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Health Insurance Act 1973

Authoritative Version
  • - C2004A00101
  • In force - Superseded Version
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Act No. 42 of 1974 as made
An Act providing for Payments by way of Medical Benefits and Payments for Hospital Services and for other purposes
Administered by: Health
Date of Assent 08 Aug 1974

HEALTH INSURANCE ACT 1973

 

No. 42 of 1974

 

An Act providing for Payments by way of Medical Benefits and Payments for Hospital Services and for other purposes.

 

BE IT ENACTED by the Queen, the Senate and the House of Representatives of Australia, as follows:—

PART I—PRELIMINARY

Short title.

1.    This Act may be cited as the Health Insurance Act 1973.

Commencement.

2.    This Act shall come into operation on the day on which it receives the Royal Assent.

Interpretation.

3. (1) In this Act, unless the contrary intention appears—

“agreement” means an agreement under section 30;

“amendment alleviating the operation of the means test”, in relation to a person, means an amendment of the Social Services Act 1947-1967, or the Repatriation Act 1920-1966, that operates to diminish or eliminate any reduction that would otherwise be made in the rate of pension or allowance payable to or in respect of a person by reason of his means as assessed as defined by—

(a) section 18 or 59 of the Social Services Act 1947-1967 or of that Act as amended at any time; or

(b) section 83 of the Repatriation Act 1920-1966 or of that Act as amended at any time,

as the case may be;

“approved bed”, in relation to a hospital, means a bed included in the number of beds at the hospital to which the approval under section 24 in relation to the hospital relates;

“Australian resident” means a person who is residing in Australia and includes—

(a) a person whose domicile is in Australia, other than a person in respect of whom the Commission is satisfied that the person’s permanent place of abode is outside Australia; and

(b) a person who has been in Australia, whether continuously or intermittently, during more than one-half of the year ending on the day on which the question whether he


 

is or is not an Australian resident arises, other than a person in respect of whom the Commission is satisfied that—

(i) the person’s usual place of abode is outside Australia; and

(ii) the person does not intend to take up residence in Australia,

but does not include—

(c) the head of a diplomatic mission established in Australia;

(d) a member of the staff (not being an Australian citizen) of a diplomatic mission established in Australia; or

(e) a member of the family of a person referred to in paragraph (c) or (d) who forms part of the household of that person and is not an Australian citizen;

“Commission” means the Health Insurance Commission established by the Health Insurance Commission Act 1973;

“dental practitioner” means a person registered or licensed as a dental practitioner or dentist under a law of a State or Territory that provides for the registration or licensing of dental practitioners or dentists;

“dependant”, in relation to an eligible pensioner, means—

(a) the wife of the pensioner;

(b) a woman who is living with the pensioner as his wife on a permanent and bona fide domestic basis, although not legally married to him;

(c) a child under the age of 16 years in the custody, care and control of the pensioner or of the wife or husband of the pensioner; or

(d) a person wholly or substantially dependent on the pensioner or on the wife or husband of the pensioner, being a person who—

(i) has attained the age of 16 years;

(ii) is receiving full-time education at a school, college or university;

(iii) is not in receipt of an invalid pension under Part III of the Social Services Act 1947-1973; and

(iv) except where the pensioner is a person to whom, or in respect of whom, there is being paid a service pension under the Repatriation Act 1920-1973—is wholly or substantially dependent on the pensioner;


 

“diagnostic service” means a professional service covered by—

(a) unless the regulations otherwise provide, item 631, 632, 641, 651 or 661 or an item in Part VII or Part VIII of the table; or

(b) any other prescribed item,

and includes any professional service given for health-screening purposes;

“eligible pensioner” means—

(a) a person to whom or in respect of whom—

(i) there is being paid an age pension, an invalid pension, a widow’s pension or a sheltered employment allowance under the Social Services Act 1947-1973; or

(ii) such a pension or allowance would be payable if the person were not receiving vocational training under Part VIII of that Act,

other than such a person to whom or in respect of whom such a pension or allowance would not be payable if any amendment of that Act, being—

(iii) an amendment alleviating the operation of the means test in relation to that person made after the date on which the Social Services Act 1967 received the Royal Assent; or

(iv) an amendment of a rate of pension, allowance or benefit made after the date of commencement of the Social Services Act (No. 4) 1973,

had not been made;

(b) a person to whom or in respect of whom there is being paid a service pension under the Repatriation Act 1920-1973, other than such a person to whom or in respect of whom such a pension would not be payable if—

(i) any amendment of that Act, being—

(A) an amendment alleviating the operation of the means test in relation to that person made after the date of commencement of the Repatriation Act 1966; or

(B) an amendment of a rate of pension, allowance or benefit under Division 5 of Part III made after the date of commencement of the Repatriation Act (No. 3) 1973,

had not been made; or

(ii) any amendment of the Social Services Act 1947-1967, being—

(A) an amendment alleviating the operation of the means test in relation to that person made after the date on which the Social Services Act 1967 received the Royal Assent; or

(B) an amendment of a rate of pension, allowance or benefit made after the date of commencement of the Social Services Act (No. 4) 1973,

had not been made; and

(c) a person to whom or in respect of whom there is being paid an allowance under the Tuberculosis Act 1948;

“eligible person” means an Australian resident and, except as otherwise prescribed, includes any other person in Australia;

“friendly society” means a society registered under a State Act or a law of a Territory providing for the registration of friendly or benefit societies;

“hospital” means premises approved as a hospital by the Minister under section 24;

“hospital patient”, in relation to a hospital, means an in-patient in respect of whom the hospital provides comprehensive care, including all necessary medical, nursing and diagnostic services and, if they are available at the hospital, dental and paramedical services, by means of its own staff or by other agreed arrangements;

“hospital treatment” means accommodation and nursing care for the purpose of permitting the provision of professional attention;

“in-patient”, in relation to a hospital, means a person who occupies an approved bed in a hospital for the purpose of hospital treatment but does not include—

(a) a member of the staff of the hospital who is receiving treatment in his or her own quarters; or

(b) except as provided by sub-section (2), a newly-born child whose mother also occupies a bed in the hospital;

“item” means an item in the table;

“medical benefit” means a medical benefit under Part II;

“medical expenses” means an amount payable in respect of a professional service;

“medical practitioner” means a person registered or licensed as a medical practitioner under a law of a State or Territory that provides for the registration or licensing of medical practitioners;

“net operating costs” means—

(a) in relation to all recognized hospitals in a State—net operating costs as defined by the agreement with that State; or

(b) in relation to a recognized hospital in an internal Territory—net operating costs as prescribed;

“nursing care ” means nursing care given by or under the supervision of a registered nurse;

“organization” means a society, body or group of persons, whether corporate or unincorporate;

“out-patient service”, in relation to a hospital, means a health service or procedure provided by the hospital to an eligible person other than an in-patient of the hospital;

“practitioner” means a medical practitioner or a dental practitioner;

“private hospital” means a hospital that is not a recognized hospital;

“private patient”, in relation to a hospital, means an in-patient of the hospital who is not a hospital patient;

“professional attention” means—

(a) medical or surgical treatment by or under the supervision of a medical practitioner;

(b) obstetric treatment by or under the supervision of a medical practitioner or a registered nurse with obstetric qualifications; or

(c) dental treatment by or under the supervision of a dental practitioner,

“professional service” means—

(a) a medical service specified in an item that is rendered by or on behalf of a medical practitioner; or

(b) a prescribed medical service specified in an item that is rendered in an operating theatre of a hospital by a dental practitioner approved by the Minister for the purposes of this definition;

“proprietor”, in relation to premises, includes an authority or body of persons that has lawful control of the premises;

“recognized hospital” means a hospital that is a recognized hospital for the purposes of an agreement or for the purposes of section 32;

“registered nurse” means—

(a) a person registered under a law of a State or Territory (other than the State of South Australia) as a general nurse; or

(b) a person registered under a law of the State of South Australia as a nurse;

“table” means the table of medical services set out in Schedule 1.

(2) For the purposes of this Act—

(a) a newly-born child who occupies an approved bed in an intensive care facility in a hospital, being a facility approved by the Minister for the purposes of this sub-section, for the purpose of the provision of special care shall be deemed to be an in-patient of the hospital; and

(b) where there are two or more newly-born children of the same mother in a hospital—each such child in excess of one shall be deemed to be an in-patient of the hospital.

(3) Where an anaesthetic is administered to a patient—

(a) pre-medication of the patient in preparation for the administration of the anaesthetic; and

(b) pre-operative examination of the patient in preparation for the administration of the anaesthetic, being an examination carried out during the attendance at which the anaesthetic is administered,

shall, for the purposes of this Act, be deemed to form part of the professional service constituted by the administration of the anaesthetic.

(4) A reference in this Act to a professional attendance or to an attendance is a reference to an attendance by a medical practitioner on a patient, including an attendance at the medical practitioner’s rooms or surgery.

(5) Unless the Minister otherwise directs, a professional service, not being a service specified in an item in Part I of the table, shall be deemed to include all professional attendances necessary for the purposes of post-operative treatment of the person to whom the professional service is rendered.

(6) Where a professional service rendered to a person includes a medical procedure that would, but for this sub-section, itself be a professional service, that procedure shall, in respect of that person, be deemed not to be a professional service.

Variations and alterations of table of medical services.

4. (1) The regulations may provide that this Act shall have effect as if the table were varied—

(a) by omitting an item or rule of interpretation from the table;

(b) by inserting an item or rule of interpretation in the table; or

(c) by substituting another amount for an amount set out in an item in the table.

(2) The regulations may prescribe a table of medical services in accordance with the form of table set out in Schedule 1.

(3) On the commencement of a regulation prescribing a table of medical services—

(a) the table so prescribed has effect as if it were set out in Schedule 1 in the place of the table (in this sub-section referred to as “the superseded table”) in that Schedule; and

(b) the superseded table or, if another table has effect, by virtue of this section, in the place of the superseded table, that other table ceases to have effect.

(4) The regulations may amend a table that has effect by virtue of paragraph (3)(a) and, on the commencement of the amendment, the table as so amended has effect in the place of the first-mentioned table.

(5) In this section, a reference to a table of medical services shall be read as including a reference to rules for the interpretation of that table.

(6) Regulations under this section shall, unless sooner repealed, cease to be in force on the day next following the fifteenth sitting day of the House of Representatives after the expiration of a period of 12 months commencing on the day on which the regulations are notified in the Gazette, and shall be deemed to have been repealed on that first-mentioned day.

Health insurance cards.

5. (1) The Commission may, for the purpose of facilitating the handling of claims under this Act, issue to an eligible person a health insurance card setting out—

(a) the name of the eligible person and the number allotted to him by the Commission; and

(b) if the Commission thinks fit, the name or names of any child or children of whom the eligible person is a parent or guardian and the number allotted to that child or to each of those children.

(2) A health insurance card shall not contain any personal particulars other than those specified in sub-section (1).

Persons in Australia may apply for application of Act to them.

6. (1) A person who is in Australia but is not an eligible person may apply to the Commission for the application to him, during his stay in Australia, and to any child or children living with him in Australia, during the stay in Australia of that child or of those children, of this Act as if he or he and that child or each of those children were an eligible person or eligible persons.

(2) The Commission may approve an application under sub-section (1) subject to such conditions as it determines, including the payment of a premium by the applicant.

(3) An approval under sub-section (2) shall be expressed to relate to a specified period, which may commence on a date earlier than the date of the approval.

(4) Where an application under sub-section (1) has been approved, a person to whom the application relates shall, subject to any condition imposed under sub-section (2) and to sub-section (5), be treated as an eligible person for the purposes of this Act during the period to which the approval relates.

(5) A person to whom an application referred to in sub-section (4) relates shall not be treated as an eligible person for the purposes of this Act during any period during which he is outside Australia.

Agreement for reciprocal treatment of visitors to Australia and other countries.

7. (1) The Government of Australia may enter into an agreement with the Government of another country under which each Government agrees to arrange for visitors to the country of that Government from the country of that other Government to be treated, for the purpose of the provision of medical and hospital care, as if they were residents or citizens of the country of that Government.

(2) A visitor to Australia to whom an agreement under sub-section (1) relates shall, subject to the agreement, be treated as an eligible person for the purposes of this Act during his stay in Australia.

 

PART II—MEDICAL BENEFITS

Interpretation.

8.    For the purposes of this Part, an internal Territory shall be deemed to form part of the State of New South Wales.

Medical benefits calculated by reference to fees.

9.    Medical benefits under this Part shall be calculated by reference to the fees for medical services set out in the table.

Entitlement to medical benefits.

10. (1) Where, on or after a date to be fixed by Proclamation for the purposes of this section, medical expenses are incurred in respect of a professional service rendered in Australia to an eligible person, a 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 medical benefit under sub-section (1) in respect of a professional service is an amount equal to—

(a) 85 per centum of the fee specified in respect of that professional service in the table in relation to the State in which the service was rendered; or

(b) if the amount calculated under paragraph (a) is less by more than $5 than the fee from which it is calculated—an amount that is less by $5 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.

Increased fee in complex cases.

11. (1) Where—

(a) a claim for a medical benefit in respect of a professional service is received by the Commission; and

(b) the claimant—

(i) being the practitioner who rendered the service, states in the claim that the service was of unusual length or complexity; or

(ii) not being the practitioner who rendered the service, forwards with the claim a statement by the practitioner who rendered the service that the service was of unusual length or complexity,

the Commission shall deal with the claim in accordance with the succeeding provisions of this section.

