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This is a Bill, not an Act. For current law, see the Acts databases.
1996
The Parliament of
the
Commonwealth of
Australia
HOUSE OF
REPRESENTATIVES
Presented and read a first
time
Health
Insurance Amendment Bill (No. 2)
1996
No. ,
1996
(Health and Family
Services)
A Bill for an Act to amend the
Health Insurance Act 1973, and for related purposes
9614020—1,0000/15.10.1996—(140/96) Cat.
No. 96 5269 8 ISBN 0644 482397
Contents
Health Insurance Act
1973 6hia20h1.html
Health Insurance Act
1973 6hia20h1.html
Health Insurance Act 1973 6hia20h1.html
A Bill for an Act to amend the Health Insurance Act
1973, and for related purposes
The Parliament of Australia enacts:
This Act may be cited as the Health Insurance Amendment Act (No. 2)
1996.
(1) Subject to this section, this Act commences on the day on which it
receives the Royal Assent.
(2) Subject to subsections (3) and (4), if this Act receives the Royal
Assent before 1 November 1996, Schedules 1 and 2 commence on 1 November
1996.
(3) Subject to subsection (4), items 5, 6, 7 and 9 of Schedule 2 commence
on a day to be fixed by Proclamation.
(4) If a provision of this Act referred to in subsection (3) does not
commence within 6 months after the day on which this Act receives the Royal
Assent, it commences on the first day after the end of that period.
(5) Schedule 3 commences on 1 November 1997.
Subject to section 2, each Act that is specified in a Schedule to this
Act is amended or repealed as set out in the applicable items in the Schedule
concerned, and any other item in a Schedule to this Act has effect according to
its terms.
1 Subsection 3(1)
Insert:
general practitioner means:
(a) a medical practitioner in respect of whom a determination under
section 3EA is in force; or
(b) a person registered under section 3F as a vocationally registered
general practitioner; or
(c) a medical practitioner of a kind specified in the
regulations.
2 Subsection 3(17)
Repeal the subsection, substitute:
(17) For the purposes of this Act and the regulations, a service is taken
to be rendered on behalf of a medical practitioner if, and only if:
(a) it is rendered by another person who is not a medical practitioner,
and who provides the service, in accordance with accepted medical practice,
under the supervision of the medical practitioner; and
(b) it is not a service of a kind specified in regulations made for the
purposes of this paragraph.
3 After section 3E
Insert:
(1) A medical practitioner may apply to the Commission for a determination
under this section.
(2) After receiving an application, the Managing Director of the
Commission must, within the required period under subsection (3), determine that
the applicant is a recognised Fellow of the Royal Australian College of General
Practitioners if the Royal Australian College of General Practitioners gives the
Managing Director written notice stating that the applicant:
(a) is a Fellow of the Royal Australian College of General Practitioners;
and
(b) is eligible, in accordance with the regulations, for a determination
under this section.
(3) The required period for the purposes of subsection (2)
is:
(a) the period of 14 days after the notice under subsection (2) was
received by the Commission; or
(b) if the application was made after the notice was received—the
period of 14 days after the application was received by the
Commission.
(4) The Managing Director must give the applicant written notice of the
day on which the determination will enter into force.
(5) The Commission may give the Royal Australian College of General
Practitioners information about whether or not determinations under this section
are in force in respect of particular persons.
(6) The Managing Director or an authorised officer may make available to
members of the public, on request:
(a) the names of medical practitioners in respect of whom determinations
under this section are in force; and
(b) the addresses at which they practise.
(7) In this section:
authorised officer means a Commission staff member authorised
by the Managing Director as an authorised officer for the purposes of this
section.
Commission staff member means a member of the staff of the
Commission referred to in subsection 28(1) of the Health Insurance Commission
Act 1973.
(1) The Managing Director of the Commission must revoke a determination
under section 3EA in respect of a medical practitioner if:
(a) the medical practitioner requests the Managing Director to do so;
or
(b) the Royal Australian College of General Practitioners gives the
Managing Director written notice that:
(i) the medical practitioner is not a Fellow of the Royal Australian
College of General Practitioners; or
(ii) the regulations require that the determination be revoked;
or
(c) the regulations require that the determination be revoked.
