This bill became law on Aug 21st, 2023.
Health, care & disability
People needing Medicare-covered cleft lip, cleft palate or craniofacial treatment can keep getting benefits after age 22 if their treatment was delayed or not arranged earlier.
Age limits and treatment delays, including COVID-19 disruptions, left some cleft and craniofacial patients denied Medicare benefits, while outdated administration rules also created inconsistencies for doctor placement and bonded service obligations. The bill removes the dental age restriction, lets Services AustraliaThe federal agency that runs the placement register and can now use computer programs to update doctor records under the bill. update placement records by computer after eligibility decisions, and aligns bonded program rules.
Medicare already covered major cleft lip, cleft palate and craniofacial treatment, but the scheme cut off eligibility at age 22 and the ActThe main law being amended; it contains the rules for Medicare benefits, approved placements and the bonded medical scheme. also contained outdated administrative rules for approved doctor placements and bonded medical service, leaving some patients denied support because of age rather than clinical need. The bill responded by removing the age cap, broadening prostheses coverage linked to dental treatment and tidying those doctor-administration rules, before Parliament passed it and Royal AssentThe final step that turns a passed bill into law after Parliament has approved it. turned the changes into law.
The main criticism was that the bill fixed one Medicare gap for cleft and craniofacial patients but still left out broader ongoing care, especially speech pathology and other multidisciplinary support many patients need for life. That concern was raised by crossbench and Greens speakers, while the Coalition also said the bill should go further, so the criticism was limited and mostly about scope rather than opposition to the bill itself.
Ged Kearney MP introduced this bill. It passed on the voices.
Did it become law?
Yes
Became law 21 Aug 2023
Final passage
Passed without a counted vote
1 recorded amendment or procedural vote was found, but no counted vote on the bill itself was recorded.
Passage speed
152 days
From introduction to the latest recorded parliamentary step
Meaning
People needing Medicare-covered cleft lip, cleft palate or craniofacial treatment can keep getting benefits after age 22 if their treatment was delayed or not arranged earlier.
Medicare can also cover prostheses linked to dental treatment more broadly, instead of limiting this support to the old prescribed dental patientThe old legal category used to decide who could get Medicare benefits for certain cleft and dental services; the bill removes the age cap tied to this label. category.
Services AustraliaThe federal agency that runs the placement register and can now use computer programs to update doctor records under the bill. can use computer programs to add and remove doctors from the Register of Approved PlacementsThe official list of doctors who are approved to take part in certain Medicare-linked training or workforce programs. after an eligibility decision has already been made.
Doctors in the Bonded Medical ProgramA program that gives medical students a Commonwealth-supported place in return for later working in regional, rural or remote areas. must now complete their rural or regional service in 156 weeks, which matches how the obligation is already counted and makes tracking simpler.
Doctors in the Bonded Medical ProgramA program that gives medical students a Commonwealth-supported place in return for later working in regional, rural or remote areas. must get at least 14 days to answer written information requests, and the government can extend that deadline in writing.
Item 4 repeals section 3BA which is in relation to prescribed dental patients. This change will confer eligibility for Medicare benefits to patients who were unable to attain treatment before reaching 22 years of age.Health Insurance Amendment (Prescribed Dental Patients and Other Measures) explanatory memorandum
Item 6 amends the definition of a health service in subsection 3C(8) by amending paragraph (d) to remove the reference to other circumstances described in paragraph (c) of this subsection. This amendment specifies that a health service means the supply of prostheses in connection with dental treatment. This is a consequential amendment subject to repealing paragraph (c) of subsection 3C(8) (refer to Item 5 of Schedule 1).Health Insurance Amendment (Prescribed Dental Patients and Other Measures) explanatory memorandum
Currently, the Health Insurance Act 1973 does not allow for this step of the process to be automated through a computer system. This bill enables Services Australia to achieve efficiencies by developing systems that support an automated approach. Specifically, systems to support placing doctors on, and removing doctors from, the Register of Approved Placements once a decision has been made by a specified body. There are over 10,000 placements processed each year.Second reading speech
Item 1 amends subsection 124ZF(1) of the Act by replacing “3 years” with “156 weeks”. This change will provide that a bonded participant must work as a medical practitioner in an eligible location for a period of 156 weeks, as opposed to 3 years.Health Insurance Amendment (Prescribed Dental Patients and Other Measures) explanatory memorandum
Item 3 amends section 124ZG which relates to the conditions of the Bonded Medical Program, by inserting two new subsections. New subsection 124ZG(3) provides that for the purposes of paragraph 124ZG(1)(e) which relates to the Secretary requesting information or documents from the bonded participant, the request must be made in writing, and that the specified period must not end sooner than 14 days after the day the request is made.Health Insurance Amendment (Prescribed Dental Patients and Other Measures) explanatory memorandum
Context
Medicare already covered major cleft lip, cleft palate and craniofacial treatment, but the scheme cut off eligibility at age 22 and the ActThe main law being amended; it contains the rules for Medicare benefits, approved placements and the bonded medical scheme. also contained outdated administrative rules for approved doctor placements and bonded medical service, leaving some patients denied support because of age rather than clinical need. The bill responded by removing the age cap, broadening prostheses coverage linked to dental treatment and tidying those doctor-administration rules, before Parliament passed it and Royal AssentThe final step that turns a passed bill into law after Parliament has approved it. turned the changes into law.
