Commonwealth Consolidated Acts

NATIONAL HEALTH ACT 1953

TABLE OF PROVISIONS

   PART I--PRELIMINARY

   1.      Short title [see Note 1]  
   2.      Commencement [see Note 1]  
   4.      Interpretation  
   4AA.    Recognised days of absence of qualified nursing home patients etc.  
   6.      Delegation  
   6A.     External Territories  
   7A.     Application of the Criminal Code  

   PART II--NATIONAL HEALTH SERVICES

   8.      Interpretation  
   9.      Provision of certain medical and dental services  
   9A.     Provision of medical and surgical aids and appliances etc. by the Commonwealth  
   9B.     Provision of vaccines  
   9BA.    The National HPV Vaccination Program Register  
   9C.     Arrangements with States for provision of surgical aids and appliances etc.  
   10.     Arrangements with other Ministers  
   11.     Arrangements with States  

   PART V--APPROVED NURSING HOMES

   39.     Interpretation  
   40AA.   Government nursing homes  
   40AB.   Approval of admission to approved nursing home  
   40AC.   Declaration that patient not in need of nursing home care  
   40AE.   Request for review of decisions  
   40AEA.  Request for review may be withdrawn  
   40AEB.  Refund of lodgment fee  
   40AEC.  Referral of request to Nursing Homes Fees Review Committee of Inquiry  
   40AED.  Examination of matter by Committee  
   40AEE.  Committee Processing Fee  
   40AEF.  Ministerial review of decisions  
   40AEG.  Refund of Committee processing fee etc.  
   40AEH.  Effect of change of proprietor on request for review  
   40AF.   Patients requiring extensive care  
   40AFK.  Proprietor to be given notice of classification of classified patient admitted to nursing home  
   40AG.   Standard fee for non-classified patients  
   40AGA.  Standard fee for classified patients  
   40AH.   Standard infrastructure allowance and special infrastructure allowance  
   40AI.   Additional patient contribution  
   41.     Certificate of approval  
   42.     Inspection of, and of records of, approved nursing homes  
   43.     Certain person to give notice on death of proprietor  
   43A.    Furnishing of audited accounts by proprietors of certain approved nursing homes  
   44.     Variation or revocation of approval  
   45.     Automatic revocation of approval as nursing home for disabled people  
   45A.    Revocation or extension of suspension  
   45B.    Effect of suspension of approval of nursing home  
   45D.    Standards for nursing home care  
   45DA.   Statements may be published about satisfaction of standards for nursing home care  
   45DB.   General information about approved nursing homes may be made available to the public  
   45DC.   Information about Ministerial action and other information about approved nursing homes may be made available to the public  

           Division 1--Preliminary

   46.     Interpretation  
   46A.    Approved nursing home patients  
   46AB.   Benefit payable for up to 2 days prior to admission  
   46B.    Meaning of overpayment  
   46C.    Secretary to determine accounting period in respect of certain approved nursing homes  
   46D.    Setting of notional fees  
   46E.    Secretary may pay or recover advances of general care benefit before notional scale of fees is set  

           Division 2--Types of benefit payable

   47.     Basic benefit for Government nursing homes and nursing homes for disabled people  
   47A.    Benefits for patients in other approved nursing homes  
   48A.    Benefit for nursing home care in transferred homes and adjusted fee government nursing homes  
   48AB.   When general care benefit becomes payable  
   48B.    Top-up benefit  
   48C.    Isolated nursing home benefit  
   48D.    Benefit in respect of patients receiving nasogastric feeding  
   48E.    Benefit in respect of patients receiving oxygen  
   49.     Extensive care benefit  
   49AA.   Respite Care  

           Division 3--Miscellaneous

   49A.    Commonwealth benefit not payable if approval of nursing home suspended  
   49B.    Payment of Commonwealth benefit to patient  
   50.     Payment of Commonwealth benefit and nursing home fund benefit in respect of same patient for same period  
   51.     Claims for benefit  
   51A.    Advances of benefit  
   51B.    Treatment of money overpaid or underpaid by way of an advance  
   51C.    Recovery of overpayments  