(2) Before revoking the determination, the Managing Director must give the
medical practitioner written notice that the determination is to be
revoked.
(3) The notice must specify the day on which the determination is to be
revoked.
(4) The day specified under subsection (3) must not be less than 14 days
after the day on which the notice is given.
4 Subsection 3F(6)
Repeal the subsection, substitute:
(6) After receiving an application, the Managing Director of the
Commission must, within the required period under subsection (6A), enter the
applicant’s name in the Register if:
(a) the Royal Australian College of General Practitioners; or
(b) a body specified in the regulations;
gives the Managing Director written notice that the applicant is, in
accordance with the regulations, eligible for registration under this section.
(6A) The required period for the purposes of subsection (6)
is:
(a) the period of 14 days after the notice under subsection (6) was
received by the Commission; or
(b) if the application was made after the notice was received—the
period of 14 days after the application was received by the
Commission.
5 At the end of paragraph
3G(1)(a)
Add “or”.
6 Paragraph 3G(1)(b)
Repeal the paragraph, substitute:
(b) the Royal Australian College of General Practitioners, or a body
specified in the regulations, gives the Managing Director written notice that
the regulations require that the medical practitioner’s name be removed
from the Register; or
7 Subsection 3G(2)
Repeal the subsection, substitute:
(2) Before removing the medical practitioner’s name from the
Register, the Managing Director shall give the medical practitioner written
notice that his or her name is to be removed.
8 Subsection 3G(3)
Omit “The decision shall be made in writing and”, substitute
“The notice”.
9 Subsection 3G(4)
Omit “the decision is made”, substitute “the notice is
given”.
10 After section 3G
Insert:
(1) The purpose of this section is to provide for registration of certain
medical practitioners in approved placements.
(2) The Commission is to establish and maintain a Register of Approved
Placements.
(3) The Register may be maintained in any form, including as a computer
record.
(4) A medical practitioner may apply to the Commission for registration
under this section.
(5) If a medical practitioner makes an application and:
(a) a body specified in the regulations gives the Managing Director of the
Commission written notice stating:
(i) that the applicant is enrolled in, or undertaking, a course or program
of a kind specified in the regulations; and
(ii) the period over which, and the location in which, the applicant will
be undertaking the course or program; or
(b) the applicant is, in accordance with the regulations, eligible for
registration under this section;
the Managing Director must, within the required period under subsection
(6), enter the applicant’s name in the Register, together with the period
in respect of which and the location in respect of which the applicant is
registered.
(6) The required period for the purposes of subsection (5)
is:
(a) if a notice was given to the Managing Director of the Commission under
paragraph (5)(a) in connection with the application:
(i) the period of 14 days after the notice was received by the Commission;
or
(ii) if the application was made after the notice was received—the
period of 14 days after the application was received by the Commission;
or
(b) if no such notice was given—the period of 14 days after the
application was received by the Commission.
(7) The Managing Director must give the applicant written notice of the
day on which the applicant’s name is to be entered in the
Register.
(8) The Commission may give a body specified in regulations made for the
purposes of paragraph (5)(a) information about the following matters, to the
extent that those matters relate to persons about whom the body has given a
notice under paragraph (5)(a):
(a) the current state of the Register;
(b) additions to the Register;
(c) deletions from the Register.
(1) The Managing Director of the Commission must remove a medical
practitioner’s name from the Register of Approved Placements if:
(a) the medical practitioner requests the Managing Director to do so;
or
(b) a body specified in regulations made for the purposes of paragraph
3GA(5)(a) gives the Managing Director written notice that the medical
practitioner (being a person about whom the body gave a notice under paragraph
(5)(a)) is not enrolled in, or undertaking, the course or program in relation to
which he or she was registered; or
(c) the regulations require that the medical practitioner’s name be
removed from the Register.
(2) Before removing the medical practitioner’s name from the
Register, the Managing Director must give the medical practitioner written
notice that his or her name is to be removed.
(3) The notice must specify the day on which the medical
practitioner’s name is to be removed from the Register.
(4) The day specified under subsection (3) must not be less than 14 days
after the day on which the notice is given.
