in the CDBS include checking eligibility and cap balance during dental visits, documenting informed financial consent between the dental provider and patient, and invoicing either by bulk billing or non-bulk billing methods.  The average amount of time taken for dentists or their staff to perform these procedures was calculated based on advice from our dental advisers.  Salary rates were sourced from Payscale.com and the standard non-wage labour on-costs multiplier was applied.

As both dentists and patients take part in these processes, similar timings for patients were applied, less the time for administrative tasks that are only undertaken by dental practices such as record keeping.  The cost of patient time was calculated using the recommended cost of leisure time.  Additional time for patients who are not bulk billed and need to seek reimbursement from Medicare via the various claiming channels available was also estimated.

There are no offsets required for the proposed Public Dental Scheme as government-to-government regulation falls outside the Regulatory Burden Measurement Framework.



Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

DENTAL BENEFITS AMENDMENT BILL 2016

This Bill is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011 .

Overview of the Bill

The Dental Benefits Legislation Amendment Bill 2016 (the Bill) amends the Dental Benefits Act 2008 (“the Act”) to close the Child Dental Benefits Schedule (CDBS) from 30 June 2016, and establish a framework for agreements between the Commonwealth and the states and territories (“the states”) to underpin a Child and Adult Public Dental Scheme.

 

The Child and Adult Public Dental Scheme is intended to provide financial assistance to the states to provide dental services to all children and concession cardholder adults.  The Bill establishes a cap on the amount of financial assistance that will be provided by the Commonwealth.  The terms and conditions for access to the financial assistance will be set out in agreements with the states.  The government intends that these agreements will be published on the COAG website, as are existing National Partnership Agreements.

 

Human rights implications

This Bill engages the following rights:

·          right to health

·          right to social security.

 

Right to health

Article 12(1) of the International Covenant on Economic, Social and Cultural Rights (ICESR) defines the right to health as “the right to the enjoyment of the highest attainable standard of physical and mental health.”

 

Whilst the UN Committee on Economic Social and Cultural Rights (the Committee) has stated that the right to health is not to be understood as a right to be healthy, it does entail a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health.

 

However, the Committee has stated that the notion of ‘the highest attainable standard of health’ takes into account both the conditions of the individual and the country’s available resources.  The right may be understood as a right of access to a variety of public health and health care facilities, goods, services, programs and conditions necessary for the realisation of the highest attainable standard of health.

 

While the CDBS targets benefits to children in low to medium income families, it does not provide benefits for adults. 

 

The Australian Institute of Health and Welfare (AIHW) report Oral health and dental care in Australia: key facts and figures 2015 found that adults have much worse oral health than children (measured by the number of decayed, filled or missing teeth). 

 

A 2008 AIHW report Oral Health of Adults in the Public Dental Sector found that public dental patients were far more likely to suffer from decay, tooth loss and gum disease than the general population.  This suggests that financially disadvantaged Australians eligible for public dental services, namely pensioners and concession card holders, have a substantially reduced ability to access affordable and timely oral health care.  

 

Accordingly, the CDBS is not seen by the Government as the best mechanism for providing Australians with equal opportunity of access to dental care.

 

The Government intends instead to direct resources for dental services to children and low income patients who traditionally access public dental services through the states and territories. 

 

The ICESCR recognises that the right to health may be subject to limitations made for the purpose of promoting the general welfare of society as a whole.  The ICESCR also recognises that the ability of a government to promote the right to health is affected by the country’s available resources.  In this context, governments must assess which measures are most suitable to address the health needs of population as a whole.

 

Accordingly, a limitation on a section of the Australian population’s access to a particular health service will be legitimate where the Government:

(i)                  believes that the service is not well targeted to providing assistance to those Australians most in financial need; and

(ii)                has limited resources and intends to re-direct resources to more appropriate programs that are more equitably targeted to those financially disadvantaged Australians in greatest need.

 

The amendments made by the Bill are for a legitimate objective and are reasonable, necessary and proportionate, and therefore are compatible with Australia’s obligations with regards to the right to health. 

 

Right to social security

Article 9 of the ICESCR contains the right to social security, including social insurance. The right requires that a country must, within its maximum available resources, ensure access to a social security scheme that provides a minimum essential level of benefits to all individuals and families that will enable them to acquire at least essential health care.  Countries are obliged to demonstrate that every effort has been made to use all resources that are at their disposal in an effort to satisfy, as a matter of priority, this minimum obligation.