(2) Where the Commission considers that the professional service referred to in the claim is of unusual length or complexity, the Commission shall—

(a) if the Commission considers that the service is of a kind in respect of which an increased fee may be fixed in accordance with principles furnished to the Commission under paragraph (b) or sub-section 12(5)—fix an increased fee for that service, in accordance with those principles, for the purposes of that claim; or

(b) in any other case—refer to the Medical Benefits Advisory Committee for its consideration and recommendation the question whether the fee specified in the item that relates to that service should, for the purpose of calculating the medical benefit under that claim, be increased, having regard to the unusual features of that service, and, if it is to be increased, what principles are to be followed in fixing the amount of the increased fee for that service for the purposes of that claim.

(3) Where the Commission receives a recommendation of the Committee under paragraph (2)(b) in favour of an increased fee in respect of a professional service to which a claim referred to in sub-section (1) relates, the Commission may fix an increased fee for that service, in accordance with the principles set out in that recommendation, for the purposes of that claim.

(4) Where an increased fee is fixed under paragraph (2)(a) or under sub-section (3) in respect of a professional service for the purposes of a claim referred to in sub-section (1), the Commission shall—

(a) inform the claimant, by notice in writing, of the amount of the increased fee so fixed; and

(b) calculate the medical benefit payable in respect of that professional service for the purposes of that claim as if the increased fee so fixed were set out in the item that relates to that professional service.


 

(5) Where the Commission considers that a professional service referred to in a claim under sub-section (1) is not of unusual length or complexity, the Commission shall inform the claimant, by notice in writing, accordingly.

Appeal from decision on increased fee.

12. (1) Where the Commission notifies a person under sub-section 11(4) or (5) of a decision of the Commission, the person may, within one month after the receipt of that notification, lodge with the Minister an appeal against that decision.

(2) The Minister shall refer an appeal under sub-section (1) to the Medical Benefits Advisory Committee for its consideration and recommendation whether the appeal should be allowed or dismissed and, if the appeal is to be allowed, what increased fee is to be fixed for the purposes of the claim to which the appeal relates.

(3) Where an appeal under sub-section (1) is against the amount of an increased fee fixed by the Commission and the appeal is to be allowed, the Committee shall not recommend an increased fee that is less than the amount of the increased fee to which the appeal relates.

(4) Where a recommendation of the Committee on an appeal under sub-section (1) specifies the amount of an increased fee to be fixed, the Committee may, in the recommendation, set out the principles followed by the Committee in calculating that amount.

(5) The Minister shall furnish to the Commission a statement of principles received by him in a recommendation referred to in subsection (4).

(6) When the Minister has received the recommendation of the Medical Benefits Advisory Committee on an appeal under sub-section (1), the Minister shall, in accordance with the recommendation, either allow or dismiss the appeal and, if he allows the appeal, shall give such directions to the Commission as are necessary to give effect to the recommendation of the Committee.

(7) Where the Minister allows or dismisses an appeal under this section he shall notify the appellant, in writing, accordingly.

Spectacle lenses.

13.  The regulations may provide that, where, at an attendance, an examination of the patient’s eyes is made in consequence of which spectacle lenses are prescribed, the medical benefit in respect of any professional service or professional services covered by an item in Part I of the table that is, or are, rendered during that attendance is such portion as is prescribed of the medical benefit that would, but for the regulations, be payable in respect of that professional service or those professional services.


 

Medical benefit not to exceed medical expenses incurred.

14.  A medical benefit payable in respect of a professional service shall not exceed the medical expenses incurred in respect of the professional service.

Calculation of medical benefit payable where two or more operations are performed.

15. (1) Subject to this section, for the purpose of calculating the amount of a medical benefit payable in respect of the medical expenses incurred in respect of two or more operations, each constituting a professional service covered by an item, that are performed on the one occasion on the one person—

(a) the amount specified in those items as fees, other than the greater or greatest of those amounts, shall be deemed to be reduced, as follows:—

(i) the greater or greatest of the amounts to be deemed to be reduced shall be deemed to be reduced by one-half; and

(ii) the other amount, or each of the other amounts, to be deemed to be reduced shall be deemed to be reduced by three-quarters; and

(b) the operations shall be deemed to constitute one professional service in respect of which the fee specified in the table in relation to the State in which the service was rendered is an amount equal to the aggregate of the amounts specified as fees in the items relating to those operations, being those amounts as reduced in accordance with paragraph (a).

(2) For the purposes of paragraph (1)(a)—

(a) where two or more amounts referred to in that sub-section are equal, one of those amounts shall be treated as being greater than the other or others of those amounts; and

(b) where, by virtue of a reduction in accordance with that subsection, an amount 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.

(3) This section does not apply in relation to an operation, being one of two or more operations performed under the one anaesthetic on the one person, if the practitioner who performed the operation—

(a) did not perform, or assist at, the other operation or any of the other operations; and

(b) did not administer the anaesthetic.

(4) In this section, “operation” does not include a medical service specified in Division 2 of Part 10 of the table.

Administration of anaesthetic and assistance at operation.

16. (1) A medical benefit is not, except with the approval of the Commission, payable in respect of the administration of an anaesthetic in connexion with a professional service unless the anaesthetic is administered by a practitioner other than the practitioner who renders the professional service in connexion with which the anaesthetic is administered.

(2) A medical benefit in respect of assistance at an operation is not payable if the assistance is rendered by the anaesthetist or a practitioner assisting the anaesthetist.

(3) Where an item relates to a professional service constituted by—

(a) assistance at an operation;

(b) the administration of an anaesthetic; or

(c) assistance in the administration of an anaesthetic,

the amount of medical benefit payable in respect of that professional service is the same whether the assistance is rendered, or the anaesthetic is administered, by one or more than one practitioner.

(4) For the purpose of calculating the amount of medical benefit payable in respect of the medical expenses incurred in respect of the administration of an anaesthetic to a person for the purposes of two or more operations performed on that person while he is under that anaesthetic—

(a) the amounts specified as fees in the items that relate to the administration of an anaesthetic for the purposes of those operations, other than the greater or greatest of those amounts, shall be deemed to be reduced as prescribed; and

(b) the administration of the anaesthetic shall be deemed to constitute one professional service in respect of which the fee specified in the table in relation to the State in which the anaesthetic was administered is an amount equal to the aggregate of the amounts specified as fees in the items relating to the administration of an anaesthetic for the purposes of those operations, being those amounts as reduced in accordance with paragraph (a).

(5) For the purposes of paragraph (4)(a)—

(a) where two or more amounts referred to in that sub-section are equal, one of those amounts shall be treated as being greater than the other or others of those amounts; and

(b) where, by virtue of a reduction in accordance with that subsection, an amount 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.

Medical benefit not payable in respect of certain medical expenses.

17. (1) A medical benefit is not payable in respect of a professional service if—

(a) the medical expenses in respect of that service have been paid, or are payable, to a recognized hospital;

(b) the medical practitioner who rendered the service was acting on behalf of an organization that was, when the service was rendered, an organization prescribed for the purposes of this paragraph; or

(c) any part of the service was rendered on the premises of an organization that was, when the service was rendered, an organization referred to in paragraph (b) or an approved organization for the purposes of Part IV.

(2) Unless the Minister otherwise directs, a medical benefit is not payable in respect of a professional service if the medical expenses in respect of that service have been paid, or are payable, by an organizaton to which an approval under section 34 relates in respect of a person who was, when the service was rendered, a hospital patient occupying a bed in a hospital controlled by the organization that was an approved bed for the purposes of that section.

Medical benefit not payable in respect of certain diagnostic services.

18. (1) Subject to this section, a medical benefit is not payable in respect of a diagnostic service if—

(a) the medical expenses in respect of that service have been paid, or are payable, by a recognized hospital in respect of a patient of diagnostic that hospital; or

(b) the diagnostic service is rendered by a medical practitioner acting on his own behalf to a private patient of a recognized hospital.

(2) Where the Minister is satisfied that—

(a) a recognized hospital cannot make satisfactory arrangements for the provision by the hospital of diagnostic services to private patients at the hospital;

(b) the hospital incurs medical expenses in respect of the provision by a medical practitioner of diagnostic services to private patients at the hospital; and

(c) the hospital does not charge private patients at the hospital, in whole or in part, for diagnostic services so provided,

the Minister may direct, in writing, that sub-section (1) does not apply, for a period specified in the direction, in relation to that hospital in respect of a diagnostic service referred to in paragraph (1)(a).


 

Medical benefit not payable in respect of certain professional services.

19.  A medical benefit is not payable in respect of a professional service that is a medical examination for the purposes of life insurance or admission to membership of a friendly society.

Persons entitled to medical benefits.

20. (1) Subject to this section, a medical benefit payable in respect of a professional service rendered in Australia is payable to the person who has incurred the medical expenses in respect of that professional service.

(2) Where a person to whom a medical benefit is payable under subsection (1) in respect of a professional service has not paid the medical expenses that he has incurred in respect of that professional service, he shall not be paid the medical benefit but, if he so requests, there shall be given to him, in lieu of that payment, a cheque for the amount of the medical benefit drawn in favour of the person who rendered the professional service or, if the professional service was rendered by that person on behalf of another person, in favour of that other person.

(3) A person to whom a medical benefit is payable under sub-section (1) (in this sub-section referred to as “the first party”) may enter into an agreement, in accordance with the prescribed form, with the medical practitioner, or other person, by whom, or on whose behalf, the professional service was rendered (in this sub-section referred to as “the second party”) under which—

(a) the first party assigns his right to the payment of the medical benefit to the second party; and

(b) the second party accepts the assignment in full payment of the medical expenses incurred by the first party in respect of that professional service.

(4) Where an agreement in respect of a medical benefit is entered into under sub-section (3), the medical benefit is payable in accordance with the agreement.

(5) A reference in sub-section (3) to a medical practitioner by whom a professional service was rendered does not include a reference to a medical practitioner who renders a professional service on behalf of another person or organization.

Medical service outside Australia.

21. (1) Subject to this section, where medical expenses are incurred in respect of a medical service specified in an item rendered outside Australia, on or after the date fixed for the purposes of section 10, to an Australian resident by, or on behalf of, a prescribed person, medical benefit is payable in respect of that medical service as if that medical service had been rendered in Australia by, or on behalf of, a medical practitioner.

(2) A medical benefit under sub-section (1) is payable to the person who has incurred the medical expenses in respect of the medical service and shall be paid to that person in such manner as the Commission determines.

(3) In this section, “prescribed person” means—

(a) a person authorized to practise as a medical practitioner under the law of the place where the medical service was rendered; or

(b) any other person approved by the Commission for the purposes of this definition.

(4) This section does not apply in relation to a medical service rendered in a country the Government of which is, when the service is rendered, a party to an agreement with the Government of Australia under section 7.

Claims for medical benefits.

22.  A claim for a medical benefit in respect of a professional service shall be made, in accordance with the prescribed form, to the Commission.


 

Undertakings with respect to pensioners.

23. (1) The Minister shall request every medical practitioner whom he considers is engaged in Australia in rendering professional services to persons to undertake that, where a professional service is rendered in Australia, on or after the date fixed for the purposes of section 10, by the medical practitioner on his own behalf or by a person acting on behalf of the medical practitioner to a person who identifies himself to the person rendering the service as an eligible pensioner or a dependant of an eligible pensioner, the medical practitioner will ensure that—

(a) the person who has incurred the medical expenses in respect of the professional service is asked whether he wishes to make an assignment under sub-section 20(3) of his right to the payment of the medical benefit in respect of the professional service; and

(b) if the person indicates that he so wishes—arrangements are made for the making and acceptance of the assignment under that sub-section.

(2) An undertaking under sub-section (1) shall be in writing and shall be lodged with the Minister.

(3) An undertaking under sub-section (1) does not apply in relation to a professional service rendered by a consultant physician, or a specialist, in the practice of his specialty to a patient who has not been referred to him if the professional service would, if the patient had been referred to him, be covered by an item that specifies a fee for the service that is higher than the fee applicable to the service.

PART III—PAYMENTS FOR HOSPITAL SERVICES

Approval of premises as hospital.

24. (1) The proprietor of premises may apply, in accordance with the prescribed form, for the approval of the premises as a hospital.

(2) Where the Minister is satisfied that the premises in respect of which an application under sub-section (1) is made—

(a) are used, or to be used, for the reception and lodging of patients exclusively or principally for the purpose of hospital treatment; and

(b) are properly fitted, furnished and staffed for that purpose,

he shall, subject to sub-section (3), approve the premises as a hospital for the purposes of this Act and determine the number of beds at the hospital to which the approval relates.

(3) The Minister shall not approve premises under sub-section (2) if he is satisfied that—

(a) the premises are used, or are to be used, exclusively or principally for the care or treatment of mentally ill or mentally defective persons and are under the control of, or the subject of a grant for maintenance from, Australia or a State; or

(b) the premises are a nursing home for the purposes of the National Health Act 1953-1973.

(4) The approval of premises as a hospital under this section is subject to such conditions as are determined, from time to time, by the Minister for the purpose of ensuring that the needs and welfare of patients at the hospital are satisfactorily provided for.

Issue of certificate of approval of premises as hospital.

25. (1) Upon approval of premises as a hospital, the Minister shall cause to be issued to the proprietor of the hospital a certificate of approval in accordance with the authorized form.

(2) Where the approval of premises as a hospital has been varied under section 29 and the certificate of approval has been forwarded to the Minister, the Minister shall cause to be issued to the proprietor of the hospital a new certificate of approval, in accordance with the prescribed form, setting out the approval as so varied.


 

Display of certificate of approval.

26. (1) The proprietor of a hospital shall cause the certificate of approval to be displayed in a prominent position in the hospital.