   PART VAB--COMMONWEALTH BENEFIT IN RESPECT OF NEWLY BUILT NURSING HOMES

           Division 1--Preliminary

   52.     Interpretation  

           Division 2--Approval-in-principle of an approval of a grant in respect of a newly built nursing home

   52D.    Minister may revoke an AIP at any time before an approval of grant is given  

           Division 3--Approval of grant of Commonwealth benefit in respect of a newly built nursing home

   53.     Application for Commonwealth benefit  
   54.     Principles applicable for grant of Commonwealth benefit  
   55.     Approval of grant  
   56.     Entitlement to benefit  
   57.     Appropriation  

   PART VAC--COMMONWEALTH BENEFIT IN RESPECT OF UPGRADED NURSING HOMES

           Division 1--Preliminary

   58.     Interpretation  
   58A.    Principles applicable to determining eligible nursing homes  

           Division 2--Approval-in-principle of a grant in respect of an upgraded nursing home

   58CB.   Minister may revoke an approval-in-principle at any time before an approval of grant is given  

           Division 3--Approval of grant of Commonwealth benefit in respect of upgraded nursing homes

   58CC.   Application for Commonwealth benefit  
   58CD.   Principles applicable for grant of Commonwealth benefit  
   58CE.   Approval of grant  
   58CF.   Entitlement to benefit  
   58CG.   Appropriation  

   PART VC--ADMINISTRATION OF PARTS V, VA, VAB AND VD

   58K.    Interpretation  
   59.     Commonwealth benefit not payable where compensation etc. is payable to patient  
   60B.    Information to be furnished by proprietor of approved nursing home  
   61.     Records to be kept by proprietors of approved nursing homes  
   61AA.   Records to be kept by former proprietors for 12 months  
   61A.    Books and records to be kept at nominated place  
   61B.    Power to require persons to answer questions and produce documents  
   61C.    Power to examine on oath etc.  
   61D.    Entry on premises and inspection of books etc.  
   61E.    Offences  
   62.     Offences  

   PART VD--REQUIREMENTS IN RESPECT OF SALE OF APPROVED NURSING HOMES

           Division 1--Preliminary

   63.     Object of Part  
   64.     Application and operation of Part  
   65.     Interpretation  

           Division 2--Requirements on sale of approved nursing home

   65A.    Vendor must give notice of sale of an approved nursing home  
   65B.    Purchaser to give notice of prospective purchase of approved nursing home  
   65C.    Investigation of accounts etc. of approved nursing homes  
   65D.    Secretary may also determine certain matters  
   65E.    Parties to a contract of sale to be informed of results of investigation etc.  
   65F.    Proprietor gives less than 90 days notice on settlement of contract of sale or settles in less than 90 days  
   65G.    If no notice of sale given or vendor sells before notified date  
   65GAA.  Effect on investigation periods of commencement of the Aged Care Act 1997  

           Division 2A--Nursing home charge

              Subdivision 1--Assessment

   65GA.   Notice of fee-reducing benefit  
   65GB.   Liability to pay nursing home charge  
   65GC.   Amount of nursing home charge  
   65GD.   Notice of liability to pay nursing home charge  
   65GE.   Assessment  
   65GF.   Amendment of assessments  
   65GG.   Refund of overpaid amounts  
   65GH.   Amended assessment to be an assessment  
   65GI.   Objections  
   65GJ.   Validity of assessment  
   65GK.   Evidentiary effect of notice of assessment etc.  

              Subdivision 2--Collection and recovery

   65GL.   Secretary may extend time for payment  
   65GM.   Penalty for late payment  
   65GN.   Recovery of unpaid nursing home charge  
   65GO.   Recovery of nursing home charge from persons with joint liability  
   65GP.   Recovery of nursing home charge from trustee of deceased chargepayer  
   65GQ.   Recovery of nursing home charge from unadministered deceased estate  