 

Further, the Committee has stated that there is a strong presumption that retrogressive measures taken in relation to the right to social security are prohibited under ICESCR.  In this context, a retrogressive measure would be one taken without adequate justification that had the effect of reducing existing levels of social security benefits, or of denying benefits to persons or groups who were previously entitled to them.

 

However, it is legitimate for a Government to re-direct its limited resources to programs which it believes are more effective at meeting the general health needs of society, particularly the needs of the more disadvantaged members of society.  The closure of the CDBS will enable the Government to focus resources for dental services targeting not only children, but also  adults with low incomes.

 

It is also relevant that the CDBS has only operated since the beginning of 2014, that before it began some eighty per cent of children saw a dentist annually, and that less than a third of eligible children have utilised the scheme.  This suggests that the CDBS has not been an important factor in supporting access to dental services to children, and that its removal will not be retrogressive. 

 

The state public dental services that will receive increased financial assistance under the amendments made by the Bill all provide services to children. 

 

The Bill does not impact upon alternative means of support for services through Commonwealth funded rebates for private health insurance covering dental treatment.

 

There is no incompatibility with the right engaged because it is for a legitimate objective and reasonable, necessary and proportionate in the circumstances.

 

Conclusion

The Dental Benefits Amendment Bill 2016 is compatible with human rights because it advances the protection of human rights by enabling limited resources to be spent more effectively and to the extent that it may limit human rights, those limitations are reasonable, necessary and proportionate.

 

The Hon Sussan Ley MP

Minister for Health

 

 

 



DENTAL BENEFITS AMENDMENT BILL 2016

 

NOTES ON CLAUSES

 

Clause 1 - Short Title

This clause provides that the Bill, once enacted, may be cited as the Dental Benefits Amendment Act 2016 .

 

Clause 2 - Commencement

This clause provides that the Bill will commence on the day following Royal Assent.

 

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. 

 

SCHEDULE 1 AMENDMENTS

 

Age Discrimination Act 2004

 

Item 1 - This item amends the Age Discrimination Act 2004 to provide that it does not apply to the new Part 1A to be added to the Dental Benefits Act 2008 by Item 5 in this Schedule. 

 

The Age Discrimination Act already provides that the Act does not apply to section 5 and Part 4 of the Dental Benefits Act.  This is because the Act has previously limited benefits to children.  It is expected that agreements with the states to be entered into under the new Part 1A will provide for services for all children but only concession cardholder adults.

 

Dental Benefits Act 2008

 

Item 2 - This item amends the title of the Act to reflect that it will no longer provide a framework for dental benefits.

 

Item 3 - This item replaces the simplified outline of the Act with a new outline reflecting its main focus on providing financial assistance to states and territories in relation to dental services.

 

Item 4 - This item limits the application of the definition of dental service in section 4 so that the term will have its ordinary meaning in the first sentence in the outline of the Act in section 3 and in the new Part 1A of the Act.

 

Item 5 - This item inserts a new Part 1A into the Act.  The new Part sets out a framework for the provision of grants of financial assistance to the states and territories.

 

New section 7B sets out a simplified outline of the Part, and section 7C defines various terms used in the Part.

 

Section 7D empowers the Minister, by notifiable instrument, to determine amounts to be paid to a state by way of financial assistance in relation to dental services provided on or after 1 July 2016.  The Minister must not make a determination unless an agreement is in place between the Commonwealth and the state as provided for in section 7E, and in making the determination the Minister must have regard to the agreement.

 

Section 7E empowers the Commonwealth to enter into agreements with the states relating to financial assistance for the provision of dental services.  The Government intends that agreement made under this section will be published on the COAG website, as are existing National Partnership Agreements.

 

Section 7F provides that the terms and conditions applying to the grant are those set out in the agreement, and any other terms and conditions determined by the Minister by legislative instrument. 

 

The ability for the Minister to set additional terms and conditions is intended as a reserve power to cover unforeseen circumstances.  As any such terms and conditions will be in a legislative instrument they will be subject to Parliamentary scrutiny and potential disallowance.

 

Section 7G provides that financial assistance is subject to a cap.  The cap for the first three years is set as:

2016-17           $415,616,000

2017-18           $415,632,000

2018-19           $420,224,000

 

For 2019-20 and later years the cap will be calculated as the previous year’s cap multiplied by an indexation factor and a population factor.