(2) Where the approval of premises as a hospital is revoked or varied the proprietor of the premises shall forthwith forward the certificate of approval to the Minister.

Penalty: $100.

Inspection of hospitals.

27. (1) The Minister may, by writing under his hand, authorize an officer or other person to inspect hospitals or any premises in respect of which an application for approval under section 24 has been made.

(2) The proprietor of premises referred to in sub-section (1) shall permit the officer or person so authorized to inspect the premises at any reasonable time.

Penalty: $100.

Notice of person ceasing to be proprietor of hospital.

28. (1) If the proprietor of a hospital ceases to be the proprietor of the hospital, he shall, by notice in writing, notify the Minister forthwith.

(2) If the proprietor of a hospital dies, the legal personal representative of the deceased proprietor shall, by notice in writing, notify the Minister forthwith.

Penalty: $100.

Revocation or variation of approval of premises as hospital.

29. (1) Where the Minister receives an application, in writing, by the proprietor of a hospital for a variation of the approval of the premises constituting the hospital, the Minister may vary that approval in accordance with the application.

(2) Where the Minister—

(a) considers that the nature of a hospital has changed since the approval of the hospital was given;

(b) receives a notice in writing under section 28 in respect of a hospital; or

(c) is satisfied that a condition determined by the Minister under sub-section 24(4) has not been complied with in respect of a hospital,

the Minister may revoke or vary the approval of the premises constituting the hospital.

(3) Where the Minister receives an application, in writing, by the proprietor of a hospital for revocation of the approval of the premises constituting the hospital, he shall revoke the approval accordingly.

Agreements with States for provision of hospital services.

30. (1) Australia may enter into an agreement with a State for the provision of hospital services by the State to eligible persons.

(2) An agreement referred to in sub-section (1) shall be substantially in accordance with the Heads of Agreement specified in Schedule 2 but may include provisions with respect to other matters.

(3) An agreement under this section shall not operate with respect to a period before a date to be fixed by Proclamation for the purposes of this section.


 

Daily bed payments to recognized hospitals.

31. (1) For the purposes of an agreement with a State or for the purposes of section 32, a daily bed payment, in relation to a recognized hospital, is a payment of $16 for each approved bed in the hospital for each day on which the bed is occupied by an eligible person who is an inpatient of the hospital.

(2) For the purposes of sub-section (1), a person shall be deemed not to occupy a bed on the day of his discharge from a hospital unless that day is also the day of his admission to the hospital.

Payments to recognized hospitals in internal Territories.

32. (1) The Minister may approve such hospitals in an internal Territory as he thinks fit as recognized hospitals for the purposes of this section.

(2) On and after the date fixed for the purposes of section 30, there is payable by Australia to each recognized hospital in an internal Territory daily bed payments in accordance with section 31.

(3) On and after the date fixed for the purposes of section 30, there is payable by Australia, in respect of each financial year or such other period as the Minister fixes, to each recognized hospital in an internal Territory, in addition to the daily bed payments under sub-section (2) in respect of that financial year or other period, an amount equal to the amount by which the aggregate of those daily bed payments is less than an amount equal to 50 per centum of the net operating costs of that hospital in respect of that financial year or other period.

Daily bed payments to private hospitals.

33. (1) On and after the date fixed for the purposes of section 30, there is payable by Australia to a private hospital in a State that is a party to an agreement or in an internal Territory a daily bed payment of $16 for each approved bed in the hospital for each day on which the bed is occupied by an eligible person who is an in-patient at the hospital.

(2) Where the charge made by a hospital referred to in sub-section (1) in respect of the occupancy for a day of an approved bed in the hospital (other than a bed that is an approved bed for the purposes of section 34) is less than the amount of the daily bed payment specified in that sub-section, the daily bed payment in respect of that bed for that day shall not exceed the amount of that charge.

(3) Where the average cost to a hospital referred to in sub-section (1) of maintaining an approved bed in the hospital (other than a bed that is an approved bed for the purposes of section 34) for a day is less than the amount of the daily bed payment specified in that sub-section, the daily bed payment in respect of each approved bed in that hospital (other than a bed that is an approved bed for the purposes of section 34) for that day shall not exceed the amount of that average cost.

(4) For the purposes of this section, a person shall be deemed not to occupy a bed on the day of his discharge from a hospital unless that day is also the day of his admission to the hospital.

Supplementary daily bed payments to private hospitals.

34. (1) This section applies to an organization that—

(a) is carried on otherwise than for the purpose of profit or gain to its individual members; and

(b) is—

(i) a religious organization;

(ii) an organization the principal objects or purposes of which are charitable or benevolent; or

(iii) an organization approved by the Minister for the purposes of this section.

(2) An organization to which this section applies may make application to the Minister, in accordance with the prescribed form, for approval to provide care and treatment without charge for eligible persons as hospital patients at a hospital (other than a recognized hospital) controlled by the organization, being a hospital in a State that is a party to an agreement or in an internal Territory.

(3) Where the Minister approves an application under sub-section (1), he shall determine the number of beds at the hospital to which the approval relates.

(4) There is payable by Australia to an organization to which this section applies a supplementary daily bed payment, at a rate fixed by the Minister, for each approved bed in a hospital controlled by the organization to which an approval under this section relates for each day on which the bed is occupied without charge by an eligible person who is a hospital patient at the hospital.

(5) A supplementary daily bed payment under sub-section (4) is not payable in respect of any period before the date fixed for the purposes of section 30.

(6) For the purposes of sub-section (4), a person shall be deemed not to occupy a bed on the day of his discharge from a hospital unless that day is also the day of his admission to the hospital.

(7) In fixing a rate for the purposes of sub-section (4), the Minister shall have regard to the loss of revenue of, and any increased cost to, the organization resulting from the provision of care and treatment without charge to eligible persons who are hospital patients occupying approved beds at the hospital.

(8) A supplementary daily bed payment under this section is payable in addition to a daily bed payment under section 33.

(9) Nothing in this section entitles an eligible person to admission as a hospital patient to a hospital controlled by an organization to which an approval under this section relates.

(10) In this section, “approved bed”, in relation to a hospital, means a bed included in the number of beds at the hospital to which the approval under this section relates.

Claims by proprietors of private hospitals.

35. A claim for a payment under this Part in respect of a private hospital—

(a) shall be made in accordance with the prescribed form to the Commission;

(b) shall relate to such period, and shall be submitted at such time, as the Commission determines; and

(c) shall be accompanied by such information relating to the claim as is shown in the prescribed form to be required or as the Minister determines.

Power to call for returns from proprietors of private hospitals.

36. The Minister may, by notice in writing, require the proprietor of a private hospital to furnish to him, within the time specified in the notice, such return or information in relation to matters relevant to the occupation of approved beds in the hospital as is specified in the notice, including a return or information verified by statutory declaration.

Access to premises.

37. (1) An authorized person may, with the consent of the occupier of any premises, enter the premises for the purpose of exercising the functions of an authorized person under this section.

(2) Where—

(a) an occupier of premises has refused consent to the entry, at a reasonable time, on the premises, of an authorized person; and

(b) an authorized person has reason to believe that there are on the premises books, documents or papers relating to the occupation of approved beds in a hospital,

the authorized person may, within one month of the refusal, make application to a Magistrate for a warrant authorizing the authorized person who makes the application to enter the premises for the purpose of exercising the functions of an authorized person under this section.

(3) If, on an application under sub-section (2), the Magistrate is satisfied, by information on oath—

(a) that there is reasonable ground for believing that there are on the premises to which the application relates any books, documents or papers relating to the occupation of approved beds in a hospital; and

(b) that the issue of a warrant is reasonably required for the purposes of this Act,

the Magistrate may grant a warrant, in accordance with the prescribed form, authorizing the authorized person, with such assistance as he thinks necessary, to enter the premises, during such hours of the day or night as the warrant specifies or, if the warrant so specifies, at any time, if necessary by force, for the purpose of exercising the functions of an authorized person under this section.

(4) Where an authorized person has entered any premises in pursuance of sub-section (1) or in pursuance of a warrant granted under subsection (3), he may exercise the functions of an authorized person under this section.

(5) A person shall not, without reasonable excuse, obstruct or hinder an authorized person acting in pursuance of a warrant under sub-section (3) or in pursuance of sub-section (4).

Penalty: $200.

(6) The functions of an authorized person under this section are to search for, inspect, take extracts from, or make copies of, any books, documents or papers relating to the occupation of approved beds in a hospital.

(7) In this section—

“authorized person” means a person authorized, in writing, by the Minister for the purposes of this section;

“occupier”, in relation to premises, includes the person in charge of the premises.

Advances.

38. (1) The Minister may direct the Commission to make such advances in respect of amounts that may become payable under this Part as the Minister determines.

(2) Advances under sub-section (1) may be made subject to such conditions as the Minister determines.

 

PART IV—HEALTH PROGRAM GRANTS

Definitions.

39.  In this Part, unless the contrary intention appears—

“approved health service” means a health service in respect of which an approval is in force under section 41;

“approved organization” means an organization in respect of which an approval is in force under section 40.

Approval of organizations.

40. (1) An organization may apply, in accordance with the prescribed form, to the Minister for approval as an organization under this Part.

(2) The Minister may require an organization that makes an application under sub-section (1) to furnish to him such further information in relation to the organization as the Minister requires.

(3) The Minister may approve an organization to which an application under sub-section (1) relates and, if he does so, he shall, in the

instrument of approval, fix a date (which may be a date earlier than the date of the approval) on and from which the approval has effect.

(4) An organization that was, immediately before this Act receives the Royal Assent, entitled, by virtue of an authorization under section 25 of the National Health Act 1953-1973, to payments under that section shall, on the day on which this Act receives the Royal Assent, be deemed to have been approved by the Minister under sub-section (3), but that approval may be revoked by the Minister at any time.

Approval of health services.

41. (1) An approved organization may apply, in accordance with the prescribed form, to the Minister for approval of a health service provided, or to be provided, by the organization.

(2) The Minister may require an organization that makes an application under sub-section (1) to furnish to him such further information in relation to the health service to which the application relates as he requires.

(3) The Minister may approve a health service to which an application under sub-section (1) relates and, if he does so, he shall, in the instrument of approval, fix a date (which may be a date earlier than the date of the approval) on and from which the approval has effect.

Entitlement to health program grant.

42.  Subject to this Part, an approved organization is entitled to be paid an amount equal to the costs incurred by the organization in providing, on or after a date to be fixed by Proclamation for the purposes of this section, an approved health service (including such part of the management expenses of the organization as the Minister considers to be attributable to the provision of the health service) or such proportion of those costs as the Minister determines from time to time.

Conditions of payment of grant.

43. (1) A payment (including an advance) under this Part to an approved organization may be made subject to such conditions as the Minister determines, including conditions relating to the terms and conditions in accordance with which the services of practitioners providing the approved health service to which the payment relates are made available to the organization.

(2) If a condition subject to which a payment (including an advance) under this Part has been made is not complied with by an approved organization, the Minister may direct that the whole or a part of that payment be recovered from the organization and, on the service by post on that organization of a copy of that direction, the amount specified in the direction is recoverable by Australia from that organization as a debt due to Australia.

Minister to consult with Commission.

44.  Before giving an approval under section 40 or 41 or making a determination under section 42 or 43, the Minister shall consult with the Australian Hospitals and Health Services Commission on the matter and shall have regard to any recommendation made to him by that Commission.

Claims for health program grants.

45. (1) A claim for a payment under this Part shall be submitted to the Commission in accordance with such form, and at such times, as the Minister directs.

(2) Where a claim has been made under sub-section (1), the Minister may require the organization that made the claim to furnish to the Minister such further information in relation to the claim as the Minister requires.

(3) Where the Minister considers that the management expenses of an approved organization that are attributable to the provision of an approved health service are excessive, he may direct that such part only of those expenses as he directs shall be taken into account in ascertaining the amount that the organization is entitled to be paid under this Part in respect of the provision of that health service.

Advances.

46. (1) The Minister may direct the Commission to make such advances in respect of amounts that may become payable under this Part as the Minister determines.

(2) Advances under sub-section (1) may be made subject to such conditions as the Minister determines.


 

PART V—COMMITTEES AND REVIEW TRIBUNALS

 

Division 1—Specialist Recognition Advisory Committees and the
 Specialist Recognition Appeal Committee

Definitions.

47.  In this Division, unless the contrary intention appears—

“Committee” means a Specialist Recognition Advisory Committee or the Specialist Recognition Appeal Committee;

“member” means a member of a Committee, and includes a person appointed under section 53 to act in the place of a member.

Establishment of Specialist Recognition Advisory Committees.

48. (1) The Minister shall establish for—

(a) each State;

(b) the Australian Capital Territory; and

(c) the Northern Territory,

a Specialist Recognition Advisory Committee.

(2) Each Specialist Recognition Advisory Committee shall consist of five medical practitioners appointed by the Minister in accordance with section 50.

(3) The exercise or performance of the powers or functions of a Specialist Recognition Advisory Committee is not affected by reason only of there being a vacancy or vacancies in the membership of the Committee.

(4) A member of a Specialist Recognition Advisory Committee holds office for a period of 3 years.

(5) A member of the Specialist Recognition Appeal Committee is not eligible to be appointed under this section to a Specialist Recognition Advisory Committee.

Establishment of Specialist Recognition Appeal Committee.

49. (1) There shall be a Specialist Recognition Appeal Committee, which shall consist of five medical practitioners appointed by the Minister in accordance with section 50.

(2) The exercise or performance of the powers or functions of the Specialist Recognition Appeal Committee is not affected by reason only of there being a vacancy or vacancies in the membership of the Committee.

