Commonwealth Numbered Acts

HEALTH INSURANCE AMENDMENT ACT (No. 2) 1978 No. 133 of 1978 - SECT 9

9. Section 10 of the Principal Act is repealed and the following section
substituted: Entitlement to Commonwealth medical benefit
'' 10. (1) Where, on or after 1 November 1978, medical expenses are incurred
by a person (in this section referred to as ' the person incurring expense ')
in respect of a professional service rendered in Australia to an eligible
person, a Commonwealth medical benefit calculated in accordance with
sub-section (2) is payable, subject to and in accordance with this Act, in
respect of that professional service.

'' (2) A Commonwealth medical benefit under sub-section (1) in respect of a
professional service is an amount equal to-

   (a)  where the person incurring expense is an eligible pensioner and the
        service is rendered to him or his dependant-

        (i)    85% of the fee specified in respect of the service in the table
               in relation to the State in which the service is rendered; or

        (ii)   if the amount calculated under sub-paragraph (i) is less by
               more than $5 than the fee from which it is calculated-an amount
               that is less by $5 than that fee;

   (b)  where-

        (i)    the person incurring expense is a person who may enter into an
               agreement, in accordance with sub-section 20A (2), with respect
               to the Commonwealth medical benefit; and

        (ii)   he enters into such an agreement,

75% of the fee specified in respect of the service in the table in relation to
the State in which the service is rendered; or

   (c)  in any other case-

        (i)    40% of the fee specified in respect of the service in the table
               in relation to the State in which the service is rendered; or

        (ii)   if the amount calculated under sub-paragraph (i) is less by
               more than $20 than the fee from which it is calculated-an
               amount that is less by $20 than that fee.

'' (3) Where an amount calculated in accordance with sub-section (2) is not a
multiple of 5 cents, the amount of cents shall be increased to the nearest
higher amount that is a multiple of 5 cents.''.