              Subdivision 3--Advance payments

   65GR.   Overview of Subdivision  
   65GS.   If paragraph 65C(1)(c) investigation done--direction to purchaser to pay amount to the Commonwealth  
   65GT.   If paragraph 65F(1)(c) investigation has been ordered--vendor's and purchaser's liability to pay advance  
   65GU.   Treatment of money paid in advance under section 65GT  
   65GV.   Directions to be in writing  
   65GW.   Scale of fees may take account of unpaid nursing home charge  

           Division 3--Payment of certain moneys to the Commonwealth

   65H.    If paragraphs 65C(1)(c) and (d) investigations done--direction to purchaser to pay amount to the Commonwealth  
   65J.    If amount determined under paragraph 65F(1)(e)--direction to purchaser to pay amount to the Commonwealth  
   65K.    Certain moneys to be paid by proprietor of nursing home to the Commonwealth on or before sale of nursing home  
   65L.    Money paid in settlement of an overpayment outstanding--how to deal with it  
   65M.    Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(2) applies  
   65N.    Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(3) applies  
   65P.    Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(4) applies  
   65Q.    Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(5) applies  
   65R.    Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(6) applies--Step 1: first investigation amount  
   65S.    Treatment of amount paid in respect of overpayment outstanding to which subsection 65K(6) applies--Step 2: second investigation amount  

           Division 4--Miscellaneous

   65SA.   Interest payable on repayments to vendors made under Division 3  
   65SB.   Interest payable on repayments to vendors made under Division 2A  
   65T.    Time when principles take effect  
   65U.    Parties to a contract of sale to be informed of certain matters after sale  

   PART VII--PHARMACEUTICAL BENEFITS

           Division 1--Preliminary

   83Z.    Repeal and saving  
   84.     Interpretation  
   84AAA.  Early supply of a specified pharmaceutical benefit  
   84AA.   Concessional benefit prescriptions, concession card prescriptions and entitlement card prescriptions  
   84A.    Participating dental practitioners  
   84AAB.  Authorised optometrists  
   84AAC.  Secretary may suspend or revoke approval  
   84AAD.  Review of decisions  
   84AB.   Pharmaceutical items  
   84ABA.  References to pharmaceutical items or combination items having a drug  
   84AC.   When listed drug is on F1 or F2  
   84AD.   When listed drug is in Part A or Part T of F2  
   84AE.   Co-marketed brands  
   84AF.   Responsible person for a brand of a pharmaceutical item  
   84AG.   Therapeutic groups  
   84AH.   Exempt items  
   84AI.   Rounding amounts  
   84AJ.   When pharmaceutical benefits are Schedule equivalent  

           Division 1A--Safety net concession cards and pharmaceutical benefits entitlement cards

   84B.    Family relationships  
   84BA.   Supplies of out-patient medication  
   84C.    Eligibility for concession and entitlement cards  
   84CA.   Modification of amounts paid  
   84D.    Pharmaceutical benefits prescription record forms etc.  
   84DA.   Issue of safety net concession card  
   84E.    Issue of pharmaceutical benefits entitlement card  
   84F.    Form of cards  
   84G.    Persons covered by card  
   84H.    Additional and replacement cards  
   84HA.   Fee to approved pharmacist etc. for issuing card  
   84J.    Period of effect of card  
   84K.    Return of card  
   84L.    Offences  