(3) A member of the Specialist Recognition Appeal Committee holds office for a period of 3 years.

(4) A member of a Specialist Recognition Advisory Committee is not eligible to be appointed under this section to the Specialist Recognition Appeal Committee.

Panels for appointments to Committees.

50. (1) Before making appointments to a Committee, the Minister shall request each of the following bodies to nominate a panel of not less than three medical practitioners for consideration for appointment to the Committee:—

(a) the Australian Medical Association;

(b) the Royal Australasian College of Surgeons;

(c) the Royal Australasian College of Physicians;

(d) the Australian Council of the Royal College of Obstetricians and Gynaecologists; and

(e) the Royal Australian College of General Practitioners.

(2) When, in accordance with a request under sub-section (1), each of the bodies referred to in that sub-section has nominated a panel of medical practitioners for consideration for appointment to a Committee, the Minister shall appoint to the Committee one medical practitioner from each of the panels.

Members of Committees under the National Health Act maybe deemed to be members of Committees under this Division.

51. (1) The Minister may direct that a person who is a member of a Specialist Recognition Advisory Committee for a State or Territory under the National Health Act 1953-1973 shall be deemed to be a member of the Specialist Recognition Advisory Committee for that State or Territory under this Act during such period, not being a period that ends after the expiration of the period for which the person was appointed under that Act as a member of that first-mentioned Committee, as the Minister specifies in the direction.

(2) The Minister may direct that a person who is a member of the Specialist Recognition Appeal Committee under the National Health Act 1953-1973 shall be deemed to be a member of the Specialist Recognition Appeal Committee under this Act during such period, not being a period that ends after the expiration of the period for which the person was appointed under that Act as a member of that first-mentioned Committee, as the Minister specifies in the direction.

(3) Sections 54 and 55 apply in relation to a person referred to in sub-section (1) or (2) as if that person had been appointed a member of the relevant Committee under section 48 or 49.

Election of Chairman of Committee.

52. (1) The Minister shall convene a meeting of a Committee for the purpose of electing one of the members to be the Chairman of the Committee.

(2) Whenever a vacancy occurs in the office of Chairman of a Committee, the Minister shall convene a meeting of the Committee for the purpose of electing one of the members to be the new Chairman.

(3) The Minister shall appoint one of the members of a Committee to preside at a meeting of the Committee under this section.

(4) The quorum for a meeting of a Committee under this section is three members of the Committee.

(5) The election of a Chairman of a Committee at a meeting under this section shall be made by a majority of votes of the members of the Committee present and voting.

(6) In the event of an equality of votes on a question before a meeting of a Committee under this section, the member of the Committee presiding at the meeting shall adjourn the meeting until a time and place to be fixed by the Minister.

(7) A member of a Committee elected as a Chairman of the Committee holds that office until the expiration of the period of his appointment as a member of the Committee or, if he earlier ceases to be such a member, until he so ceases.

Appointment of persons to act in place of member.

53. (1) Subject to sub-section (2), the Minister may, if he becomes aware that a member of a Committee will be unable to attend a meeting or meetings of the Committee, appoint a person to act in the place of that member at the meeting or meetings that the member will be unable to attend.

(2) Before making an appointment under sub-section (1), the Minister shall consult with the body that nominated the panel from which the absent member was appointed.

(3) A person appointed to act in the place of a member of a Committee who is the Chairman of the Committee is not entitled to act as the Chairman of the Committee.

(4) The Minister may, at any time, terminate an appointment made by him under this section.

Termination of appointment.

54.  The Minister may terminate the appointment of a member for misbehaviour or physical or mental incapacity.

Resignation.

55.  A member may resign his office by writing under his hand delivered to the Minister.

Appointment to vacant office.

56.  Where a vacancy occurs in the office of a member, the Minister shall request the body by whom the member was nominated to nominate a panel of not less than three medical practitioners for consideration for appointment to that office, and the Minister shall appoint one of those medical practitioners to that office.

Irregularities in nomination of members.

57.  The validity of the appointment of a member from a panel of persons nominated under section 50 or 56 shall not be called into question by reason only of a defect or irregularity in connexion with the nomination of persons to that panel.

Remuneration and allowances.

58. (1) A member shall be paid such remuneration as the Parliament fixes but, until 1 January 1975, he shall be paid such remuneration as is prescribed.

(2) A member shall be paid such allowances (not including an annual allowance) as are prescribed.

Meetings of Committees.

59. (1) The Chairman of a Committee shall convene such meetings of the Committee as are necessary for the efficient conduct of its affairs.

(2) The Chairman of a Committee shall preside at all meetings of the Committee at which he is present.

(3) In the event of the absence of the Chairman of a Committee from a meeting of the Committee, the members present shall elect one of their number to preside at that meeting and the member so elected shall preside accordingly.

(4) The quorum for a meeting of a Committee is three members of the Committee.

(5) A question arising at a meeting of a Committee shall be decided by a majority of the votes of the members of the Committee present and voting and, for that purpose, the member presiding shall have a deliberative vote only.

(6) In the event of an equality of votes on a question before a meeting of a Committee, the question shall be deemed to be unresolved and the member presiding may direct that the question be reconsidered at a time and place fixed by him.

(7) In this section, “meeting” does not include a meeting under section 52.

Proceedings at meetings.

60. (1) Subject to this Act and the regulations, a Committee may regulate and conduct proceedings at its meetings as it thinks fit.

(2)  The meetings of a Committee shall be held in private.

Recognition of consultant physician,

61. (1) The Minister may refer to a Specialist Recognition Advisory Committee the question whether a particular medical practitioner who is resident, or practises medicine, in the State or Territory for which the Committee is established should, having regard to his qualifications, experience and standing in the medical profession and the nature of his practice, be recognized for the purposes of this Act as a consultant physician, or as a specialist, in a particular specialty in respect of that State or Territory.

(2) A Committee shall consider a question referred to it under subsection (1) and may submit to the Minister—

(a) a recommendation that the medical practitioner to whom the question relates is to be recognized as a consultant physician, or as a specialist, in the specialty concerned; or

(b) a recommendation that the medical practitioner to whom the question relates is not to be recognized as a consultant physician, or as a specialist, in the specialty concerned.

(3) Subject to sub-section (4), on the receipt of a recommendation under sub-section (2), the Minister shall make a determination, for the purposes of this Act, giving effect to the recommendation.

(4) Where

(a) a recommendation under sub-section (2) is that a medical practitioner is not to be recognized as a consultant physician, or as a specialist, in a specialty; and

(b) the specialty is one in respect of which he is registered as a consultant physician or as a specialist, as the case may be, under the law of the State or Territory for which the Committee is established,

the Minister shall not make a determination giving effect to that recommendation.

(5) Where the Minister makes a determination under sub-section (3), he shall—

(a)  notify the Commission, in writing, accordingly; and

(b) where the determination is that the medical practitioner is not to be recognized—notify the medical practitioner, in writing, accordingly.

(6) A determination under sub-section (3) ceases to have effect when the medical practitioner to whom the determination relates ceases to be resident or to practise medicine, as the case may be, in the State or Territory for which the Committee is established.

(7) Nothing in this section prevents the recognition, for the purposes of this Act, as a consultant physician, or as a specialist, in a specialty, of a medical practitioner in relation to whom no determination under this section is in force.

(8) A determination of the Minister that a medical practitioner is not to be recognized as a consultant physician, or as a specialist, in a specialty does not affect entitlement to medical benefit in respect of a professional service rendered before the date of the determination.

Appeal against refusal of recognition as consultant physician.

62. (1) Where the Minister notifies a medical practitioner that the Minister has determined that the medical practitioner is not to be recognized, for the purposes of this Act, as a consultant physician, or as a specialist, in a specialty, the medical practitioner may, within 1 month after the receipt of that notification, lodge notice of appeal with the Specialist Recognition Appeal Committee and may accompany the notice with a statement of the case in support of the appeal.

(2) The Committee shall consider an appeal so lodged and, if the Committee is of the opinion that the appeal should be allowed, the Committee shall allow the appeal, but otherwise shall dismiss the appeal.

(3) Where the Committee allows or dismisses an appeal, it shall notify the appellant and the Minister, in writing, accordingly.

(4) Where the Committee allows an appeal, the Minister shall make the appropriate determination in relation to the appellant.

Committee may inform itself in any manner.

63.  For the purposes of the consideration of any matter the subject of a reference or an appeal, a Committee may inform itself in such manner as it thinks fit.


 

Chairman may engage consultants.

64.  With the approval of the Minister, the Chairman of a Committee may, on behalf of Australia, engage as consultants to the Committee persons having suitable qualifications and experience.

 

Division 2–Medical Benefits Advisory Committee

Definitions.

65.  In this Division, unless the contrary intention appears—

“Chairman” means the Chairman of the Committee;

“Committee ” means the Medical Benefits Advisory Committee;

“Deputy Chairman” means the Deputy Chairman of the Committee;

“member” means a member of the Committee, and includes a person appointed under section 70 to act in the place of a member;

“reference” means a reference to the Committee under section 67.

Establishment of Medical Benefits Advisory Committee.

66. (1) The Minister may establish a Medical Benefits Advisory Committee consisting of eight members, including at least five medical practitioners.

(2) The members of the Committee shall be appointed by the Minister and four of the members who are required to be medical practitioners shall be so appointed after consultation by the Minister with the Australian Medical Association or such other associations or colleges of medical practitioners as the Minister considers appropriate.

(3) Subject to this Act, each member holds office for such period as is specified by the Minister in the instrument of his appointment and is eligible for re-appointment.

(4) An act or decision of the Committee is not affected by reason only of there being a vacancy or vacancies in the membership of the Committee.

Functions of Committee.

67. (1) The functions of the Committee are—

(a) in pursuance of a reference to it by the Minister, to consider—

(i) in what manner, and to what extent, a particular treatment or combination of treatments should be specified in an item or items and the appropriate fee or fees that should be specified in that item or those items; or

(ii) whether the scope of, or the amount of the fee set out in, an item is anomalous, having regard to the other items,

and to make recommendations, in writing, to the Minister arising out of that consideration; and

(b) in pursuance of a reference to it by the Commission under section 11, to determine whether a fee with respect to a professional service should be increased for the purposes of a particular claim and, if it is to be so increased, to formulate the principles to be followed in fixing the increased fee, and to make recommendations, in writing, to the Commission accordingly; and

(c) in pursuance of a reference to it by the Minister under section 12, to determine whether an appeal under that section should be allowed or dismissed and, if the appeal is to be allowed, to determine the amount of the increased fee to be fixed with respect to the professional service concerned and, if the Committee thinks fit, to formulate the principles followed by the Committee in fixing that increased fee.

(2) In this section, “treatment” means a medical, surgical, obstetric or dental treatment.

Election of Chairman and Deputy Chairman.

68. (1) The Minister shall convene a meeting of the Committee for the purpose of electing one of the members to be the Chairman and another of the members to be the Deputy Chairman.

(2) Whenever a vacancy occurs in the office of Chairman or Deputy Chairman, the Minister shall convene a meeting of the Committee for the purpose of electing one of the members to be the new Chairman or Deputy Chairman.

(3) The Minister shall appoint one of the members to preside at a meeting convened under this section.

(4) The quorum for a meeting under this section is five members, including three medical practitioners.

(5) The election of a Chairman or Deputy Chairman at a meeting convened under this section shall be made by a majority of votes of the members present and voting.

(6) In the event of an equality of votes on a question before a meeting convened under this section, the member presiding at the meeting shall adjourn the meeting until a time and place to be fixed by the Minister.

(7) The member elected as the Chairman or the Deputy Chairman holds that office until the expiration of the period of his appointment as a member or, if he earlier ceases to be a member, until he so ceases.

Exercise of powers and functions of Chairman by Deputy Chairman.

69.  The Deputy Chairman may, during any period when the Chairman is absent from duty or absent from Australia or, for any other reason, is unable to perform the duties of his office, exercise the powers of the Chairman.

Appointment of person to act in place of member.

70. (1) Subject to sub-section (2), the Minister may, if he becomes aware that a member will be unable to attend a meeting or meetings of the Committee, appoint a person to act in the place of that member at the meeting or meetings that the member will be unable to attend.

(2) A person appointed to act in the place of a member who is a medical practitioner shall himself be a medical practitioner.

(3) A person appointed to act in the place of a member who is the Chairman or the Deputy Chairman is not entitled to act as the Chairman or the Deputy Chairman, as the case may be.

(4) The Minister may, at any time, terminate an appointment made by him under this section.

Termination of appointment.

71.  The Minister may terminate the appointment of a member for misbehaviour or physical or mental incapacity.

Resignation of members.

72.  A member may resign his office by writing under his hand delivered to the Minister.

Appointment to vacant office.

73. (1) Subject to sub-section (2), where a vacancy occurs in the office of a member, the Minister may appoint a person to that office.

(2) Where an office referred to in sub-section (1) was occupied by a medical practitioner who had been appointed after a consultation referred to in sub-section 66(2), the Minister shall appoint a medical practitioner to that office and, before making that appointment, shall consult the Australian Medical Association or such other associations or colleges of medical practitioners as he considers appropriate.

(3) Subject to this Act, a member appointed under this section holds office for such period as is specified by the Minister in the instrument of his appointment and is eligible for re-appointment.

Remuneration and allowances.

74. (1) A member shall be paid such remuneration as the Parliament fixes but, until 1 January 1975, shall be paid such remuneration as is prescribed.

(2) A member shall be paid such allowances (not including an annual allowance) as are prescribed.

Meetings of Committee.

75. (1) The Chairman shall convene such meetings of the Committee as are necessary for the efficient conduct of its affairs.

