Health Insurance Amendment (Extended Medicare Safety Net) Act 2009 No. 101, 2009 An Act to amend the Health Insurance Act 1973, and for related purposes Contents 1 Short title 2 Commencement 3 Schedule(s) Schedule 1—Health Insurance Act 1973 Health Insurance Amendment (Extended Medicare Safety Net) Act 2009 No. 101, 2009 An Act to amend the Health Insurance Act 1973, and for related purposes [Assented to 7 October 2009] The Parliament of Australia enacts: 1 Short title This Act may be cited as the Health Insurance Amendment (Extended Medicare Safety Net) Act 2009. 2 Commencement This Act commences on 1 January 2010. 3 Schedule(s) Each Act that is specified in a Schedule to this Act is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Act has effect according to its terms. Schedule 1—Health Insurance Act 1973 1 After subsection 10ACA(7) Insert: (7A) Despite subsections (2) and (7), if the current claim is for a service specified in an item determined under section 10B to be an item to which this subsection applies, the increase under this section in the benefit payable in respect of the claim cannot exceed the amount determined under section 10B as the maximum increase for that item. Note: This subsection does not limit the increase payable in respect of a claim for a service specified in an item not determined under section 10B to be an item to which this subsection applies. (7B) If: (a) for the purposes of the pathology services table: (i) 2 or more pathology services are treated as a single pathology service; and (ii) the fee for the single service is the fee specified in one or more particular items in the table; and (b) one or more of those particular items (the limited increase items) are items determined under section 10B to be items to which subsection (7A) of this section applies; then, for the purposes of that subsection, the single service is taken to be specified in the limited increase item or, if there are 2 or more limited increase items, in the one of those items for which the maximum increase determined under section 10B is the greatest. Note: Section 4B lets regulations provide for a rule of interpretation of the pathology services table to treat 2 or more pathology services as a single pathology service. 2 After subsection 10ADA(8) Insert: (8A) Despite subsections (3) and (8), if the current claim is for a service specified in an item determined under section 10B to be an item to which this subsection applies, the increase under this section in the benefit payable in respect of the claim cannot exceed the amount determined under section 10B as the maximum increase for that item. Note: This subsection does not limit the increase payable in respect of a claim for a service specified in an item not determined under section 10B to be an item to which this subsection applies. (8B) If: (a) for the purposes of the pathology services table: (i) 2 or more pathology services are treated as a single pathology service; and (ii) the fee for the single service is the fee specified in one or more particular items in the table; and (b) one or more of those particular items (the limited increase items) are items determined under section 10B to be items to which subsection (8A) of this section applies; then, for the purposes of that subsection, the single service is taken to be specified in the limited increase item or, if there are 2 or more limited increase items, in the one of those items for which the maximum increase determined under section 10B is the greatest. Note: Section 4B lets regulations provide for a rule of interpretation of the pathology services table to treat 2 or more pathology services as a single pathology service. 3 After section 10A Insert: 10B Determinations for subsections 10ACA(7A) and 10ADA(8A) (1) The Minister may by legislative instrument do either or both of the following: (a) determine that subsections 10ACA(7A) and 10ADA(8A) apply to specified items; (b) determine amounts as the maximum increases for items to which subsections 10ACA(7A) and 10ADA(8A) are determined to apply. Note: For specification by class, see subsection 13(3) of the Legislative Instruments Act 2003. (2) A determination made under subsection (1) does not come into effect until it has been approved by resolution of each House of the Parliament. 3A After section 10A Insert: 10C Evaluation of the caps measures (1) The Minister must cause an independent evaluation to be conducted of the impact and operation of determinations made by the Minister under section 10B. (2) The evaluation must start not later than 1 April 2011. (3) The Minister must cause a written report of the evaluation to be prepared. (4) The Minister must cause a copy of the report to be laid before each House of the Parliament by 1 July 2011. 4 Application Subsections 10ACA(7A) and 10ADA(8A) of the Health Insurance Act 1973 (as amended by this Schedule) apply in relation to services rendered on or after the commencement of those subsections. [Minister's second reading speech made in— House of Representatives on 28 May 2009 Senate on 16 June 2009] (90/09)