HEALTH INSURANCE (PATHOLOGY SERVICES) REGULATIONS 1989 NO. 75 HEALTH INSURANCE (PATHOLOGY SERVICES) REGULATIONS 1989 NO. 75 - TABLE OF PROVISIONS 1. Citation 2. Repeal of former Health Insurance (Pathology Services) Regulations 3. Interpretation 4. Requests for pathology services 5. Termination of undertaking-sections 23DE and 23DH of the Act 1989 No. 75 HEALTH INSURANCE (PATHOLOGY SERVICES) REGULATIONS - REG 1 Citation 1. These Regulations may be cited as the Health Insurance (Pathology Services) Regulations. 1989 No. 75 HEALTH INSURANCE (PATHOLOGY SERVICES) REGULATIONS - REG 2 Repeal of former Health Insurance (Pathology Services) Regulations 2. Statutory Rules 1977 No. 127, 1979 No. 66, 1983 Nos. 254 and 256 and 1984 No. 6 are repealed. 1989 No. 75 HEALTH INSURANCE (PATHOLOGY SERVICES) REGULATIONS - REG 3 Interpretation 3. In these Regulations, unless the contrary intention appears: "the Act" means the Health Insurance Act 1973. 1989 No. 75 HEALTH INSURANCE (PATHOLOGY SERVICES) REGULATIONS - REG 4 Requests for pathology services 4. (1) In this regulation, unless the contrary intention appears: "provider number", in relation to a practitioner or an approved pathology practitioner, has the same meaning as in the Health Insurance Regulations; "relevant address", in relation to a treating practitioner or an approved pathology practitioner, who makes a request, means: (a) where the request is made from a place of practice of the treating practitioner or approved pathology practitioner-the address of that place; or (b) where paragraph (a) does not apply-the address of any place of practice of the treating practitioner or approved pathology practitioner; "request" means a request for a pathology service (other than a pathologist-determinable service to which subsection 16A (6) of the Act applies) made in accordance with subsection 16A (3) of the Act; "treating practitioner" has the same meaning as in section 16A of the Act. (2) A request shall, subject to subregulation (8), contain the particulars required by subregulations (3), (4), (5), (6) and (7) to be included in a request. (3) A request shall include the following particulars in respect of the treating practitioner, or approved pathology practitioner, who makes the request (in this subregulation called the "requesting practitioner"): (a) the surname and the initials of the given names of the requesting practitioner or, where the requesting practitioner is a member of a group of practitioners, being practitioners at least one other of whom has the same surname and the same initials as the requesting practitioner, the surname and such of the given names of the requesting practitioner as would distinguish him or her from each of those other practitioners in that group; (b) the relevant address; and (c) the provider number that relates to the place of practice of the requesting practitioner at that address. (4) A request shall include the following particulars in respect of the person to whom the request is made: (a) where the person is an approved pathology practitioner: (i) the surname and the initials of the given names of the approved pathology practitioner or, where the approved pathology practitioner is a member of a group of practitioners, being practitioners at least one other of whom has the same surname and the same initials as the approved pathology practitioner, the surname and such of the given names of the approved pathology practitioner as would distinguish him or her from each of those other practitioners in that group; and (ii) the address of a place of practice of the approved pathology practitioner; (b) where the person is an approved pathology authority: (i) the full name of the approved pathology authority; and (ii) the address of a place of practice of the approved pathology authority. (5) A request shall include the following particulars in respect of the person in relation to whom the service is requested: (a) the name of the person; (b) the address of the person; (c) whether the person is: (i) a hospital patient in a recognized hospital; (ii) a private patient in a recognized hospital; (iii) a private patient in a private hospital; or (iv) a private patient in a day hospital facility; (d) whether the request is made in the course of the provision in relation to the person of an out-patient service at a recognized hospital. (6) A request shall include the following particulars in respect of the service, or each service, requested: (a) a description of the service in terms or symbols that: (i) would be generally understood by medical practitioners; and (ii) are sufficient to identify the service for the purpose of ascertaining the item (if any) in which that service is specified; (b) the date on which the service was determined to be necessary; (c) whether the service is a pathology service in relation to a bodily specimen obtained from a person while the person was an in-patient of a hospital or day hospital facility that is to be performed after the person has ceased to be such a patient. (7) Where a request for a service is made to an approved pathology practitioner or approved pathology authority by an approved pathology practitioner (in this subregulation called the "referring pathologist") to whom the treating practitioner has made a request for the service, the first-mentioned request shall include the following particulars, namely, the name, address and provider number of the treating practitioner as included in the request made by him or her to the referring pathologist. (8) Where: (a) a practitioner determines that a service is, or services are, necessary in relation to a person; (b) the practitioner makes a request to an approved pathology practitioner in relation to that service or those services; and (c) the approved pathology practitioner referred to in paragraph (b) makes a request to another approved pathology practitioner or to an approved pathology authority in relation to that service or those services; the request referred to in paragraph (c) (in this subregulation referred to as "the first-mentioned request"), when made, or confirmed, in writing, shall not be required to include the particulars referred to in subregulations (5), (6) and (7) if: (d) the request referred to in paragraph (b) relates to the service, or services, to which the first-mentioned request relates and no other service; and (e) the document in writing containing or confirming the request referred to in paragraph (b) is annexed to the document containing or confirming the first-mentioned request. 1989 No. 75 HEALTH INSURANCE (PATHOLOGY SERVICES) REGULATIONS - REG 5 Termination of undertaking-sections 23DE and 23DH of the Act 5. For the purposes of sections 23DE and 23DH of the Act, a notice of termination shall be given by addressing it, and sending it by pre-paid post, to the Minister at the office of the Health Insurance Commission, P.O. Box 1001, Tuggeranong, A.C.T. 2901. - NOTES 1989 No. 75*1* HEALTH INSURANCE (PATHOLOGY SERVICES) REGULATIONS *1* Notified in the Commonwealth of Australia Gazette on 4 May 1989.