(2) The Chairman shall preside at all meetings of the Committee at which he is present.

(3) In the event of the absence of the Chairman from a meeting the Deputy Chairman shall preside at that meeting.

(4) In the event of the absence of the Chairman and of the Deputy Chairman from a meeting, the members present shall elect one of their number to preside at that meeting.

(5) The quorum for a meeting shall be five members including three medical practitioners.

(6) A question arising at a meeting of the Committee shall be decided by a majority of the votes of the members present and voting and, for that purpose, the member presiding shall have a deliberative vote only.

(7) In the event of an equality of votes on a question before a meeting of the Committee, the question shall be deemed to be unresolved and the member presiding may direct that the question be reconsidered at a time and place fixed by him.

(8) In this section, “meeting” does not include a meeting under section 68.

Proceedings at meetings.

76. (1) Subject to this Act and the regulations, the Committee may regulate the proceedings at its meetings as it thinks fit.

(2) The meetings of the Committee shall be held in private.

Committee may inform itself in any manner.

77.  For the purposes of the consideration of any matter the subject of a reference, the Committee may inform itself in such manner as it thinks fit.

Chairman may engage consultants.

78.  With the approval of the Minister, the Chairman may, on behalf of Australia, engage as consultants to the Committee persons having suitable qualifications and experience.

Division 3—Medical Services Committees of Inquiry

Interpretation.

79. (1) In this Division, unless the contrary intention appears—

“Chairman” means the Chairman of a Committee;

“Committee” means a Medical Services Committee of Inquiry;

“Deputy Chairman” means the Deputy Chairman of a Committee;

“excessive services” means professional services, being services in respect of which medical benefit has become or may become payable, that are not reasonably necessary for the adequate medical care of the patient;

“hearing” means a hearing conducted under section 94;

“member” means a member of a Committee, and includes a person appointed under section 85 to act in the place of a member;

“reference” means a reference by the Minister to a Committee under section 82.

(2) For the purposes of this Division—

(a) the Australian Capital Territory shall be deemed to be part of the State of New South Wales; and

(b) the Northern Territory shall be deemed to be part of the State of South Australia.


 

Establishment of Medical Services Committees of Inquiry.

80. (1) The Minister shall establish for each State a Committee to be called a Medical Services Committee of Inquiry for that State and may establish two or more such Committees for a State.

(2) Each Committee shall consist of five medical practitioners.

(3) The members of each Committee shall be appointed by the Minister and four of them shall be so appointed after consultation by the Minister with the Australian Medical Association or such other associations or colleges of medical practitioners as the Minister considers appropriate.

(4) Subject to this Act, each member holds office for such period as is specified by the Minister in the instrument of his appointment and is eligible for re-appointment.

(5) An act or decision of a Committee is not affected by reason only of there being a vacancy or vacancies in the membership of the Committee.

Members of Committees under the National Health Act may be deemed to be members of Committees under this Division.

81. (1) The Minister may direct that a person who is a member of a Medical Services Committee of Inquiry for a State under the National Health Act 1953-1973 shall be deemed to be a member of the Medical Services Committee of Inquiry for that State under this Act during such period, not being a period that ends after the expiration of the period for which the person was appointed under that Act as a member of that first- mentioned Committee, as the Minister specifies in the direction.

(2) Sections 86 and 87 apply in relation to a person referred to in sub-section (1) as if that person had been appointed a member of the relevant Committee under section 80.

Function of Committees.

82. (1) A Committee shall inquire into, and report to the Minister on, any matter referred to the Committee by the Minister, being a matter that is relevant to the operation or administration of this Act and arises out of or relates to—

(a) the rendering, on or after the date fixed for the purposes of section 10, in the State for which the Committee is established, of professional services to eligible pensioners or dependants of eligible pensioners; or

(b) the rendering, on or after that date, in the State for which the Committee is established, of such other professional services as are prescribed.

(2) Before making any regulations for the purposes of paragraph (1)(b), the Governor-General shall take into consideration any recommendation with respect to the matters to be prescribed made to the Minister by the Australian Medical Association.

Election of Chairman and Deputy Chairman.

83. (1) The Minister shall convene a meeting of each Committee for the purpose of electing one of the members of the Committee to be the Chairman of the Committee and another of the members to be the Deputy Chairman of the Committee.

(2) Whenever a vacancy occurs in the office of Chairman of a Committee or Deputy Chairman of a Committee, the Minister shall convene a meeting of the Committee for the purpose of electing one of the members to be the new Chairman or Deputy Chairman.

(3) The Minister shall appoint one of the members of a Committee to preside at a meeting of the Committee convened under this section.

(4) The quorum for a meeting of a Committee under this section is three members of the Committee.

(5) The election of a Chairman of a Committee or Deputy Chairman of a Committee at a meeting convened under this section shall be made by a majority of votes of the members of the Committee present and voting.

(6) In the event of an equality of votes on a question before a meeting of a Committee convened under this section, the member of the Committee presiding at the meeting shall adjourn the meeting until a time and place to be fixed by the Minister.

(7) A member of a Committee elected as the Chairman of the Committee or the Deputy Chairman of the Committee holds that office until the expiration of the period of his appointment as a member of the Committee or, if he earlier ceases to be such a member, until he so ceases.

Exercise of powers and functions of Chairman by Deputy Chairman.

84.  The Deputy Chairman of a Committee may, during any period when the Chairman of the Committee is absent from duty or absent from Australia or, for any other reason, is unable to perform the duties of his office, exercise the powers of the Chairman of the Committee.

Appointment of person to act in place of member.

85. (1) Subject to sub-section (2), the Minister may, if he becomes aware that a member of a Committee will be unable to attend a meeting or meetings of the Committee, appoint a medical practitioner to act in the place of that member at the meeting or meetings that the member will be unable to attend.

(2) A person appointed to act in the place of a member who is the Chairman or the Deputy Chairman is not entitled to act as the Chairman or the Deputy Chairman, as the case may be.

(3) The Minister may, at any time, terminate an appointment made by him under this section.

Termination of appointment.

86.  The Minister may terminate the appointment of a member for misbehaviour or physical or mental incapacity.

Resignation.

87.  A member may resign his office by writing under his hand delivered to the Minister.

Appointment to vacant office.

88. (1) Subject to sub-section (2), where a vacancy occurs in the office of a member, the Minister may appoint a person to that office.

(2) Where an office referred to in sub-section (1) was occupied by a medical practitioner who had been appointed after a consultation referred to in sub-section 80(3), the Minister shall appoint a medical practitioner to that office and, before making that appointment, shall consult the Australian Medical Association or such other associations or colleges of medical practitioners as he considers appropriate.

(3) Subject to this Act, a member appointed under this section holds office for such period as is specified by the Minister in the instrument of his appointment and is eligible for re-appointment.

Remuneration and allowances.

89. (1) A member shall be paid such remuneration as the Parliament fixes but, until 1 January 1975, shall be paid such remuneration as is prescribed.

(2) A member shall be paid such allowances (not including an annual allowance) as are prescribed.

Meetings of Committee.

90. (1) The Chairman of a Committee shall convene such meetings of the Committee as are necessary for the efficient conduct of its affairs.

(2) The Chairman of a Committee shall preside at all meetings of the Committee at which he is present.

(3) In the event of the absence of the Chairman from a meeting of a Committee the Deputy Chairman of that Committee shall preside at that meeting.

(4) In the event of the absence of the Chairman and of the Deputy Chairman from a meeting of a Committee, the members present shall elect one of their number to preside at that meeting.

(5) The quorum for a meeting of a Committee is three members.

(6) A question arising at a meeting of a Committee shall be decided by a majority of the votes of the members present and voting and, for that purpose, the member presiding shall have a deliberative vote only.

(7) In the event of an equality of votes on a question before a meeting of a Committee, the question shall be deemed to be unresolved and the member presiding may direct that the question be reconsidered at a time and place fixed by him.

(8) In this section, “meeting” does not include a meeting under section 83.

Proceedings at meetings.

91. (1) Subject to this Act and the regulations, a Committee may regulate the proceedings at its meetings as it thinks fit.

(2) The meetings of a Committee shall be held in private.

Committee may inform itself in any manner.

92.  Subject to section 94, the Committee may, for the purpose of its inquiry into a matter the subject of a reference, inform itself in such manner as it thinks fit.

Chairman may engage consultants.

93.  With the approval of the Minister, the Chairman of a Committee may, on behalf of Australia, engage as consultants to the Committee persons having suitable qualifications and experience.

Hearing by Committee.

94.  Where, after consideration of a matter referred to a Committee by the Minister and of any documents that accompany the reference supplied by the Minister, it appears to the Committee that a practitioner may have rendered excessive services, the Committee shall conduct a hearing into the question whether the practitioner has rendered excessive services.

Notice to practitioner of hearing.

95. (1) A Committee shall cause a notice in writing of the time and place of a proposed hearing to be given to the practitioner, or to each of the practitioners, concerned at least 10 days before the date of the proposed hearing.

(2) A notice under sub-section (1) shall give particulars of the alleged conduct to which the hearing relates.

(3) A notice under sub-section (1) may be served on a person either personally or by post.

Rights of practitioner at hearing.

96. Where a notice has been served on a practitioner under section 95

(a) the practitioner may appear in person, or may be represented by another person, at the hearing to which the notice relates; and

(b) if the practitioner appears, or is represented, at the hearing, he or his representative shall be given the opportunity to give evidence, or to call witnesses, on behalf of the practitioner, to examine other witnesses appearing at the hearing and to address the Committee.

Conduct of hearing.

97. (1) A hearing shall be held in private.

(2) At a hearing, the Chairman or, in the absence of the Chairman, the Deputy Chairman or, in the absence of the Chairman and the Deputy Chairman, the member appointed for the purpose by the Committee shall preside.

(3) The rules of evidence do not apply in relation to a hearing and the procedure for conducting the hearing is, subject to this Act and the regulations, within the discretion of the member presiding.

(4) Where a document, book or writing is produced at a hearing—

(a) a member may inspect the document, book or writing;

(b) the member presiding at the hearing may retain the document, book or writing in his possession for such reasonable period as he thinks fit; and

(c) where the document, book or writing is so retained, a member may make copies of, or take extracts from, that document, book or writing.

(5) The member presiding at a hearing may adjourn the hearing from time to time as he thinks fit.

Evidence at hearing.

98. Evidence at a hearing shall be taken on oath or affirmation and, for the purposes of this Act, any member may administer an oath or affirmation.

Summons to give evidence, &c.

99. (1) For the purposes of this Act, a member may, by writing under his hand, summon a person to appear at a hearing to give evidence and to produce such document, book or writing as is referred to in the summons.

(2) A summons under sub-section (1) may be served on the person concerned personally or by post.

Allowances for witnesses at hearing.

100. A person appearing as a witness at a hearing, whether summoned under section 99 or not, shall be paid by Australia such allowances for expenses in respect of his attendance before the Committee as are prescribed.

Failure to attend.

101. A person served with a summons to appear at a hearing shall not fail, without reasonable excuse, so to appear.

Penalty: $200.

Refusal to be sworn or give evidence.

102. (1) A person appearing as a witness at a hearing (whether summoned to appear or not) shall not, without reasonable excuse—

(a) refuse or fail to be sworn or to make an affirmation;

(b) refuse or fail to answer a question that he is required by a member to answer; or

(c) refuse or fail to produce a document, book or writing that he is required under this Act to produce.

Penalty: $200.

(2) A statement or disclosure made by a witness at a hearing is not admissible in evidence against him in civil or criminal proceedings in a court except in a prosecution for giving false testimony at the hearing.

(3) It is a defence in proceedings for an offence of refusing or failing, without reasonable excuse, to produce a document, book or writing at a hearing if it is proved that the document, book or writing was not relevant to the subject matter of the hearing.


 

Protection of members’ representatives and witnesses at hearing.

103. (1) A member has, in the performance of his duties, the same protection and immunity as a Justice of the High Court.

(2) A person appearing at a hearing on behalf of another person has the same protection and immunity as a barrister has in appearing for a party in proceedings in the High Court.

(3) A person appearing at a hearing as a witness has the same protection, and is, in addition to the penalties provided by this Act, subject to the same liabilities, as a witness in proceedings in the High Court.

Report by Committee.

104. (1) After completion by a committee of a hearing under section 94 in relation to a practitioner, the Committee shall report to the Minister its opinion on the question whether the practitioner has rendered excessive services and, if the Committee is of opinion that the practitioner has rendered excessive services, the report shall identify the excessive services.

(2) Where, under sub-section (1), the Committee reports that it is of opinion that a practitioner has rendered excessive services, the Committee shall send to the Minister with the report a transcript of the proceedings at the hearing, and shall return any documents that accompanied the reference.

Recommendation by Committee.

105. Where—

(a) a Committee has, in a report under section 104, expressed the opinion that a practitioner has rendered excessive services, and has identified those services; and

(b) medical benefit is payable, or has been paid, whether to the practitioner or to another person in respect of any of those services,

the Committee may recommend in that report that—

(c) where the medical benefit is payable, but has not been paid, to the practitioner—the medical benefit or a specified part of the medical benefit cease to be payable; or

(d) where the medical benefit has been paid to the practitioner, or has been paid or is payable to another person—the amount of the medical benefit be payable to Australia by the practitioner.

Determination by Minister.

106. (1) Where a Committee makes a recommendation in accordance with section 105, the Minister may make a determination, in writing, in accordance with that recommendation.

(2) Where the Minister makes a determination under sub-section (1), he shall serve on the practitioner, either personally or by post, a notification in writing setting out the determination.

