ATTACHMENT

 

Details of the Health Insurance (General Medical Services Table) Amendment (After-hours Rural Area) Regulations 2018

 

Section 1 - Name

 

This section provides for the Regulations to be referred to as the Health Insurance (General Medical Services Table) Amendment (After-hours Rural Area) Regulations 2018.

 

Section 2 - Commencement

 

This section provides that the Regulations commence on 1 January 2019.

Section 3 - Authority 

 

This section provides that the Regulations are made under the Health Insurance Act 1973.

 

Section 4 - Schedule(s)

 

This section provides that each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

 

Schedule 1 - Amendments

 

Health Insurance (General Medical Services Table) Regulations 2018

 

Item 1 - Clause 2.16.4 of Schedule 1 (definition of after-hours rural area)

This item inserts "Modified Monash 2 area" after "area that is a". This allows services provided under item 588 to be claimed in Modified Monash 2 areas from 1 January 2019.

 

This change also amends the eligible area for item 591 to restrict it to Modified Monash 1 areas. Services in Modified Monash 2 areas that were previously claimed under this item will now be billed under item 588 which has a higher patient benefit.   

 

Modified Monash is a geographical classification system developed by the Department of Health (the Department) for categorising metropolitan, regional, rural and remote locations according to both geographical remoteness and population size, based on population data published by the Australian Bureau of Statistics. The Department uses the Australian Statistical Geography Standard (ASGS) system as published by the Australian Bureau of Statistics in July 2011, but has different numbering system. Maps of the Modified Monash areas and the Department's remoteness classification are available at www.doctorconnect.gov.au.

 

 

 

Statement of Compatibility with Human Rights

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

 

Health Insurance (General Medical Services Table) Amendment (After-hours Rural Area) Regulations 2018

This Legislative Instrument 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 Legislative Instrument

On 1 March 2018 changes were made to the existing Medicare urgent after-hours items and new items introduced to improve the quality of after-hours services and incentivise better value care through targeted benefits. This change was made through the Health Insurance Legislation Amendment (After-Hours Services) Regulations 2018.

 

Currently item 588 can only be claimed when the service is performed in an after-hours area (Modified Monash areas 3 to 7). Item 591 is claimed for any services outside of this area (Modified Monash areas 1 and 2). The purpose of the Health Insurance (General Medical Services Table) Amendment (After-hours Rural Area) Regulations 2018 (the Regulations) is to amend the eligible areas for these items.

 

From 1 January 2019 the eligible areas for item 588 will be Modified Monash areas 2 to 7 and, for item 591, Modified Monash area 1.  

Human rights implications

The Regulations engage Articles 9 and 12 of the International Covenant on Economic Social and Cultural Rights (ICESCR), specifically the rights to health and social security.

The Right to Health

The right to the enjoyment of the highest attainable standard of physical and mental health is contained in Article 12(1) of the ICESCR.  The UN Committee on Economic Social and Cultural Rights (the Committee) has stated that the right to health is not a right for each individual to be healthy, but is a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health.

The Committee reports that the 'highest attainable standard of health' takes into account the country's available resources.  This 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.

The Right to Social Security

The right to social security is contained in Article 9 of the ICESCR.  It 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.

The Committee reports 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 previously entitled to them.  However, it is legitimate for a Government to re-direct its limited resources in ways that it considers to be more effective at meeting the general health needs of all society, particularly the needs of the more disadvantaged members of society.

Analysis

The Regulations will maintain rights to health and social security by ensuring access to publicly subsidised health services which are clinically effective and cost-effective. Patients will continue to have access to clinically necessary urgent after-hours services under Medicare.

Conclusion

This Legislative Instrument is compatible with human rights as it does not raise any human rights issues.

 

Greg Hunt

Minister for Health