5. Definitions

(1) In this Determination:

Act means the Health Insurance Act 1973.

Attendance means undertaking all of the following activities in relation to a TAVI Case Conference:

(a) retaining a record of the day the conference was held, and the times the conference started and ended;

(b) retaining a record of the names of the participants;

(c) provision of expertise to inform the recommendation resulting from the case conference;

(d) retaining a record of the recommendation resulting from the conference.

Coordination means undertaking all of the following activities in relation to a TAVI Case Conference:

(a) ensuring that the patient is aware of the purpose and nature of the patient’s TAVI Case Conference and has consented to their TAVI Case Conference;

(b) recording the day the conference was held, and the times the conference started and ended;

(c) recording the names of the participants of the conference;

(d) provision of expertise to inform the recommendation resulting from the case conference;

(e) recording minutes of the TAVI Case Conference including the recommendation resulting from the conference;

(f) ensuring that the patient is aware of the recommendation.

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 Determination.

TAVI means Transcatheter Aortic Valve Implantation.

TAVI Case Conference means a process by which:

(a) there is a team of 3 or more participants, where:

(i) the first participant is a cardiothoracic surgeon; and

(ii) the second participant is an interventional cardiologist; and

(iii) the third participant is a specialist or consultant physician who does not perform a service described in item 38495, 38514 or 38522 for the patient being assessed; and

(iv) either the first or the second participant is also a TAVI Practitioner; and

(b) the team assesses a patient’s risk and technical suitability to receive the service described in item 38495, 38514 or 38522, taking into account matters such as:

(i) the patient’s risk and technical suitability for a surgical aortic valve replacement; and

(ii) the patient’s cognitive function and frailty; and

(c) the result of the assessment is that the team makes a recommendation about whether or not the patient is suitable to receive the service described in item 38495, 38514 or 38522; and

(d) the particulars of the assessment and recommendation are recorded in writing.

TAVI Hospital means a hospital, as defined by subsection 121‑5(5) of the Private Health Insurance Act 2007, that is clinically accepted as being a suitable hospital in which the service described in item 38495, 38514 or 38522 may be performed.

TAVI Patient means a patient who, as a result of a TAVI Case Conference, has been assessed as having a high, intermediate or low risk for open surgical aortic valve replacement and is recommended as being suitable to receive the service described in item 38495, 38514 or 38522.

TAVI Practitioner means a cardiothoracic surgeon or interventional cardiologist who is accredited by the Cardiac Accreditation Services Limited.

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

 clinically relevant service

 general medical services table

 item

 practitioner

 professional service

(2) Unless the contrary intention appears, a reference in this Determination 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.