(3) Where the Minister makes a determination under sub-section (1), then—

(a) if no request for review of the determination under Division 4 is lodged within the period allowed for such a request—the determination takes effect at the expiration of that period;

(b) if a request for review of the determination under Division 4 is lodged within the period allowed for such a request—then—

(i) if the determination is disallowed on the review—the determination does not take effect; or

(ii) if the determination is upheld or varied on the review and no appeal against the decision on the review is made under section 122 within the period allowed for such an appeal—the determination takes effect, or takes effect as so varied, at the expiration of that period; or

(c) if an appeal against the decision on the review is made under section 122 within the period allowed for such an appeal, the determination does not have effect until the appeal, and any further appeal to the High Court, are determined and, upon the determination of the appeal and any such further appeal, the determination takes effect as varied or does not take effect, in accordance with the judgment or order on the appeal or further appeal.


 

(4) Where a determination under sub-section (1) that gives effect to a recommendation that an amount of medical benefit be payable to Australia by a practitioner takes effect, that amount is recoverable by Australia from the practitioner as a debt due to Australia.

 

Division 4—Medical Services Review Tribunals

Definitions.

107. In this Division, unless the contrary intention appears—

“determination” means a determination under section 106;

“judicial office” means an office of judge of a Federal Court or of the Supreme Court of a State or Territory;

“member” means a member of a Tribunal, and includes the President of a Tribunal;

“Tribunal” means a Medical Services Review Tribunal.

Establishment of Medical Services Review Tribunals.

108. (1) The Governor-General may establish one or more Medical Services Review Tribunals for the purposes of this Act.

(2) A Tribunal shall consist of a President and two other members, who shall be appointed in accordance with this section.

(3) The President of a Tribunal shall be a person who—

(a) is or has been the holder of a judicial office; or

(b) is a legal practitioner of the High Court or of a Supreme Court of a State or Territory of not less than 5 years’ standing.

(4) Of the members of a Tribunal other than the President—

(a) one shall be a medical practitioner nominated by the Minister after consultation with the Australian Medical Association or such other associations or colleges of medical practitioners as the Minister considers appropriate; and

(b) one shall be a medical practitioner employed in a Department of State.

(5) The members of a Tribunal shall be appointed by the Governor-General and, subject to this Act, each member holds office for such period, not exceeding 5 years, as is specified by the Governor-General in the instrument of his appointment and is eligible for re-appointment.

(6) A member of a Medical Services Committee of Inquiry shall not be eligible for appointment as a member of a Tribunal.

Termination of appointment.

109. The Governor-General may terminate the appointment of a member (other than the holder of a judicial office) for misbehaviour or physical or mental incapacity.

Resignation of members.

110. A member may resign his office by writing under his hand delivered to the Governor-General.

Appointment to vacant office.

111. Where a vacancy occurs in the office of a member, the Governor-General may appoint a person to that office in accordance with section 108.

Irregularities in nomination of members.

112. The validity of the appointment of a member other than the President of a Tribunal shall not be called into question by reason only of a defect or irregularity in connexion with the nomination of that member.

Remuneration and allowances.

113. (1) A member, not being the holder of a judicial office, shall be paid such remuneration and such annual allowances (if any) as the Parliament fixes, but, until 1 January 1975, shall be paid such remuneration and annual allowance (if any) as are prescribed.

(2) A member, not being the holder of a judicial office, shall be paid such allowances (not including an annual allowance) as are prescribed.

Request for review of determination.

114. (1) A practitioner to whom a determination relates may, by notice in writing given to the Minister within a period of 30 days after the date upon which the notification of the determination is served on him, request the Minister to refer the determination to a Medical Services Review Tribunal for review.

(2) There shall be set out in the request the grounds on which the request is made.

Request for review to be forwarded to Tribunal.

115. Upon receipt by the Minister of a request under section 114 for the review of a determination, the Minister shall forward the request to the President of a Tribunal together with—

(a) a copy of the reference that gave rise to the determination;

(b) a transcript of the proceedings at the hearing conducted for the purposes of that reference;

(c) the report on that reference and any documents sent to the Minister with that report; and

(d) the determination.

Review to be arranged.

116. Where the President of a Tribunal receives from the Minister under section 115a request for the review of a determination, the President shall—

(a) arrange for the determination to be reviewed in proceedings before the Tribunal; and

(b) serve, either personally or by post, on the Minister and on the practitioner to whom the determination relates a notification, in writing, setting out the time and place so arranged.

Rights of parties at proceedings on review.

117. (1) Where a practitioner makes a request for the review of a determination—

(a) the practitioner may appear in person, or may be represented by another person, at the proceedings on the review arranged under section 116; and

(b) if he appears, or is represented, at those proceedings—he or his representative shall be given the opportunity to address the Tribunal.

(2) The Minister may be represented at proceedings referred to in sub-section (1) and, if he is so represented, his representative shall be given the opportunity to address the Tribunal.

Procedure of Tribunals.

118. (1) Proceedings before a Tribunal—

(a) shall be in private; and

(b) shall be conducted with as little formality and technicality as a proper consideration of the matter before the Tribunal permits.

(2) The procedure of a Tribunal is, subject to this Act and the regulations, within the discretion of the President.

(3) The parties to the proceedings are the Minister and the practitioner who requested the review.

Proceedings on review.

119. (1) A tribunal that reviews a determination in accordance with a request—

(a) shall consider the matter to which the determination relates having regard to the grounds set out in the request, the documents forwarded by the Minister with the request and any


 

addresses made to the Tribunal during the proceedings on the review; and

(b) shall, subject to sub-section (2)—

(i) uphold the determination;

(ii) vary the determination in such manner as it thinks fit but so that the determination, as so varied, is one that the Minister could have made in giving effect to a recommendation of a Committee; or

(iii) disallow the determination.

(2) A Tribunal shall not uphold or vary a determination unless it is satisfied that the practitioner concerned has rendered the excessive services to which the determination relates.

(3) Subject to the Constitution, the decision of a Tribunal on a review is final except in so far as an appeal may be brought to the Australian Industrial Court in accordance with section 122 or an appeal may be brought to the High Court from a judgment or order of the Australian Industrial Court given or made under that section.

Costs of proceedings before Tribunal.

120. The costs incurred by a practitioner in relation to proceedings before a Tribunal shall be borne by Australia, unless the Tribunal is of opinion that the costs, or part of the costs, were unnecessarily incurred and directs that the costs, or that part of the costs, be borne by the practitioner.

Protection of members of Tribunal, &c.

121. (1) A member of a Tribunal has, in the performance of the duties of his office, the same protection and immunities as a Justice of the High Court.

(2) A person representing another person before a Tribunal has the same protection and immunities as a barrister has in appearing for a party in proceedings in the High Court.

Appeals.

122. (1) A party in proceedings before a Tribunal may, in such manner and within such time as is prescribed, appeal, on a question of law only, to the Australian Industrial Court from a decision of the Tribunal.

(2) The Australian Industrial Court has jurisdiction to hear and determine an appeal instituted in that Court in accordance with subsection (1).

(3) The Australian Industrial Court shall hear and determine the appeal and give such judgment, or make such order, as, in all the circumstances, it thinks fit, and, in particular—

(a) may uphold, vary or disallow the decision of the Tribunal; or

(b) may remit the matter the subject of the decision of the Tribunal to the Tribunal for further review in accordance with the directions of the Court.

Exercise of jurisdiction of Australian Industrial Court.

123. (1) Subject to sub-section (2), the jurisdiction of the Australian Industrial Court with respect to appeals under section 122 shall be exercised by a single judge.

(2) The Chief Judge of the Australian Industrial Court may, if in his opinion an appeal under section 122 involves the determination of a question of law of sufficient importance, direct that, for the purpose of that appeal, the Court shall be constituted by three judges.

Division 5—Other Committees

Other Committees.

124. In addition to the Committees for the establishment of which express provision is made in the preceding Divisions of this Part, the regulations may provide for the establishment of other Committees and may make provision for and in relation to the constitution, powers, functions, duties and procedure of, and the filling of vacancies on, those Committees.


 

PART VI—FINANCE

Payments to be made by Commission.

125. All amounts (including advances) payable by Australia under Part II, Part III (including an agreement under that Part) or Part IV and amounts of hospital benefits payable under the regulations shall be paid, on behalf of Australia, by the Commission.

Health Insurance Fund.

126. (1) There shall be a Health Insurance Fund.

(2) The Health Insurance Fund is a Trust Account for the purposes of section 62a of the Audit Act 1901-1969.

(3) There shall be paid into the Health Insurance Fund—

(a) such amounts as are appropriated by the Parliament from time to time for the purpose;

(b) amounts recovered by Australia under sub-section 43(2) or 106(4); and

(c) premiums referred to in sub-section 6(2).

(4) The time and manner of payment of the moneys referred to in paragraph (3)(a) shall be as determined by the Treasurer.

(5) There shall be paid to the Commission from time to time, out of the Health Insurance Fund, such amounts as the Treasurer thinks necessary for the purpose of enabling the Commission to make payments referred to in section 125.

(6) Interest from the investment of any moneys standing to the credit of the Health Insurance Fund shall be credited to the Fund.

 

PART VII—MISCELLANEOUS

Use of health insurance cards.

127. A person shall not use a health insurance card for the purpose of obtaining payment of a medical benefit payable in respect of a professional service rendered to a person other than a person whose name is on the card.

Penalty: $500.

Offences in relation to returns.

128. A person shall not fail or neglect duly to furnish a return or information that he is required under this Act or the regulations to furnish.

Penalty: $500.

False statements, &c.

129. (1) A person shall not make a statement, either orally or in writing, or issue or present a document, that is false or misleading in a material particular and is capable of being used in, in connexion with or in support of, an application for approval for the purposes of this Act or for payment of an amount under this Act.

Penalty: $500 or imprisonment for 6 months.

(2) A person shall not furnish, in pursuance of this Act or of the regulations, a return or information that is false or misleading in a material particular.

Penalty: $500 or imprisonment for 6 months.

(3) In a prosecution of a person for an offence against this section, it is a defence if the person shows that he did not know, and had no reason to suspect, that the statement, document, return or information to which the prosecution relates was false or misleading, as the case may be.

Officers to observe secrecy.

130. (1) A person shall not, directly or indirectly, except in the performance of his duties, or in the exercise of his powers or functions, under this Act, and while he is, or after he ceases to be, an officer, make a record of, or divulge or communicate to any person, any information with respect to the affairs of another person acquired by him in the performance of his duties, or in the exercise of his powers or functions, under this Act.

Penalty: $500.

(2) A person who is, or has been, an officer shall not, except for the purposes of this Act, be required—

(a) to produce in court any document that has come into his possession or under his control in the performance of his duties or functions under this Act; or

(b) to divulge or communicate to a court any matter or thing that has come under his notice in the performance of any such duties or functions.

(3) Notwithstanding anything contained in the preceding provisions of this section, an officer may—

(a) if the Minister certifies that it is necessary in the public interest that any information acquired by the officer in the performance of his duties, or in the exercise of his powers or functions, under this Act, should be divulged, divulge that information to such person as the Minister directs;

(b) divulge any such information to any prescribed authority or person; or

(c) divulge any such information to a person who, in the opinion of the Minister, is expressly or impliedly authorized by the person to whom the information relates to obtain it.

(4) An authority or person to whom information is divulged under sub-section (3), and any person or employee under the control of that authority or person, shall, in respect of that information, be subject to the same rights, privileges, obligations and liabilities under sub-sections (1) and (2) as if he were a person performing duties under this Act and had acquired the information in the performance of those duties.

(5) Nothing in this section prohibits the publication of statistics by the Commission or by the Commonwealth Statistician but such statistics shall not be published in a manner that enables the identification of an individual patient or an individual practitioner.

(6) In this section, “officer” means a person performing duties, or exercising powers or functions, under, or in relation to, this Act.

Delegation.

131. (1) Subject to this section, the Minister may, by writing under his hand, delegate all or any of his powers and functions under this Act (except this power of delegation) to any officer of the Department of Social Security.

(2) A power or function so delegated may be exercised or performed by the delegate in accordance with the instrument of delegation.

(3) A delegation under this section is revocable at will and does not prevent the exercise of a power or the performance of a function by the Minister.

Evidence.

132. (1) The Minister may, by writing under his hand, certify that, during a period or on a date specified in the certificate—

(a) any premises were, or were not, a hospital; or

(b) a document annexed to the certificate is a true copy of a determination or direction by the Minister under this Act or of any other document made or issued under this Act.

(2) In proceedings under this Act or another Act or under regulations under this Act or another Act, a certificate purporting to have been given under this section—

(a) is evidence of the facts stated in the certificate; and

(b) shall, unless the contrary is proved, be deemed to have been given by the person purporting to give the certificate.

Regulations.

133. (1) The Governor-General may make regulations, not inconsistent with this Act, prescribing all matters required or permitted by this Act to be prescribed, or necessary or convenient to be prescribed for carrying out or giving effect to this Act and, in particular—

(a) requiring the proprietor of a private hospital to keep records relating to, and to furnish, to such persons as are prescribed, returns or information relating to, the occupation of approved beds in the hospital; and

(b) prescribing penalties, not exceeding a fine of $200, for offences against the regulations.

(2) Where an item specifies a medical service that is to be rendered by a consultant physician, or a specialist, in the practice of his specialty to a patient who has been referred to him, the regulations may require that, for the purposes of the item, the patient be referred in a manner prescribed by the regulations.

(3) The regulations may provide for the payment by Australia of hospital benefits, at such rates and subject to such conditions as are prescribed by or under the regulations, to persons who have incurred expense in respect of the care and treatment outside Australia in hospitals, as defined by or under the regulations, of persons who are Australian residents temporarily absent from Australia.