Existing age cap leaves some cleft and craniofacial patients without Medicare support
Speeches on the bill said the current scheme limited eligibility to people treated by age 22, which meant some patients could be denied Medicare benefits because of age rather than clinical need.
Hansard ↗Government introduces a bill to remove the age restriction and fix health administration rules
The second reading speech said the bill would remove age limits for eligible cleft and craniofacial services, broaden prostheses coverage and align rules for approved placements and bonded doctors.
Hansard ↗Parliament passes the bill
Both houses passed the bill in the same form, completing its parliamentary passage and clearing the way for the changes to take legal effect.
Parliamentary timeline ↗Royal AssentThe final step that turns a passed bill into law after Parliament has approved it. makes the changes law
Royal AssentThe final step that turns a passed bill into law after Parliament has approved it. turned the bill into an Act, locking in ongoing Medicare access for eligible cleft and craniofacial patients beyond age 22 and the related administrative amendments.
Parliamentary timeline ↗Legislative route
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
Introduced and read a first time
A minister or sponsoring member moved the second reading, opening the main debate on the bill's purpose and principles.
Second reading moved
The bill reached this recorded parliamentary step.
The bill reached this recorded parliamentary step.
Referred to Federation Chamber
The bill reached this recorded parliamentary step.
Second reading debate
The chamber agreed to the bill at second reading, meaning it accepted the bill in principle and allowed it to continue.
Second reading agreed to
The bill reached this recorded parliamentary step.
Reported from Federation Chamber
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Third reading agreed to
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
Introduced and read a first time
A minister or sponsoring member moved the second reading, opening the main debate on the bill's purpose and principles.
Second reading moved
The bill reached this recorded parliamentary step.
The chamber agreed to the bill at second reading, meaning it accepted the bill in principle and allowed it to continue.
Second reading agreed to
The bill reached this recorded parliamentary step.
The bill reached this recorded parliamentary step.
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Third reading agreed to
Both houses passed the bill in the same form, completing parliamentary passage.
Finally passed both Houses
The Governor-General gave Royal AssentThe final step that turns a passed bill into law after Parliament has approved it., turning the bill into an Act.
Key criticism
The main criticism was that the bill fixed one Medicare gap for cleft and craniofacial patients but still left out broader ongoing care, especially speech pathology and other multidisciplinary support many patients need for life. That concern was raised by crossbench and Greens speakers, while the Coalition also said the bill should go further, so the criticism was limited and mostly about scope rather than opposition to the bill itself.
Criticism focused on remaining gaps and consultation, not on blocking the bill.
Too narrow to cover ongoing care
Critics said the bill removed an unfair age limit but still did not cover important ongoing care linked to cleft and craniofacial conditionsBirth-related face and skull conditions, such as cleft lip and cleft palate, that often need long-term treatment., especially speech pathology and broader multidisciplinary treatment. Their concern was that patients would still face major support gaps even after this reform.
Consultation concerns
A narrower criticism was that the government had not properly worked with the cleft community on the remaining gaps, with concern that people directly affected were not adequately consulted about what services should be included.
Further sources
Votes
The bill passed both chambers on the voices. The counted divisions below were about amendments or procedure, not final passage.
House agreed to the bill's third reading on the voices, so there is no list of individual Aye and No votes for final passage in that chamber.
Passed on the voices
In a voice vote, members call out Aye or No and the presiding officer judges which side has it. Individual names are only recorded if a formal division is called.
Senate agreed to the bill's third reading on the voices, so there is no list of individual Aye and No votes for final passage in that chamber.
Passed on the voices
In a voice vote, members call out Aye or No and the presiding officer judges which side has it. Individual names are only recorded if a formal division is called.
Amendments grouped by chamber. These cards include amendment outcomes recorded without a counted division.
Senate
Defeated 10 to 26. Support came from Greens and Jacqui Lambie Network. Opposition came from Labor, UAP, Liberal Party, One Nation, and minor parties and independents.
The request was defeated, so the bill kept its original scope and did not add speech pathology items to the scheme.