11 Subsection 3H(1)
Omit “section 3F or 3G”, substitute “paragraph (6) of the
definition of general practitioner in subsection 3(1), section
3EA, 3EB, 3F or 3G.
12 Subsection 3H(2)
Omit “section 3F or 3G”, substitute “the provision
concerned”.
13 After subsection 3J(4)
Insert:
(4A) If a person to whom a determination under subsection (1) applies
ceases to have the right to remain in Australia, the determination ceases to
apply to the person.
14 After section 19A
Insert:
(1) A medicare benefit is not payable in respect of a professional service
if the person who rendered the service:
(a) first became a medical practitioner on or after 1 November 1996;
and
(b) was not, at the time the service was rendered:
(i) a specialist (whether or not the service was rendered in the
performance of the specialist’s specialty); or
(ii) a consultant physician (whether or not the service was rendered in
the performance of the consultant physician’s specialty); or
(iii) a general practitioner; or
Note: For general practitioner, see subsection
3(1).
(iv) subject to subsection (3), a person registered under section 3GA;
or
(v) a person to whom a determination under subsection 3J(1)
applied.
Note: Subsection (5) gives a restricted meaning to the term
professional service for the purposes of this
section.
(2) A medicare benefit is not payable in respect of a professional service
if the medical practitioner on whose behalf the service was rendered:
(a) first became a medical practitioner on or after 1 November 1996;
and
(b) was not, at the time the service was rendered:
(i) a specialist (whether or not the service was rendered in the
performance of the specialist’s specialty); or
(ii) a consultant physician (whether or not the service was rendered in
the performance of the consultant physician’s specialty); or
(iii) a general practitioner; or
Note: For general practitioner, see subsection
3(1).
(iv) subject to subsection (3), a person registered under section 3GA;
or
(v) a person to whom a determination under subsection 3J(1)
applied.
Note 1: An effect of subsection 3(17) is that a service
cannot be taken to be rendered on behalf of a medical practitioner if it is
rendered by another medical practitioner.
Note 2: Subsection (5) gives a restricted meaning to the
term professional service for the purposes of this
section.
(3) Subparagraphs (1)(b)(iv) and (2)(b)(iv) only apply in relation to a
professional service that was rendered:
(a) during the period in respect of which, and in the location in respect
of which, the person is registered under section 3GA; or
(b) in such other circumstances (which may include circumstances relating
to the period during which, or the location in which, services are rendered) as
are specified in the regulations.
(4) For the purposes of this section, a medical practitioner who, on
1 November 1996:
(a) was a medical practitioner who had not commenced, or who had
not completed, training as an intern; or
(b) was not an Australian citizen or a permanent resident within the
meaning of the Migration Act 1958;
is taken to have first become a medical practitioner on 1 November
1996.
(5) In this section:
intern means a medical practitioner who is
undertaking:
(a) a period of internship (by whatever name called); or
(b) a period of supervised training (by whatever name called);
under a law of a State or Territory specified in the regulations (whether
or not the medical practitioner is a resident in a hospital for some or all of
that period).
professional service does not include a service of a kind
referred to in paragraph (b), (ba) or (c) of the definition of
professional service in subsection 3(1).
15 After section 19CB
Insert:
A medical practitioner, or a person acting on behalf of the medical
practitioner, is guilty of an offence if:
(a) he or she renders to another person a professional service in respect
of which a medicare benefit is not payable because of section 19AA;
and
(b) before the service is rendered, such steps as are reasonable in all
the circumstances have not been taken to inform:
(i) the other person; or
(ii) if the other person is in the care of someone else—that
person;
that a medicare benefit would not be payable.
Penalty: 1 penalty unit.
Insert:
(5C) This section does not prohibit a person providing to:
(a) the Royal Australian College of General Practitioners; or
(b) a body specified in regulations made for the purposes of paragraph
3F(6)(b);
information to assist the Royal Australian College of General Practitioners
or that body to decide whether a medical practitioner is, in accordance with the
regulations, eligible for registration under section 3F.
(5D) This section does not prohibit a person providing to:
(a) the Royal Australian College of General Practitioners; or
(b) a body specified in regulations made for the purposes of paragraph
3G(1)(b);
information to assist the Royal Australian College of General Practitioners
or that body to decide whether regulations made for the purposes of that
paragraph require that a medical practitioner’s name be removed from the
Vocational Register of General Practitioners referred to in section
3F.