 

________

 

SCHEDULE 1                                     Sections 9 and 10

RULES FOR THE INTERPRETATION OF THE TABLE OF MEDICAL SERVICES

1.    Where an item in Part 1, 3 or 4 of the table includes the symbol “(S)” the item shall be taken to relate to the service specified in the item when rendered by a specialist in the practice of his specialty.

2.    Where an item in Part 1,3 or 4 of the table includes the symbol “(G) ”, the item shall be taken to relate to the service specified in the item when rendered otherwise than by a specialist in the practice of his specialty.

3.    Where an item, other than an item in Part 1, 3 or 4 of the table, includes the symbol “(S)”, the item shall be taken to relate to the service specified in the item when rendered by a specialist in the practice of his specialty to a patient who has been referred to him.

4.    Where an item, other than an item in Part 1, 3, or 4 of the table, includes the symbol “(G)”, the item shall be taken to relate to the service specified in the item when rendered otherwise than by a specialist in the practice of his specialty to a patient who has been referred to him.

5.    A reference in rule 3 or 4 or in Part 1 of the table to the referring of a patient to a specialist shall be read as a reference to a referring by a medical practitioner and—

(a) where the specialist concerned is an ophthalmologist—shall be read as including a reference to a referring by a registered optometrist or by a registered optician; and


 

SCHEDULE-continued

(b) where a referring arises out of a dental service rendered to the person who has been referred—shall be read as including a reference to a referring by a dental practitioner.

6.    Where an item includes the symbol “(D)”, the item shall be taken to relate to the service specified in the item when rendered in an operating theatre of a hospital in the course of dental practice by a dental practitioner approved by the Minister for the purposes of the definition of’ professional service’ in sub-section 3(1).

7.    A reference in a column in an item referred to in a paragraph of this rule to an amount under this rule shall be read as a reference to an amount equal to the aggregate of the fee set out in that column in the item that relates to a radiographic examination of the kind referred to in the first-mentioned item and—

(a) in the case of item 2254—$5;

(b) in the case of item 2362 or 2367—$5.50; or

(c) in the case of item 2420—$3,

and an amount equal to that aggregate shall be deemed to be set out in that column in the place of that reference.

8.    A reference in a column in an item referred to in a paragraph of this rule to an amount under this rule shall be read as a reference to an amount equal to the aggregate of the fee set out in that column in the item that relates to a dislocation or fracture of the kind treated and—

(a) in the case of item 6414, 6416, 6651 or 6652—one-half of that fee;

(b) in the case of item 6647 or 6648—one-third of that fee; or

(c) in the case of item 6655 or 6656—three-quarters of that fee,

and an amount equal to that aggregate shall be deemed to be set out in that column in the place of that reference.

9.    A reference in a column in an item referred to in a paragraph of this rule to an amount under this rule shall be read as a reference to an amount equal to—

(a) in the case of item 6659, 6660, 6663 or 6664—one-half of the fee set out in that column in the item that would, but for that first-mentioned item, relate to the reduction effected;

(b) in the case of item 6667 or 6668—the fee set out in that column in the item that would but for that first-mentioned item, relate to the reduction effected; or

(c) in the case of item 6671—the fee set out in that column in the item that relates to a simple and uncomplicated fracture of the part treated,

and an amount equal to the amount so referred to shall be deemed to be set out in that column in the place of that reference.

TABLE OF MEDICAL SERVICES

 

Fees

 

Item

 

 

 

No.

Medical service

N.S.W

Vic.

Qld

S.A.

W.A.

Tas.

 

$

$

$

$

$

$

 

PART I—PROFESSIONAL ATTENDANCES NOT COVERED BY AN ITEM IN ANY OTHER PART OF THIS SCHEDULE

70

Professional attendance at consulting rooms of not more than 5 minutes duration (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 72—each attendance

3.50

3.20

3.15

3.15

3.15

3.20


 

 

 

Fees

 

 

 

 

 

Item No.

 

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

72

Professional attendance at consulting rooms of not more than 5 minutes duration (not being an attendance covered by any other item in this Part)—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. on a day not being a Saturday, Sunday or public holiday

6.00

5.70

5.65

5.65

5.65

5.70

75

Professional attendance at consulting rooms of more than 5 minutes duration but not more than 25 minutes duration (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 78—each attendance

4.70

4.30

4.20

4.20

4.20

4.30

78

Professional attendance at consulting rooms of more than 5 minutes duration but not more than 25 minutes duration (not being an attendance covered by any other item in this Part)—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. on a day not being a Saturday, Sunday or public holiday

7.20

6.80

6.70

6.70

6.70

6.80

81

Professional attendance at consulting rooms of more than 25 minutes duration but not more than 45 minutes duration (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 84—each attendance

9.00

8.30

8.10

8.10

8.10

8.30

84

Professional attendance at consulting rooms of more than 25 minutes duration but not more than 45 minutes duration (not being an attendance covered by any other item in this Part)—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. on a day not being a Saturday, Sunday or public holiday

11.50

10.80

10.60

10.60

10.60

10.80

87

Professional attendance at consulting rooms of more than 45 minutes duration (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 90—each attendance

13.50

12.50

12.20

12.20

12.20

12.50

 


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

90

Professional attendance at consulting rooms of more than 45 minutes duration (not being an attendance covered by any other item in this Part)—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. on a day not being a Saturday, Sunday or public holiday

16.00

15.00

14.70

14.70

14.70

15.00

93

Professional attendance at a place other than consulting rooms, hospital or nursing home of not more than 5 minutes duration (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 96—each attendance  .......

5.25

4.80

4.75

4.75

4.75

4.80

96

Professional attendance at a place other than consulting rooms, hospital or nursing home of not more than 5 minutes duration (not being an attendance covered by any other item in this Part)—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. on a day not being a Saturday, Sunday or public holiday........................................................

7.75

7.30

7.25

7.25

7.25

7.30

99

Professional attendance at a place other than consulting rooms, hospital or nursing home of more than 5 minutes duration but not more than 25 minutes duration (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 102—each attendance.........................

7.00

6.45

6.30

6.30

6.30

6.45

102

Professional attendance at a place other than consulting rooms, hospital or nursing home of more than 5 minutes duration but not more than 25 minutes duration (not being an attendance covered by any other item in this Part)—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. on a day not being a Saturday, Sunday or public holiday

9.50

9.00

8.80

8.80

8.80

9.00

105

Professional attendance at a place other than consulting rooms, hospital or nursing home of more than 25 minutes duration but not more than 45 minutes duration (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 108—each attendance ........................

11.35

11.00

10.75

10.75

10.75

11.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

108

Professional attendance at a place other than consulting rooms, hospital or nursing home of more than 25 minutes duration but not more than 45 minutes duration (not being an attendance covered by any other item in this Part)—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. on a day not being a Saturday, Sunday or public holiday

13.85

13.50

13.25

13.25

13.25

13.50

111

Professional attendance at a place other than consulting rooms, hospital or nursing home of more than 45 minutes duration (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 114—each attendance....................

15.85

15.25

15.00

15.00

15.00

15.25

114

Professional attendance at a place other than consulting rooms, hospital or nursing home of more than 45 minutes duration (not being an attendance covered by any other item in this Part)—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. on a day not being a Saturday, Sunday or public holiday

18.35

17.75

17.50

17.50

17.50

17.75

117

Professional attendance at a hospital or nursing home (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 120—each attendance when only one patient is seen....

7.00

6.45

6.30

6.30

6.30

6.45

120

Professional attendance at a hospital or nursing home (not being an attendance covered by any other item in this Part)—each attendance on a public holiday, on a Sunday, before 8 a.m. or after 1 p.m. on a Saturday or at any time other than between 8 a.m. and 8 p.m. on a day not being a Saturday, Sunday or public holiday, when only one patient is seen.............................................................

9.50

9.00

8.80

8.80

8.80

9.00

123

Professional attendance at a hospital (not being an attendance covered by any other item in this Part) at a time other than a time covered by item 126—each attendance on two or more patients in the one hospital on the one occasion—each patient................................

4.70

4.30

4.20

4.20

4.20

4.30

 


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

126

Professional attendance at a nursing home (not being an attendance covered by any other item in this Part)—each attendance on two or more patients in the one nursing home on the one occasion—each patient ........................

3.50

3.20

3.15

3.15

3.15

3.20

188

Professional attendance by a specialist in the practice of his specialty where the patient is referred to him—an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at consulting rooms, hospital or nursing home ..........................................................

12.10

11.00

11.00

11.00

9.40

8.80

189

Professional attendance by a specialist in the practice of his specialty where the patient is referred to him—an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at a place other than consulting rooms, hospital or nursing home.............................

17.60

16.50

16.50

16.50

14.90

14.30

190

Professional attendance by a specialist in the practice of his specialty where the patient is referred to him—each attendance that is a second or subsequent attendance in a single course of treatment......................................

6.10

6.10

5.50

5.50

5.50

5.50

191

Professional attendance by a consultant physician in the practice of his specialty where the patient is referred to him by a medical practitioner—an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at consulting rooms, hospital or nursing home...............................................

22.00

19.80

19.80

19.80

19.80

16.50

192

Professional attendance by a consultant physician in the practice of his specialty where the patient is referred to him by a medical practitioner—an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at a place other than consulting rooms, hospital or nursing home.................

27.50

25.30

25.30

25.30

25.30

22.00

193

Professional attendance by a consultant physician in the practice of his specialty where the patient is referred to him by a medical practitioner—each attendance that is a second or subsequent attendance in a single course of treatment ...........................

9.40

8.30

8.30

8.30

8.30

7.20


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

194

Prolonged professional attendance, for not less than 2 hours but less than 3 hours, on a patient in a critical condition arising from electric shock, drowning, caisson disease, tetanus, respiratory or circulatory failure or involving resuscitation of the new born, that requires constant attention to the exclusion of all other patients

22.00

22.00

22.00

22.00

22.00

22.00

195

Prolonged professional attendance, for a period of not less than 3 hours but less than 4 hours, in the circumstances referred to in item 194......................................................

33.00

33.00

33.00

33.00

33.00

33.00

196

Prolonged professional attendance, for a period of not less than 4 hours but less than 5 hours, in the circumstances referred to in item 194 .....................................................

43.50

43.50

43.50

43.50

43.50

43.50

197

Prolonged professional attendance, for a period of 5 hours or more, in the circumstances referred to in item 194.................................

55.00

55.00

55.00

55.00

55.00

55.00

198

Pre-operative examination of a patient in preparation for the administration of an anaesthetic, being an examination carried out at an attendance other than that at which the anaesthetic is administered (G)....................

4.40

4.00

3.90

3.80

3.90

4.00

199

Pre-operative examination of a patient in preparation for the administration of an anaesthetic, being an examination carried out at an attendance other than that at which the anaesthetic is administered (S).....................

5.50

5.00

5.50

5.00

5.50

4.40

PART 2—OBSTETRICS

Division 1—General

202

Antenatal care where attendances do not exceed ten—each attendance......................

4.00

3.60

3.50

3.40

3.50

3.60

205

Antenatal care where attendances exceed ten..

40.00

36.00

35.00

34.00

35.00

36.00

209

Confinement and postnatal care for 9 days where the medical practitioner has not given the antenatal care (G)..................................

33.00

30.00

30.00

25.00

25.00

25.00

210

Confinement and postnatal care for 9 days where the medical practitioner has not given the antenatal care (S)...................................

65.00

45.00

45.00

40.00

40.00

35.00

220

Confinement, including a professional attendance that would, but for this item, be covered by item 188 (S)..............................

30.00

25.00

25.00

25.00

25.00

20.00

221

Antenatal care, confinement and postnatal care for 9 days (G)..............................................

50.00

50.00

45.00

40.00

40.00

40.00

222

Antenatal care, confinement and postnatal care for 9 days (S)..............................................

100.00

80.00

70.00

80.00

70.00

60.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

 

Division 2—Special Services

225

Antenatal care, confinement and postnatal care for 9 days with surgical induction of labour (G).................................................

61.00

60.00

55.50

50.00

50.00

50.00

228

Antenatal care, confinement and postnatal care for 9 days with surgical induction of labour (S)..................................................

111.00

90.00

80.50

90.00

80.00

70.00

232

Antenatal care, confinement and postnatal care for 9 days with surgical induction of labour; requiring major regional or field block (including abdominal; brachial plexus; caudal; cervical plexus; epidural (peridural); paravertebral (thoracic or lumbar); pudendal; sacral; spinal) (G).......

77.50

75.00

71.50

65.00

65.00

64.00

233

Antenatal care, confinement and postnatal care for 9 days with surgical induction of labour; requiring major regional or field block (including abdominal; brachial plexus; caudal; cervical plexus; epidural (peridural); paravertebral (thoracic or lumbar); pudendal; sacral; spinal) (S).......

127.50

105.00

96.50

105.00

95.00

84.00

235

Caesarean section and postnatal care for 9 days (G)....................................................

80.00

80.00

70.00

70.00

70.00

60.00

236

Caesarean section and postnatal care for 9 days (S)....................................................

120.00

100.00

100.00

90.00

100.00

70.00

243

Treatment of habitual miscarriage by injection of hormones—each injection up to a maximum of 12 injections ................

2.80

2.00

2.10

2.35

2.40

2.10

247

Threatened abortion, threatened miscarriage or hyperemesis gravidarum, requiring admission to hospital, treatment of—each attendance................................................

2.80

2.00

2.50

2.35

2.40

2.10

251

Cervix, purse string ligation of, for threatened miscarriage (G)........................