           Division 2--Supply of pharmaceutical benefits

   85.     Pharmaceutical benefits  
   85A.    Determinations of forms of pharmaceutical benefits or pharmaceutical items with respect to classes of persons  
   85AB.   Minister may determine that a listed drug is on F1 or F2  
   85AC.   Minister may determine that a listed drug is in Part A or Part T of F2  
   85AD.   Price agreements  
   85B.    Price determinations and special patient contributions  
   86.     Entitlement to receive pharmaceutical benefits  
   86A.    Pharmaceutical benefits not to be supplied in respect of persons reasonably believed not to be in Australia  
   86B.    Approved supplier may request provision of medicare number  
   86C.    On and after 1 January 2001 approved supplier must request provision of medicare number in certain circumstances  
   86D.    Power of approved suppliers to record and retain medicare numbers and expiry dates  
   86E.    Minister may determine certain persons to be special evidentiary categories  
   87.     Limited charges for pharmaceutical benefits  
   87A.    Entitlement to refund in certain circumstances  
   88.     Prescribing of pharmaceutical benefits  
   88AA.   Power of PBS prescribers to record and retain medicare numbers and expiry dates  
   88A.    Prescription of certain pharmaceutical benefits authorised only in certain circumstances  
   89.     Pharmaceutical benefits to be supplied only on prescription etc.  
   90.     Approved pharmacists [see Note 1]  
   90A.    Minister may substitute decision approving pharmacist  
   90B.    Request to Minister to approve pharmacist  
   90C.    Circumstances in which request may not be made  
   90D.    Provision of further information  
   90E.    Effect of decision by Minister to approve pharmacist  
   91.     Application to supply pharmaceutical benefits following the death of approved pharmacist  
   92.     Approved medical practitioners  
   92A.    Approvals to be subject to conditions  
   92B.    Persons not to enter into certain refund agreements  
   93.     Supply of certain pharmaceutical benefits by medical practitioners  
   93A.    Supply of certain pharmaceutical benefits to patients in private hospitals or aged care facilities  
   94.     Approved hospital authorities  
   95.     Suspension or revocation of approval  
   98.     Cancellation by Secretary of approval of pharmacists etc.  
   98AA.   Cancellation by Minister of approval of hospital  

           Division 3--Payment for supply of pharmaceutical benefits

   98A.    Establishment of Pharmaceutical Benefits Remuneration Tribunal  
   98B.    Functions of Tribunal  
   98BA.   Inquiries by Tribunal  
   98BAA.  Tribunal must give effect to certain agreements  
   98BB.   Constitution of Tribunal  
   98BC.   Procedure of Tribunal  
   98BD.   Findings etc. of Tribunal to be made public  
   98BE.   Date of operation of determination of the Tribunal  
   98C.    Determinations by Minister  
   98D.    Form, and date of operation, of determinations under section 98C  
   98E.    Secrecy  
   99.     Payment for supply of benefits  
   99AAA.  Claim for payment relating to supply of benefits  
   99AAB.  Certain suppliers exempted from requirement to use the Claims Transmission System  
   99AAC.  Declaration by Secretary exempting approved supplier from using Claims Transmission System  
   99AA.   Unauthorised payments etc.  
   99AB.   Advances  

           Division 3A--Price reductions

              Subdivision A--Preliminary

   99AC.   What this Division is about  

              Subdivision B--requires there to be at least a 12.5% price reduction in the price of a new brand of a pharmaceutical item that is not a combination item.

              Subdivision C--sets out the circumstances in which price reductions are required for combination items.

              Subdivision D--provides for price reductions for pharmaceutical items (including for combination items in some cases):

   99ACA.  Definitions etc.  

              Subdivision B--12

   99ACB.  12.5% price reduction for new brands of pharmaceutical items that are not combination items  

              Subdivision C--Price reductions for combination items

   99ACC.  Price reductions for single brands of combination items  
   99ACD.  12.5% price reduction for new brands of combination items  
   99ACE.  Flow-on of 12.5% price reduction to related brands of combination items  

              Subdivision D--Other statutory price reductions

   99ACF.  Statutory price reductions  
   99ACG.  Other price reductions do not apply if 12.5% statutory price reduction or price disclosure reduction applies  
   99ACH.  12.5% statutory price reduction flow-on to related brands  
   99ACI.  2% statutory price reduction  
   99ACJ.  25% statutory price reduction on single day  
   99ACK.  25% statutory price reduction phased over 2 or more days  

           Division 3B--Price disclosure

              Subdivision A--Preliminary

   99AD.   What this Division is about  
   99ADA.  Application of this Division  
   99ADB.  Definitions etc.  