 

The cap for a financial year applies to the amount payable in respect of services rendered in that financial year, but does not limit the amount to be paid during that financial year.  If the terms of a section 7E agreement involve the calculation of  payments based on activity during a financial year, and that activity is not reported until a later financial year, payments can still be made in that later financial year (as long as the cap for the first year has not been reached). 

 

Section 7H sets out the calculation of the indexation factor by reference to the ratio between the ABS CPI index number for the twelve months to December preceding the financial year, and the ABS CPI index number for the preceding twelve months.

 

Section 7J sets out the population factor by reference to the growth in the estimated resident population in the twelve months to December preceding the financial year.  This figure is published by the Australian Bureau of Statistics in its quarterly publication 3101.0 - Australian Demographic Statistics.

 

Indexation under sections 7H and 7J by reference to a period ending before the financial year will allow the cap on financial assistance to be determined before the financial year begins, thus allowing certainty for state governments in planning the provision of public dental services.

 

Section 7K creates a special appropriation for the purpose of making the grants under section 7D. 

 

Section 7L requires the Minister to commission an independent review of the operation of the Part to be conducted before the end of 2020, and sets out the composition of the panel to conduct the review.  The report of the review must be tabled in the Parliament within 15 sitting days of its provision to the Minister. 

 

This provision mirrors the existing section 68 of the Act (to be repealed by Item 27), except that it is a once-off rather than a recurring triennial review.  The government will continue to monitor the operation of the Act, and does not consider triennial statutory reviews to be necessary.

 

Items 6 and 7 - These items amend the heading and simplified outline of Part 2 of the Act to make it clear that the Part establishes an entitlement to dental benefits only for services rendered before 1 July 2016.

 

Item 8 - This item amends subsection 9(1) to provide that dental benefits are only payable in respect of services rendered before 1 July 2016.

 

Items 9 and 10 - These items amend the heading and simplified outline of Part 3 of the Act to make it clear that the Part deals with the payment of dental benefits only for services rendered before 1 July 2016.

 

Item 11 - This item amends subsection11(1) to provide that dental benefits are only payable in respect of services rendered before 1 July 2016.

 

Items 12 and 13 - These items amend section 20B, dealing with directions by the Minister to practitioners who are wholly or partly disqualified from providing dental services to refrains from providing services.  Item 12 amends subsection 20B(1) to provide that directions can only be provided before 1 July 2016, and Item 13 inserts a new subsection 20B(3A) to provide for the revocation of any directions at the end of 30 June 2016.

 

Items 14 and 15 - These items amend section 20D, dealing with directions by the Minister to practitioners who are wholly or partly disqualified from providing dental services to display notices of disqualification.  Item 14 amends subsection 20D(1) to provide that directions can only be provided before 1 July 2016, and Item 15 inserts a new subsection 20D(4A) to provide for the revocation of any directions at the end of 30 June 2016.

 

Items 16 to 18 - These items amend the heading and simplified outline of Part 4 of the Act to make it clear that the Part does not require vouchers to be issued after 1 July 2016, and that any vouchers issued for 2016 cease to have effect at the end of 30 June 2016.

 

Item 19 - This item inserts a new section 22A providing that a reference to a calendar year in Part 4 does not include a calendar year after 2016.

 

Item 20 - This item amends section 27 to insert new subsection 27(2A) providing that a voucher must not be issued after 30 June 2016.

 

Items 21 to 23 - These items amend the heading of section 31, and include a new subsection 31(2) providing that a voucher issued for the 2016 calendar year ceases to have effect at the end of 30 June 2016.

 

Item 24 - This item amends section 34, to provide that protected information does not include information obtained by a person performing duties or functions or exercising powers under new Part 1A of the Act.  Under Part 1A information will only relate to the affairs of states, not individuals.

 

Item 26 - This item amends the simplified outline of Part 6 to make it clear that Division 4 does not deal with recovery of amounts paid under new Part 1A.

 

Item 25 - This item amends the heading of Division 4 of Part 6 to make it clear that the Division does not deal with recovery of amounts paid under new Part 1A.

 

Item 27 - This item repeals section 68, dealing with the review of the Act.  Item 5 inserts a new section 7L requiring a review of the new Part 1A of the Act by the end of 2020.

 

Human Services (Medicare) Act 1973

 

Item 28 - This item amends the definition of dental service in subsection 3A(3) to align it with the definition in the Dental Benefits Act as amended by Item 4 in this schedule.

 

Item 29 - This item amends section 41G to provide that services, benefits, programs or facilities provided under new Part 1A of the Dental Benefits Act are not “medicare programs”.