The Senate agreed on voices to a second-reading statement calling for speech pathology funding for people affected by cleft lip and palate.
Carried on voices
The chamber decided this amendment without a counted division, so there is no list of individual Aye and No votes.
These are amendment votes, not the final passage vote on the bill itself. The bill passed both chambers on the voices.
Parliamentary debate
Start here — lead voices
Ged Kearney supports the bill, saying it will make Medicare fairer for people needing cleft and craniofacial treatment and improve health workforce administration.
Read in Hansard ↗Ryan supports the bill because it removes age limits that can block Medicare access for people with cleft and craniofacial conditionsBirth-related face and skull conditions, such as cleft lip and cleft palate, that often need long-term treatment..
Read in Hansard ↗Chisholm supports the bill, saying it will remove unfair age limits on Medicare support for cleft and craniofacial patients and improve access to timely treatment.
Read in Hansard ↗Freelander supports the bill and says it will remove age restrictions for patients with severe cleft and craniofacial conditionsBirth-related face and skull conditions, such as cleft lip and cleft palate, that often need long-term treatment., improve access to needed dental care, and simplify some related Medicare and bonded medical programA program that gives medical students a Commonwealth-supported place in return for later working in regional, rural or remote areas. rules.
Read in Hansard ↗All speeches by bloc
3 speakers · 5 contributions · 3 support
Hansard records 2 separate contributions by Anthony Chisholm, including an amendment-moving contribution. They are grouped here so the speaker is listed once.
Moved amendment
Chisholm supports the bill, saying it will remove unfair age limits on Medicare support for cleft and craniofacial patients and improve access to timely treatment. He also backs the administrative changes because they streamline placement processes and the Bonded Medical ProgramA program that gives medical students a Commonwealth-supported place in return for later working in regional, rural or remote areas..
“This Bill proposes changing the Cleft Lip and Cleft Palate Scheme to remove the unfair age restrictions that deny a small cohort of patients a Medicare reimbursement for treatment beyond the age of 22 years. This Bill will confer Medicare benefits eligibility to disadvantaged patients, including those who did not have treatment organised by their parents before reaching the age of 22, or those who have their treatment delayed beyond the age of 22 for other reasons, for example due to the COVID-19 pandemic.”Read this contribution in Hansard ↗
Second reading speech
Chisholm supports the bill, saying it will improve access to cleft and craniofacial treatment, speed up Medicare administration and fix inconsistencies in the bonded medical programA program that gives medical students a Commonwealth-supported place in return for later working in regional, rural or remote areas.. He says the government will not support the Greens' amendments because any further MBSThe list of medical services Medicare pays for; this bill changes which cleft, craniofacial and dental-related services can still attract benefits. changes need to be based on clinical evidence and MSACThe advisory body the government says should provide clinical evidence before adding more Medicare items. advice.
“The Medical Services Advisory Committee is an independent and expert committee comprising experienced clinicians and health economists. MSAC provides advice to government on whether a new medical service should be publicly funded and, if so, circumstance on and assessment of its comparative safety, clinical effectiveness, cost-effectiveness and total costs using the best available evidence. Any changes to the MBS funding for allied health services, including speech pathology for cleft patients, needs to be informed by a clinical evidence base and advice from the MSAC. For these reasons the government will not be supporting the amendments put forward by the Australian Greens. Options and pathways for further government consideration of the CleftPALS proposal will be determined by the MSAC executive. This could include consideration of further changes to the disability items in the MBS and may involve consideration of changes to the cleft scheme, as proposed by CleftPALS. The department will continue to consult with CleftPALS, Speech Pathology Australia and other stakeholders in progressing this work. The Australian government is committed to strengthening Medicare and putting the health of Australians first. I thank senators for their contribution to the debate on this bill.”Read this contribution in Hansard ↗
“All in all, this is a very important bill. It's not a minor bill. It does make some important differences to workforce training. We certainly know we need to improve our ability to get GPs, in particular, working in rural and regional areas. It also makes a big difference to those who've already signed up to the Bonded Medical Program being able to plan their lifestyle around much easier conditions. When I say 'easier conditions', I mean conditions that are simpler to understand. All in all, I commend this bill to the House. I know that, in the cleft palate community, this is going to make a big difference to many families.”Read the full speech in Hansard ↗
Hansard records 2 separate contributions by Ged Kearney, including an amendment-moving contribution. They are grouped here so the speaker is listed once.
Moved amendment
Ged Kearney supports the bill, saying it will make Medicare fairer for people needing cleft and craniofacial treatment and improve health workforce administration. She presents it as a practical strengthening of Medicare that removes unfair age limits and streamlines services for regional and rural communities.
