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HEALTH INSURANCE ACT 1973 - SECT 16D Medicare benefits not payable for certain diagnostic imaging services: registration

HEALTH INSURANCE ACT 1973 - SECT 16D

Medicare benefits not payable for certain diagnostic imaging services: registration

  (1)   Unless the Minister otherwise directs, a medicare benefit is not payable in respect of a diagnostic imaging service rendered by or on behalf of a medical practitioner unless the diagnostic imaging procedure used in rendering that service is:

  (a)   carried out using diagnostic imaging equipment that:

  (i)   is ordinarily located at registered diagnostic imaging premises; and

  (ii)   is of a type that, on the day on which the procedure is carried out, is listed for the premises; or

  (b)   carried out using diagnostic imaging equipment that:

  (i)   is ordinarily located at a registered base for mobile diagnostic imaging equipment when not in use; and

  (ii)   is not ordinarily located at diagnostic imaging premises; and

  (iii)   is of a type that, on the day on which the procedure is carried out, is listed for the base.

Meaning of registered diagnostic imaging premises and registered base for mobile diagnostic imaging equipment

  (2)   Diagnostic imaging premises are registered at a particular time if a registration for the premises under Division   4 of Part   IIB is in effect at that time.

  (3)   A base for mobile diagnostic imaging equipment is registered at a particular time if a registration for the base under Division   4 of Part   IIB is in effect at that time.

What equipment is listed for premises or a base?

  (4)   Diagnostic imaging equipment is of a type listed for particular diagnostic imaging premises at a particular time if, at that time:

  (a)   the Diagnostic Imaging Register states that equipment of a particular type is ordinarily located at the premises; and

  (b)   the equipment is of that type.

  (5)   Diagnostic imaging equipment is of a type listed for a particular base for mobile diagnostic imaging equipment at a particular time if, at that time:

  (a)   the Diagnostic Imaging Register states that pieces of equipment of a particular type are ordinarily located at the base when not in use and not ordinarily located at diagnostic imaging premises; and

  (b)   the equipment is of that type.

Some circumstances in which diagnostic imaging equipment is taken to be ordinarily located at diagnostic imaging premises

  (6)   Diagnostic imaging equipment is taken to be ordinarily located at diagnostic imaging premises if:

  (a)   the equipment is:

  (i)   on trial at the premises for a period of not more than 3 months; and

  (ii)   of the same type as equipment listed for the premises during the period of the trial; or

  (b)   each of the following circumstances exist:

  (i)   the equipment (the substituted equipment ) is used, for a period of not more than 3 months, in substitution for diagnostic imaging equipment that is not in operation;

  (ii)   the substituted equipment is of the same type as the equipment that is not in operation;

  (iii)   the equipment that is not in operation is ordinarily located at the premises.

  (7)   Nothing in subsection   (6) limits the circumstances in which diagnostic imaging equipment is ordinarily located at diagnostic imaging premises for the purposes of this Part or Division   4 or 5 of Part   IIB.

Some circumstances in which diagnostic imaging equipment is taken to be ordinarily located at a base for mobile diagnostic imaging equipment when not in use and not ordinarily located at diagnostic imaging premises

  (8)   Diagnostic imaging equipment is taken to be ordinarily located at a base for mobile diagnostic imaging equipment when not in use, and not ordinarily located at diagnostic imaging premises, if:

  (a)   the equipment is:

  (i)   on trial through the base for a period of not more than 3 months; and

  (ii)   not ordinarily located, or taken to be ordinarily located, at diagnostic imaging premises during the period of the trial; and

  (iii)   of the same type as equipment listed for the base during the period of the trial; or

  (b)   each of the following circumstances exist:

  (i)   the equipment (the substituted equipment ) is used, for a period of not more than 3 months, in substitution for diagnostic imaging equipment that is not in operation;

  (ii)   the substituted equipment is of the same type as the equipment that is not in operation;

  (iii)   the equipment that is not in operation is ordinarily located at the base when not in use and not ordinarily located at diagnostic imaging premises.

  (9)   Nothing in subsection   (8) limits the circumstances in which diagnostic imaging equipment is ordinarily located at a base for mobile diagnostic imaging equipment, but not ordinarily located at diagnostic imaging premises, for the purposes of this Part or Division   4 or 5 of Part   IIB.

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