On May 20, AST GVT registered some instruments re health insurance.
AST GVT registered Health insurance (section 3C co-dependent pathology services) amendment (no. 1) determination 2024 (first instrument) to amend co-dependent Medicare Benefits Schedule (MBS) pathology item in the principal determination.
Principal determination is titled Health insurance (section 3C co-dependent pathology services) determination 2018; issued explanatory statement regarding amendment.
Follows AST GVT Dec. 2021 compiled health insurance determination, see #125054.
Other Instruments Registered
AST GVT also registered Health insurance legislation amendment (nuclear medicine imaging services) determination 2024 (second instrument), explanatory statement.
In addition, it also registered the Health insurance (section 3C general medical services - heart health assessment no.2) amendment (prescribed medical practitioner) determination 2024 (third instrument), along with an explanatory statement re same.
Section 3C Co-Dependent Pathology
AST GVT said first instrument aims to enable medical practitioners to request testing.
Specifically, for additional groups of patients; namely those with triple-negative early breast cancer (referred to as TNBC) or hormone receptor (HR)-positive, HER2-negative early (stage 1 to 2) breast cancer with high-risk characteristics of high-grade tumor.
AST GVT said the purpose of testing is to determine if they can access poly-ADP ribose polymerase inhibitor (PARP) inhibitors on the Pharmaceutical Benefits Scheme (PBS).
Section 3C Diagnostic Imaging
AST GVT said second instrument amends the Health insurance (section 3C diagnostic imaging - conjunctive thallium-201 nuclear medicine imaging service) determination 2023 as well as the Health insurance (section 3C diagnostic imaging services - conjunctive gallium-67 nuclear medicine imaging service) determination 2022.
Namely, to increase the schedule fee for MBS temporary items 61470 and 61477.
This aims to address ongoing worldwide supply issue for certain radiopharmaceuticals.
General Medical Services
Third instrument amends Health insurance (section 3C general medical services - heart health assessment no.2) determination 2019 in order to apply annual fee indexation.
Plus, makes administrative amendments post the Nov. 1, 2023 incorporation of Health insurance insurance (section 3C general medical services - other medical practitioner) determination 2018 into Health insurance (general medical services table) regulations.
These administrative amendments will update terminology to reflect use of prescribed medical practitioner in Health insurance (general medical services table) regulations (referred to as the GMST); and simplify provisions applying to MBS items 699 and 177.
Effectiveness
All of the amendment instruments commence on Jul. 1, 2024.
May 21, 2024 Additional Instrument Registered
On May 21, 2024, AST GVT registered Health insurance (section 3C pathology services - respiratory pathogen testing) determination 2024, which introduces new permanent pathology items 69421 and 69422 to the MBS; issued explanatory statement re same.
The new items will allow for nucleic acid testing for respiratory pathogens, which may include Covid-19, in patients with suspected respiratory infection; in force Jul. 1, 2024.
AST GVT also published explanatory statement which elaborates on the determination.
This determination amends Health insurance (section 3C diagnostic imaging – conjunctive thallium-201 nuclear medicine imaging service) determination 2023 above.
In addition, it also amends Health insurance (section 3C diagnostic imaging services – conjunctive gallium-67 nuclear medicine imaging service) determination 2022 above.
AST GVT also published explanatory statement to explain the amendments.
It amends item 38461 in the Health insurance (section 3C general medical services—transcatheter mitral valve repair) determination 2021 to allow additional devices to be accessed for transcatheter mitral valve repair in patients with degenerative mitral valve regurgitation; the determination will remove a requirement from item 38461.
It inserts new pathology item 73813 for point-of-care testing for detection of sexually transmissible bacterial infections such as neisseria gonorrhoea (NG).
An equivalent item for point-of-care testing by a nurse practitioner (item 73825) will be introduced on Nov. 1, 2024 by the Health insurance (section 3C midwife and nurse practitioner services) amendment (no. 1) determination 2024.
Both of the determinations commence on Nov. 1, 2024.
Explanatory statement said it also removes the requirement for a collaborative arrangement between participating nurse practitioner/midwife and medical practitioner.
Its explanatory statement said that it amends transcatheter aortic valve implantation (TAVI) items 38514 and 38522 to update the circumstances in which the items apply.
Both of the determinations commence on Nov. 1, 2024.