“With this Bill, we will make it fair and equitable for young people needing cleft palate and craniofacial procedures, ensuring access to essential health care. We will also make significant administrative improvements to support our health workforce to deliver the care regional and rural communities need.”Read this contribution in Hansard ↗
Second reading speech
Kearney supports the bill, saying it will remove unfair age restrictions for cleft and craniofacial patients, speed up doctor placement on the Medicare register, and fix administrative inconsistencies in the health insurance laws.
“Under the current legislative arrangements, Medicare eligibility for treatment under the Cleft Lip and Cleft Palate Scheme requires a patient to meet complex and problematic access restrictions, with some patients being denied Medicare reimbursement for treatment based on age alone. Age limits for some patients were previously amended under the Health Insurance Amendment (Professional Services Review and Other Matters) Bill 2002. However, there continues to be a small number of patients who are denied treatment based on age. These changes will provide equity of access to treatment for those patients who suffer from certain cleft and craniofacial conditions relying upon a clinical requirement rather than age.”Read this contribution in Hansard ↗
3 speakers · 3 support
“The coalition supports the intent of this bill to improve access to affordable and life-changing procedures for those Australians impacted by these conditions and to ensure increased access to critical health care through Medicare. However, more can be done for these children, such as timely and affordable speech therapy.”Read the full speech in Hansard ↗
“Once again, we support the administrative improvements that are being introduced through this bill, particularly the affordable access to critical procedures that this legislation will provide to more young Australians impacted by cleft palate and craniofacial conditions.”Read the full speech in Hansard ↗
“Once again, we support this bill, in recognition of the important access to life-changing procedures that this legislation will provide to young Australians impacted by cleft palate and craniofacial conditions.”Read the full speech in Hansard ↗
1 speaker · 1 support
“Every year in Australia around 400 babies are born with a cleft. So the Australian Greens welcome this bill, the Health Insurance Amendment (Prescribed Dental Patients and Other Measures) Bill 2023, today. It will enable those with a cleft lip or palate to have access to the surgery they require at any age. Under current legislation, Medicare eligibility for treatment under the Cleft Lip and Cleft Palate Scheme for prescribed dental patients requires a person to meet complex and problematic access restrictions, with some people being denied treatment on the basis of age alone rather than on the basis of clinical need. This bill will allow a small cohort of patients who are currently denied Medicare reimbursement for treatment based on age alone to access Medicare benefits for the treatment they need, so the Greens join with the community in support of this bill.”Read the full speech in Hansard ↗
1 speaker · 1 support
“I rise to speak in support of the Health Insurance Amendment (Prescribed Dental Patients and Other Measures) Bill 2023. The purpose of this legislation is to amend the Health Insurance Act 1973 to improve access to the Medicare Benefits Schedule for eligible people with cleft and craniofacial conditions by removing the age restrictions, as well as making changes to rules around the Register of Approved Placements and rules around the administration of the Bonded Medical Program for medical graduates.”Read the full speech in Hansard ↗
Record
House · Introduced and read a first time
Introduced
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
House · Second reading moved
Second reading opened
A minister or sponsoring member moved the second reading, opening the main debate on the bill's purpose and principles.
House · Second reading debate
Second reading debate
The bill reached this recorded parliamentary step.
House · Referred to Federation Chamber
Referred to Federation Chamber
The bill reached this recorded parliamentary step.
House · Second reading debate
Second reading debate
The bill reached this recorded parliamentary step.
House · Second reading agreed to
Second reading agreed
The chamber agreed to the bill at second reading, meaning it accepted the bill in principle and allowed it to continue.
House · Reported from Federation Chamber
Reported from Federation Chamber
The bill reached this recorded parliamentary step.
House · Third reading agreed to
Third reading agreed
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Senate · Introduced and read a first time
Introduced
The bill was formally presented to the chamber and read a first time, which starts its parliamentary journey.
Senate · Second reading moved
Second reading opened
A minister or sponsoring member moved the second reading, opening the main debate on the bill's purpose and principles.
Senate · Second reading debate
Second reading debate
The bill reached this recorded parliamentary step.
Senate · Second reading agreed to
Second reading agreed
The chamber agreed to the bill at second reading, meaning it accepted the bill in principle and allowed it to continue.
Senate · Committee of the Whole debate
Committee of the Whole debate
The bill reached this recorded parliamentary step.
Senate · Committee of the Whole debate
Committee of the Whole debate
The bill reached this recorded parliamentary step.
Senate · Third reading agreed to
Third reading agreed
The chamber agreed to the bill at third reading, which completed passage through that chamber.
Parliament · Finally passed both Houses
Passed both houses
Both houses passed the bill in the same form, completing parliamentary passage.
Assent · Assent
Assent
The Governor-General gave Royal AssentThe final step that turns a passed bill into law after Parliament has approved it., turning the bill into an Act.
