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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). The 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.