              Subdivision B--Price disclosure requirements

   99ADC.  The price disclosure requirements  

              Subdivision C--When the price disclosure requirements apply

   99ADD.  Mandatory compliance with the price disclosure requirements  
   99ADE.  Voluntary compliance with the price disclosure requirements  

              Subdivision D--Consequences for failing to comply with the price disclosure requirements

   99ADF.  Offence for failing to comply with the price disclosure requirements  
   99ADG.  Other consequences for failing to comply with the price disclosure requirements  

              Subdivision E--Price reduction

   99ADH.  Price reduction based on information provided under the price disclosure requirements  

           Division 3C--Guarantee of supply

              Subdivision A--Preliminary

   99AE.   What this Division is about  
   99AEA.  Definitions  

              Subdivision B--Guarantee of supply

   99AEB.  Guarantee of supply  

              Subdivision C--Brands that are guaranteed brands

   99AEC.  Guaranteed brand: new brand  
   99AED.  Guaranteed brand: first brand to offer a lower price  

              Subdivision D--Meaning of fails to supply and unable to supply

   99AEE.  Meaning of fails to supply  
   99AEF.  Meaning of unable to supply  

              Subdivision E--Requirement to notify Minister of failure or inability to supply etc

   99AEG.  Requirement to notify Minister of failure to supply etc.  

              Subdivision F--Consequences for guaranteed brands of failure or inability to supply

   99AEH.  Minister's powers if responsible person fails to supply, or is unable to supply, guaranteed brand  

              Subdivision G--Consequences for other brands

   99AEI.  Minister may increase approved price to pharmacists etc. if guaranteed brand delisted  
   99AEJ.  Minister may determine drug is on F1 if guaranteed brand delisted  
   99AEK.  Minister may revoke or vary formulary determination if guaranteed brand delisted  
   99AEL.  Minister may determine price disclosure election is revoked if guaranteed brand delisted  

           Division 4--Provisions relating to members of the Pharmaceutical Benefits Remuneration Tribunal

   99A.    Terms and conditions of appointment  
   99B.    Remuneration and allowances  
   99C.    Resignation and removal from office  
   99D.    Acting Chairperson  
   99E.    Acting additional member  

           Division 4A--Indexation

   99F.    Definitions  
   99G.    Indexation  

           Division 4B--Australian Community Pharmacy Authority

   99H.    Interpretation  
   99J.    Establishment of Authority  
   99K.    Functions  
   99L.    Determination of rules by Minister  
   99M.    Powers  
   99N.    Membership  
   99P.    Terms and conditions not provided for by this Act  
   99Q.    Defective appointment not invalid  
   99R.    Remuneration and allowances  
   99S.    Leave of absence  
   99T.    Disclosure of interests  
   99U.    Resignation  
   99V.    Termination of appointment  
   99W.    Meetings  
   99X.    Committees  
   99Y.    Cessation of operation [see Note 1]  

           Division 4C--Cost recovery

              Subdivision A--Preliminary

   99YB.   What this Division is about  

              Subdivision B--provides for regulations to set out the fees that are payable for those services, as well as other matters relating to the payment of those fees and the provision of those services (including some consequences of failing to pay a fee).

              Subdivision C--sets out another possible consequence of failing to pay a fee by providing for the Minister to refuse to exercise certain powers until the fee is paid.

              Subdivision D--provides that the Minister must cause a review to be undertaken of the impact of cost-recovery measures provided for under this Division and any regulations made under this Division, and must table an annual report on related processes.

              Subdivision B--Payment of fees etc

   99YBA.  Payment of fees etc. for certain services  

              Subdivision C--Consequences if fees not paid

   99YBB.  Minister may refuse to exercise certain powers if prescribed fees not paid  

              Subdivision D--Review of cost-recovery measures

   99YBC.  Review of impact of cost-recovery measures  

           Division 4D--Export restriction

   99ZH.   Definitions  
   99ZI.   Restrictions on carriage or consignment of drug like substances  
   99ZJ.   Detention of certain drug like substances being carried out of Australia and retention of related documents  
   99ZK.   Detention of certain drug like substances consigned for export and retention of related documents  
   99ZL.   Examination and inspection powers  
   99ZM.   Customs may detain some drug like substances and not others  
   99ZN.   Customs treatment of detained substances and retained documents  
   99ZO.   Treatment by the Medicare Australia CEO of detained substances and retained documents  
   99ZP.   Right of compensation in certain circumstances for substances destroyed  
   99ZQ.   Disposal of forfeited substances  
   99ZR.   Liability for acts done in good faith  
   99ZS.   Guidelines for detention of, dealing with, and disposal of, substances  
   99ZT.   Forfeiture of substances detained under section 99ZJ or 99ZK  

