Health Insurance (Section 3C General Medical Services — Artificial Bowel Sphincter Services) Determination 2023

Contents

1Name#

This instrument is the Health Insurance (Section 3C General Medical Services — Artificial Bowel Sphincter Services) Determination 2023.

3Authority#

This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.

4Cessation#

Unless revoked earlier, this instrument will cease on 30 June 2028.

5Definitions#

(1)In this instrument:

Act means the Health Insurance Act 1973.

(Anaes.) has the meaning given by subclause 5.9.4(1) of the general medical services table.

(H) has the meaning given by clause 1.1.7 of the general medical services table.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health act 1953, relating to medical services, professional services or items.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.

Schedule means a Schedule to this instrument.

Note: The following terms are defined in subsection 3(1) of the Act

 clinically relevant service;

 general medical services table;

 item;

 professional service.

(2)Unless the contrary intention appears, a reference in this instrument to a provision of the Act of the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

6Treatment of relevant services#

For subsection 3C(1) of the Act, a relevant service, provided in accordance with this instrument and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a)it were both a professional service and a medical service; and

(b)there were an item in the general medical services table that:

i. related to the service; and

ii. specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

7Application of provisions of the general medical services table#

(1)Clause 1.2.6 of the general medical services table shall have effect as if the item in the Schedule of this instrument were specified in subsection (1) of that clause.

(2)Clause 1.2.7 of the general medical services table shall have effect as if the item in the Schedule of this instrument were specified in subsection (1) of that clause.

(3)Clause 5.1.1 of the general medical services table shall have effect as if the item in the Schedule of this instrument were specified for the purposes of that clause.

8When artificial bowel sphincter is contraindicated for item 32221#

(1)An artificial bowel sphincter under item 32221 is contraindicated in:

(a)patients with inflammatory bowel disease, pelvic sepsis, pregnancy, progressive degenerative diseases or a scarred or fragile perineum; and

(b)patients who have had an adverse reaction to radiopaque solution; and

(c)patients who engage in receptive anal intercourse.

8A Indexation

(1) At the start of 1 July 2026 (the indexation time), each amount covered by subsection (2) is replaced by the amount worked out using the following formula:

Note: The indexed fees could in 2026 be viewed on the Department of Health, Disability and Ageing’s MBS Online website (www.mbsonline.gov.au).

(2) The amounts covered by this subsection are the fee for each item in Schedule 1 of this Determination.

(3) An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).

9Schedules#

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 · Relevant Services

Group T8—Surgical operations
Column 1Item	Column 2Description	Column 3Fee ($)
Subgroup 2—Colorectal
32221	Removal or revision of an artificial bowel sphincter (with or without replacement) for severe faecal incontinence in the treatment of a patient for whom conservative and other less invasive forms of treatment are contraindicated or have failed (H) (Anaes.) (Assist.)	1,054.45

Sourced from the Federal Register of Legislation at legislation.gov.au, © Commonwealth of Australia, licensed under CC BY 4.0. Compilations may have been reformatted.

Health Insurance (Section 3C General Medical Services — Artificial Bowel Sphincter Services) Determination 2023

1Name#

3Authority#

4Cessation#

5Definitions#

6Treatment of relevant services#

7Application of provisions of the general medical services table#

8When artificial bowel sphincter is contraindicated for item 32221#

9Schedules#

Schedule 1 · Relevant Services

Connections

Defined terms · 6

Key facts

History · 1 version

1Name#

3Authority#

4Cessation#

5Definitions#

6Treatment of relevant services#

7Application of provisions of the general medical services table#

8When artificial bowel sphincter is contraindicated for item 32221#

9Schedules#

Schedule 1 · Relevant Services