{"id":"F2023L00741","name":"Health Insurance (Section 3C Pathology –17p chromosomal deletion testing) Determination 2023","slug":"health-insurance-section-3c-pathology-17p-chromosomal-deletion-testing-determination-2023","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441918,"registerId":"F2023L00741-fast-fetch-1775957082582","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Health Insurance (Section 3C Pathology –17p chromosomal deletion testing) Determination 2023","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 22.10.0\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![Commonwealth Coat of Arms of Australia](image.001.jpeg)\n\n \n\nHealth Insurance (Section 3C Pathology –17p chromosomal deletion testing) Determination 2023\n\nI, Daniel McCabe, delegate of the Minister for Health and Aged Care, make the following Determination.\n\nDated  6 June 2023\n\nDaniel McCabe\n\nFirst Assistant Secretary\n\nMedicare Benefits and Digital Health Division\n\nHealth Resourcing Group\n\nDepartment of Health and Aged Care\n\n \n\n \n\n \n\n \n\n \n\n \n\nContents\n\n1.  Name\n\n2.  Commencement\n\n3.  Authority\n\n4.  Definitions\n\n5.  Treatment of relevant services\n\n6.  Schedules\n\nSchedule – relevant services\n\n1.  Name\n\n This instrument is the Health Insurance (Section 3C Pathology –17p chromosomal deletion testing) Determination 2023.\n\n2.  Commencement\n\n(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.\n\n \n\n- Commencement information\n- Column 1 Column 2 Column 3\n- Provisions Commencement Date/Details\n- 1. The whole of this instrument Immediately after the commencement of Schedule 3 of the Health Insurance Legislation Amendment (2023 Measures No. 2) Determination 2023\n\n\n Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.\n\n(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.\n\n3.  Authority\n\n  This instrument is made under subsection 3C(1) of the Health Insurance Act 1973.\n\n4.  Definitions\n\n (1) In this instrument:\n\nAct means the Health Insurance Act 1973.\n\nPathology services table means the table prescribed under subsection 4A(1) of the Act.\n\nrelevant 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.\n\nrelevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.\n\nSchedule means a Schedule to this instrument.\n\nNote: The following terms are defined in subsection 3(1) of the Act:\n\n- clinically relevant service;\n- pathology services table;\n- item;\n- professional service.\n\n\n (2) Unless the contrary intention appears, a reference in this instrument to a provision of the Act or 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.\n\n \n\n5.  Treatment of relevant services\n\n \n\n(1)     For subsection 3C(1) of the Act a relevant service, provided in accordance with this Determination and as a clinically relevant service, is to be treated, for the relevant provisions, as if:\n\n(a)      it were both a professional service and a pathology service; and\n\n(b)     there were an item in Group P7 of the pathology services table that:\n\n(i)  related to the service; and\n\n(ii) specified for the service a fee in relation to each State, being the fee specified in Schedule 1 in relation to the service.\n\n \n\n6.  Schedules\n\nEach instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable term in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.\n\n \n\n \n\nSchedule – relevant services\n\n \n\n- Group P7—Genetics\n- Item Description Fee ($)\n- 73343 Detection of 17p chromosomal deletions by fluorescence in situ hybridisation or genome wide micro-array, in a patient with chronic lymphocytic leukaemia or small lymphocytic lymphoma, on a peripheral blood, bone marrow or lymph node sample, requested by a specialist or consultant physician.For any particular patient at initial diagnosis, at disease relapse, or on disease progression only where initiation of, or change in therapy is anticipated. 589.90\n\n\n \n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":2,"scope_assessment":{"changed":false,"description":"This instrument serves its precise original purpose: adding one specific genetic test to the Medicare Benefits Schedule. It does not expand beyond the narrow scope of subsidising 17p chromosomal deletion testing for CLL/SLL patients."},"complexity_factors":["Very short instrument (6 sections plus 1-item Schedule)","Only 4 defined terms in section 4","Single operational provision (section 5) with straightforward deeming mechanism","No nested exceptions or conditional logic beyond the clinical criteria in the Schedule item","Minimal cross-referencing (only to parent Act and standard pathology table provisions)","Single service item with clear fee specification ($589.90)"],"plain_english_summary":"This law adds a Medicare-funded genetic test for 17p chromosomal deletions in patients with chronic lymphocytic leukaemia or small lymphocytic lymphoma. It’s available when treatment is being considered or changed—at diagnosis, relapse, or progression—and must be requested by a specialist or consultant physician.\n\nWhy it matters: the test identifies patients unlikely to respond to standard chemotherapy, directing them to better-targeted therapies and avoiding out‑of‑pocket costs (~$590)."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"The Determination expands the scope of Medicare‑funded pathology services by adding item 73343 (17p deletion testing for CLL/SLL) to Group P7 with an explicit fee of $589.90 and specific clinical request conditions. This creates a new payable service under subsection 3C(1), altering which tests are treated as clinically relevant and eligible for Medicare benefits."},"complexity_factors":["Single substantive change: insertion of one pathology item (Item 73343) with a single fee; limited legislative content to amend.","Cross‑references to multiple statutes and provisions (subsection 3C(1) of the Health Insurance Act 1973; pathology services table; National Health Act 1953) require familiarity with external billing and clinical definitions.","Operational conditions embedded in the item (requested by specialist/consultant; limited to initial diagnosis, relapse, or progression when therapy change is anticipated) create conditional eligibility that affects clinical decision and billing workflows.","Commencement is tied to an external instrument (Schedule 3 of a named Amendment Determination), so implementation timing requires coordination across instruments.","Treatment as both a 'professional service' and a 'pathology service' affects how providers classify and bill the test within Medicare rules, potentially implicating different administrative rules despite a single item entry."],"plain_english_summary":"This Determination adds a single pathology item to Medicare: detection of 17p chromosomal deletions (by FISH or genome‑wide microarray) for patients with chronic lymphocytic leukaemia or small lymphocytic lymphoma. The test is item 73343 in Group P7 with a fee of $589.90. It is payable when a specialist or consultant physician requests the test at initial diagnosis, relapse, or progression where starting or changing therapy is anticipated. Medicare will treat the service as both a professional and pathology service for billing under the Health Insurance Act."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/health-insurance-section-3c-pathology-17p-chromosomal-deletion-testing-determination-2023","history":"/api/acts/health-insurance-section-3c-pathology-17p-chromosomal-deletion-testing-determination-2023/history","analysis":"/api/acts/health-insurance-section-3c-pathology-17p-chromosomal-deletion-testing-determination-2023/analysis","conflicts":"/api/acts/health-insurance-section-3c-pathology-17p-chromosomal-deletion-testing-determination-2023/conflicts","importantCases":"/api/acts/health-insurance-section-3c-pathology-17p-chromosomal-deletion-testing-determination-2023/important-cases","documents":"/api/acts/health-insurance-section-3c-pathology-17p-chromosomal-deletion-testing-determination-2023/documents"}}