           Division 5--General

   100.    Special arrangements  
   100AA.  Special pharmaceutical products  
   100A.   Establishment and membership of the Pharmaceutical Benefits Advisory Committee  
   100B.   Appointment etc. of members of the Pharmaceutical Benefits Advisory Committee  
   100C.   Termination of appointment  
   100D.   Remuneration  
   101.    Functions of Pharmaceutical Benefits Advisory Committee  
   101A.   Sub-committees of the Pharmaceutical Benefits Advisory Committee  
   102.    Testing of drugs  
   103.    Offences  
   104A.   Pharmacists to furnish statement of stocks  
   104B.   Report on impact of National Health Amendment (Pharmaceutical Benefits Scheme) Act 2007  
   105.    Regulations  

   PART VIIA--REVIEWS BY ADMINISTRATIVE APPEALS TRIBUNAL

   105AA.  Interpretation  
   105AAB. Applications for review by Tribunal of certain decisions under Part V  
   105AB.  Application for review by Tribunal  
   105AC.  Statements to accompany notification of decisions  
   105AD.  Application for review by Tribunal of decisions of the Australian Community Pharmacy Authority  
   105AE.  Time limits  

   PART VIII--COMMITTEES OF INQUIRY

           Division 1--Preliminary

   107.    Interpretation  

           Division 3--Pharmaceutical Services Committees of Inquiry

   113.    Pharmaceutical Services Federal Committee of Inquiry  
   114.    Functions of Federal Committee  
   115.    Pharmaceutical Services State Committees of Inquiry  
   116.    Functions of State Committee  
   117.    Reports not to relate to conduct of PBS prescribers  

           Division 3A--Nursing Homes Fees Review Committees of Inquiry

   117A.   Nursing Homes Fees Review Committees of Inquiry  
   117B.   Functions of State Committees  

           Division 4--Provisions applicable to Committees generally

   118.    Interpretation  
   119.    Membership of Committees  
   119A.   Acting Member  
   120.    Chairperson  
   120A.   Vacancies in Committees  
   121.    Procedure of Committees  
   122.    Evidence  
   123.    Proceedings in private  
   124.    Determination of questions at meetings  
   125.    PBS prescriber or pharmacist affected by inquiry to be given notice  
   126.    Summoning of witnesses  
   127.    Committee may examine upon oath or affirmation  
   128.    Failure to attend or produce documents  
   129.    Refusal to be sworn or give evidence  
   130.    Protection of witnesses  
   131.    Allowances to witnesses  
   132.    Protection of members  

   PART IX--MISCELLANEOUS

   133.    Effect of prosecution for offence  
   133A.   Territories  
   134.    Effect of suspension or cancellation of approval or authority  
   134A.   Publication of particulars of certain action taken under this Act  
   134B.   Time for commencing prosecutions  
   134C.   Defence in certain prosecutions  
   134E.   Conduct by directors, servants or agents  
   135.    Right of Commonwealth officers to practise  
   135A.   Officers to observe secrecy  
   135AAA. Prescribers and approved suppliers must observe secrecy in relation to medicare numbers and expiry dates provided for pharmaceutical benefit scheme purposes  
   135AA.  Privacy guidelines  
   135AB.  Breaches of the privacy guidelines  
   135AC.  Authorisation of collection of particular health information  
   135B.   Prosecution of offences  
   136.    Committees  
   136A.   Filling of vacancies on committees  
   137.    Moneys from which payments under this Act are to be made  
   138.    Exercise of Secretary's powers subject to directions of Minister  
   138A.   Telephone access to offices  
   139.    Judicial notice of signature of Secretary  
   139A.   Evidence  
   139B.   Certain instruments subject to disallowance  
   139C.   Information with respect to concessional beneficiaries  
   140.    Regulations  
           SCHEDULE 4 Nursing Homes whose approvals as Nursing Homes for disabled people are to be revoked