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AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH AND AGED CARE

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Aboriginal Community Controlled Health Services) Direction (No. 3) 2024

I, Nigel Murray, Assistant Secretary, MBS Policy and Specialist Programs Branch, Medicare Benefits and Digital Health Division, Health Resourcing Group, delegate for the Minister for Health and Aged Care, acting under subsection 19(2) of the Health Insurance Act 1973 (the Act) hereby:

    (1)               REVOKE the Direction made under subsection 19(2) of the Act in respect of professional services provided by Aboriginal Community Controlled Health Services titled the Health Insurance (Medicare Benefits Payable in Respect of Professional Services – Aboriginal Community Controlled Health Services) Direction (No. 2) 2024, dated 17 June 2024; and

    (2)               DIRECT that Medicare benefits shall be payable in respect of:

      (a)     a professional service (as defined in section 3 of the Act) which has been agreed to be provided as part of the Indigenous Australians' Health Program between the Department of Health and Aged Care (ABN: 83 605 426 759) and the organisations listed in Schedule B of this Direction, in relation to medical services for which:

         (i)     items specified in Schedule A of this Direction and of the general medical services table (means the table prescribed under subsection 4(1) of the Act) relate, diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Act) or pathology services table (means the table prescribed under subsection 4A(1) of the Act) relate; and

      (b)     where the professional service is provided to:

         (i)     an eligible person (as defined in section 3 of the Act) who is;

             (A) not receiving the service as part of an episode of hospital treatment (as defined in section 121-5 of the Private Health Insurance Act 2007); and

             (B) not receiving a service which attracts a payment through the 2020-2025 Addendum to the National Health Reform Agreement for a service rendered to a public patient; and
      (c)     the professional services referred to in paragraph 2(a) must be provided:

        (i)       by, or on behalf of, a salaried medical practitioner, or by a salaried participating midwife or participating nurse practitioner, where the service is a non-referred professional service; or

        (ii)     by a salaried allied health professional, dental practitioner, optometrist, eligible Aboriginal and Torres Strait Islander health practitioner or eligible Aboriginal health worker, where the service is a referred professional service; and

        (iii)  by a person who is employed or engaged by an organisation listed in Schedule B to this Direction.

DECLARE that this Direction commences on 19 August 2024 and ceases to have effect at the end of 30 June 2032 unless earlier revoked.

Note, a number of expressions used in this direction