1 After section 4
Insert:
(1) This section does not limit the generality of section 4.
(2) A regulation under section 4 may provide for a reduction in the fee
applicable to a medical service (other than a diagnostic imaging service or a
pathology service), where:
(a) that service; and
(b) at least one other service, which may be a diagnostic imaging service
or a pathology service;
are provided to the same patient.
2 After section 4AA
Insert:
(1) This section does not limit the generality of section 4AA.
(2) A regulation under section 4AA may provide for a reduction in the fee
applicable to a diagnostic imaging service, where:
(a) that service; and
(b) at least one other medical service, which may be a service other than
a diagnostic imaging service;
are provided to the same patient.
3 Subsection 10(5) (definition of greatest
permissible gap)
Omit “$26.80”, substitute “$50.00”.
4 Subsection 10(5) (definition of
patient)
Repeal the definition.
5 Sections 11 and 12
Repeal the sections.
6 Paragraphs 67(1)(a) and
(aa)
Add at the end “and”.
7 Paragraphs 67(1)(b) and
(c)
Repeal the paragraphs.
8 Saving provision—greatest permissible
gap
Subsection 10(5) of the Health Insurance Act 1973, as in force
before the commencement of this item, continues to apply after that commencement
in relation to a professional service rendered before that
commencement.
9 Saving provision—increased fee in
complex cases
(1) Despite the repeal of section 11 of the Health Insurance Act
1973 by this Act, that section continues to apply, after the commencement of
this item, in relation to a claim for a medicare benefit in respect of a
professional service, if the claim is lodged with the Commission before that
commencement.
(2) Despite the repeal of section 12 of the Health Insurance Act
1973 made by this Act, that section continues to apply, after the
commencement of this item, in relation to a decision of the Commission under
subsection 11(5) of that Act.
(3) Despite the repeal of paragraph 67(1)(b) of the Health Insurance Act
1973 by this Act, that paragraph continues to apply, after the commencement
of this item, in relation to a claim for a medicare benefit in respect of a
professional service, if the claim is lodged with the Commission before that
commencement.
(4) Despite the repeal of paragraph 67(1)(c) of the Health Insurance Act
1973 made by this Act, that paragraph continues to apply, after the
commencement of this item, in relation to an appeal under section 12 of that
Act.
1 Subsection 3J(1)
Omit “unless the Minister determines otherwise”,
substitute:
unless:
(c) the person has qualifications of a kind that the Minister has
determined in writing to be appropriate for the purposes of this section;
and
(d) an exemption granted by the Minister in writing applies to the
person.
2 Subsections 3J(2) and (3)
Omit “A determination under subsection (1)”, substitute
“An exemption under paragraph (1)(d)”.
3 Subsections 3J(4) and
(4A)
Omit “a determination under subsection (1)”, substitute
“an exemption under paragraph (1)(d)”.
4 Subsections 3J(4) and
(4A)
Omit “the determination” (wherever occurring), substitute
“the exemption”.
5 Paragraph 3J(5)(a)
Omit “a determination under subsection (1)”, substitute
“an exemption under paragraph (1)(d)”.
6 Paragraph 3J(5)(b)
Omit “a determination”, substitute “an
exemption”.
7 After subsection 3J(5)
Insert:
(5A) Determinations under paragraph (1)(c) are disallowable instruments
for the purposes of section 46A of the Acts Interpretation Act
1901.
8 Subparagraphs 19AA(1)(b)(v) and
(2)(b)(v)
Omit “a determination under subsection 3J(1)”, substitute
“paragraphs 3J(1)(c) and (d)”.
9 Saving provision—determinations under
subsection 3J(1)
If, immediately before the commencement of this item, a person was a person
to whom a determination under subsection 3J(1) of the Health Insurance Act
1973 applied:
(a) the person is taken, after that commencement, to be a person to whom
paragraph 3J(1)(c) of that Act applies; and
(b) the determination is taken, after that commencement, to be an
exemption granted under paragraph 3J(1)(d) of that Act.