22.50

22.50

22.50

22.50

22.50

22.50

252

Cervix, purse string ligation of, for threatened miscarriage (S).........................

30.00

30.00

30.00

30.00

30.00

30.00

255

Cervix, removal of purse string ligature of, under general anaesthesia (G) ..................

8.00

8.00

8.00

8.00

8.00

8.00

256

Cervix, removal of purse string ligature of, under general anaesthesia (S)....................

11.00

11.00

11.00

11.00

11.00

11.00

259

Pre-eclampsia, eclampsia or antepartum haemorrhage, treatment of— each attendance

2.80

2.00

2.50

2.35

2.40

2.10

260

Amnioscopy ................................................

10.00

10.00

10.00

10.00

10.00

10.00

261

Amnioscopy with surgical induction of labour

15.00

15.00

15.00

15.00

15.00

15.00

263

Amniocentesis..............................................

11.00

11.00

11.00

11.00

11.00

11.00

265

Version, external or internal, under anaesthesia (G).........................................

10.00

10.00

10.00

10.00

10.00

10.00

268

Version, external or internal, under anaesthesia (S)..........................................

11.00

11.00

11.00

11.00

11.00

11.00

271

Surgical induction of labour..........................

11.00

10.00

10.50

10.00

10.00

10.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

275

Decapitation, craniotomy, cleidotomy or evisceration of foetus or any two or more of those services.......................................

44.00

44.00

44.00

44.00

44.00

44.00

279

Evacuation by intrauterine manual removal of the products of conception such as retained foetus, placenta, membranes or mole.........................................................

16.50

12.00

12.50

12.50

12.50

12.00

283

Manipulative correction of acute inversion of uterus, with or without incision of cervix

48.00

48.00

48.00

48.00

48.00

48.00

287

Postpartum haemorrhage requiring special procedures such as packing, treatment of (G)............................................................

8.00

8.00

8.00

8.00

8.00

8.00

288

Postpartum haemorrhage requiring special procedures such as packing, treatment of (S)

11.00

11.00

11.00

11.00

11.00

11.00

291

Third degree tear, repair of, involving anal sphincter muscles 70................................

22.00

20.00

22.00

20.00

20.00

20.00

PART 3—ANAESTHETICS

Division 1— Anaesthetics other than Gaseous Anaesthetics not Covered by an Item in any other Part of this Schedule

301

Administration of an anaesthetic (not including an anaesthetic referred to in Division 2 of this Part) in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees specified in this table, does not exceed $25 (G)............................................................

6.50

8.00

7.50

6.50

7.50

7.00

302

Administration of an anaesthetic (not including an anaesthetic referred to in Division 2 of this Part) in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees specified in this table, does not exceed $25 (S).............................................................

8.50

9.50

9.00

8.00

9.00

8.50

305

Administration of an anaesthetic (not including an anaesthetic referred to in Division 2 of this Part) in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees specified in this table, exceeds $25, but does not exceed $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania(G) ............................................

9.00

10.00

10.50

10.00

12.00

12.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

306

Administration of an anaesthetic (not including an anaesthetic referred to in Division 2 of this Part) in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $25, but does not exceed $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania (S).............................................................

11.00

12.00

12.50

12.00

14.00

14.00

309

Administration of an anaesthetic (not including an anaesthetic referred to in Division 2 of this Part) in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90 (G) ...

16.50

16.00

16.00

15.00

16.00

15.00

310

Administration of an anaesthetic (not including an anaesthetic referred to in Division 2 of this Part) in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90 (S)....

20.00

19.00

19.00

18.00

19.00

18.00

313

Administration of an anaesthetic (not including an anaesthetic referred to in Division 2 of this Part) in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $90 but does not exceed $140

22.00

22.00

22.00

22.00

22.00

22.00

317

Administration of an anaesthetic (not including an anaesthetic referred to in Division 2 of this Part) in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $140.........

33.00

33.00

33.00

33.00

33.00

33.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

321

Administration of an anaesthetic other than gaseous, in addition to a gaseous anaesthetic referred to in Division 2 of this part

3.50

3.00

3.00

2.50

2.50

3.00

 

323

Administration of neuroleptal analgesia 

12.00

12.00

12.00

12.00

12.00

12.00

 

Division 2—Gaseous Anaesthetics

341

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table, does not exceed $25 (G).................

10.00

10.00

10.50

9.00

10.00

10.00

342

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services for which the fee, or the aggregate of the fees specified in this table, does not exceed $25 (S)..........................................

12.00

12.00

12.50

11.00

12.50

12.00

344

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services for which the fee, or the aggregate of the fees specified in this table, exceeds $25, but does not exceed $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania (G)............................................

13.00

12.50

12.50

12.00

12.00

12.50

345

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services for which the fee, or the aggregate of the fees specified in this table, exceeds $25, but does not exceed $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania (S).............................................

16.00

15.00

15.00

15.00

15.00

15.00

347

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90 (G).....................

19.00

20.00

19.00

18.00

18.00

18.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

348

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90 (S).....................

23.00

24.00

23.00

22.00

22.00

22.00

351

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $90 but does not exceeds 140 (G).................................................................

20.00

22.00

22.00

20.00

22.00

22.00

352

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $90 but does not exceed $140 (S).................................................................

24.00

26.00

26.00

24.00

26.00

26.00

355

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $140 but does not exceed $200..

33.00

35.00

33.00

33.00

33.00

33.00

357

Administration of an anaesthetic in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $200............................................

45.00

45.00

45.00

45.00

45.00

45.00

 

Division 3—Groupings of Anaesthetics and Related Procedures

370

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table does not exceed $25 (G)............................................................

13.50

13.00

13.50

11.50

12.50

13.00

371

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table does not exceed $25 (S).............................................................

15.50

15.00

15.50

13.50

15.00

15.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

375

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $25, but does not exceed $45 where the anaesthetic is administered in New South Wales or Victoria or $44.00 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania (G) ...........................................................

16.50

15.50

15.50

14.50

14.50

15.50

376

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $25, but does not exceed $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania (S).............................................................

19.50

18.00

18.00

17.50

17.50

18.00

378

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90 (G)

22.50

23.00

22.00

20.50

20.50

21.00

379

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90 (S)

26.50

27.00

26.00

24.50

24.50

25.00


 

 

Fees

 

 

No. 42              235

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

381

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $90 but does not exceed $140 (G).........................

23.50

25.00

25.00

22.50

24.50

25.00

382

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $90 but does not exceed $140 (S).........................

27.50

29.00

29.00

26.50

28.50

29.00

384

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $140 but does not exceed $200...............................

36.50

38.00

36.00

35.50

35.50

36.00

386

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $200.........

48.50

48.00

48.00

47.50

47.50

48.00

388

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90; and intravenous or subcutaneous infusion or injection of fluids—percutaneous (G)......

28.00

28.00

27.00

25.50

25.50

26.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

389

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90; and intravenous or subcutaneous infusion or injection of fluids—percutaneous (S).......

32.00

32.00

31.00

29.50

29.50

30.00

391

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $90 but does not exceed $140; and intravenous or subcutaneous infusion or injection of fluids—percutaneous (G).........................

29.00

30.00

30.00

27.50

29.50

30.00

392

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $90 but does not exceed $140; and intravenous or subcutaneous infusion or injection of fluids—percutaneous (S)..........................

33.00

34.00

34.00

31.50

33.50

34.00

394

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $140 but does not exceed $200; and intravenous or subcutaneous infusion or injection of fluids—percutaneous................................

42.00

43.00

41.00

40.50

40.50

41.00


 

 

Fees

 

 

No. 42              237

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

396

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90; and blood transfusion, using blood already collected (G).............................................

33.50

35.00

32.50

31.50

31.50

31.00

397

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $45 where the anaesthetic is administered in New South Wales or Victoria or $44 where the anaesthetic is administered in Queensland, South Australia, Western Australia or Tasmania, but does not exceed $90; and blood transfusion, using blood already collected (S)..............................................

37.50

39.00

36.50

35.50

35.50

35.00

399

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table, exceeds $90 but does not exceed $140; and blood transfusion using blood already collected (G)............................................................

34.50

37.00

35.50

33.50

35.50

35.00

400

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table exceeds $90 but does not exceed $140; and blood transfusion, using blood already collected (S).............................................................

38.50

41.00

39.50

37.50

39.50

39.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

402

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic, in connexion with a professional service, or a series or combination of professional services, for which the fee, or the aggregate of the fees, specified in this table, exceeds $140 but does not exceed $200; and blood transfusion, using blood already collected .................................................................

47.50

50.00

46.50

46.50

46.50

46.00

Division 4—Dental Anaesthetics

430

Administration by a medical practitioner of an anaesthetic, other than an endotracheal anaesthetic, in connection with a dental operation..................................................

8.00

8.00

8.00

8.00

8.00

8.00

435

Administration by a medical practitioner of an endotracheal anaesthetic in connection with a dental operation (G).......................

13.00

15.00

15.00

12.00

12.00

12.00

436

Administration by a medical practitioner of an endotracheal anaesthetic in connection with a dental operation (S)........................

15.50

18.00

18.00

14.50

14.50

14.50

PART 4—REGIONAL NERVE OR FIELD BLOCK

451

Initial major regional or field block, including abdominal; brachial plexus; caudal; cervical plexus; epidural (peridural); paravertebral (thoracic or lumbar); pudendal; sacral; spinal

16.50

15.00

16.00

15.00

15.00

14.00

452

Subsequent major regional or field block, including abdominal; brachial plexus; caudal; cervical plexus; epidural (peridural); paravertebral (thoracic or lumbar); pudendal; sacral; spinal..............

11.50

10.00

11.00

10.00

10.00

9.00

455

Intravenous regional anaesthesia of limb by retrograde perfusion (G)...........................

11.50

11.50

11.50

11.50

11.50

11.50

456

Intravenous regional anaesthesia of limb by retrograde perfusion (S)............................

15.00

15.00

15.00

15.00

15.00

15.00

PART 5—ASSISTANCE IN ADMINISTRATION OF AN ANAESTHETIC

501

Assistance in the administration of an anaesthetic in connexion with a professional service, or a series of combination of professional services, for which the fee, or the aggregate of the fees specified in this table exceeds $165 ........

12.00

12.00

12.00

12.00

12.00

12.00

PART 6—MISCELLANEOUS PROCEDURES

601

Electrocardiography, phonocardiography, stethography or ballistocardiography .......

7.00

8.00

7.80

6.00

6.00

6.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

$

$

$

$

$

$

611

Continuous electrocardiographic monitoring during anaesthesia....................................

8.80

8.50

7.80

7.50

7.50

7.50

616

Restoration of cardiac rhythm by electrical stimulation, other than in the course of cardiac surgery.........................................

14.00

14.00

14.00

14.00

14.00

14.00

621

Intracardiac pressure recording at operation..

33.00

33.00

33.00

33.00

33.00

33.00

625

Blood pressure recording by intravenous cannula.....................................................

30.00

30.00

30.00

30.00

30.00

30.00

631

Ultrasonic echography, unidimensional (including echoencephalography).............

11.00

11.00

11.00

11.00

11.00

11.00

632

Ultrasonic cross-sectional echography bidimensional...........................................

30.00

30.00

30.00

30.00

30.00

30.00

641

Electroencephalography, not covered by item 631, 632, 651 or 661................................

16.50

16.00

17.00

17.00

14.00

13.00

651

Electroencephalography, temporosphenoidal

24.00

24.00

24.00

24.00

24.00

24.00

661

Electrocorticography.....................................

33.00

33.00

33.00

33.00

33.00

33.00

681

Electromyography—involving estimation of nerve conduction times or stimulating response recording....................................

8.20

8.20

8.20

8.20

8.20

8.20

691

Electromyography—involving sampling of muscle activity—each attendance at which procedure is performed ...........................

6.60

6.60

6.60

6.60

6.60

6.60

698

Retinal angiography—one eye......................

15.00

15.00

15.00

15.00

15.00

15.00

699

Retinal angiography—both eyes...................

20.00

20.00

20.00

20.00

20.00

20.00

701

Tonography, in the management of glaucoma

10.00

7.00

10.50

10.00

8.00

8.00

703

Provocative test or tests for glaucoma, including water drinking...........................

6.00

6.00

6.00

6.00

6.00

6.00

705

Electroretinography.......................................

18.00

18.00

18.00

18.00

18.00

18.00

711

Audiogram, air conduction...........................

4.50

4.50

4.50

4.50

4.50

4.50

712

Audiogram, air conduction and bone conduction

6.50

6.50

6.50

6.50

6.50

6.50

713

Audiogram, air conduction, bone conduction and speech................................................

8.50

8.50

8.50

8.50

8.50

8.50

714

Audiogram, air conduction, bone conduction and speech, with other cochlear tests........

10.50

10.50

10.50

10.50

10.50

10.50

723

Caloric tests of labyrinth or labyrinths..........

7.50

7.50

7.50

7.50

7.50

7.50

725

Electronystagmography.................................

7.50

7.50

7.50

7.50

7.50

7.50

731

Bronchospirometry, including gas analysis

27.50

27.50

27.50

27.50

27.50

27.50

741

Estimation of respiratory function by spirometer or other simple techniques—each attendance at which one or more tests are performed...........................................

11.00

10.00

10.50

9.00

9.00

8.50

751

Estimation of respiratory function requiring complicated techniques— each attendance at which one or more tests are performed.

15.50

15.50

15.50

15.50

15.50

15.50


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

$

$

$

$

$

$

753

Hyperbaric oxygen therapy where the medical practitioner is not in the chamber................................................................

25.00

25.00

25.00

25.00

25.00

25.00

755

Hyperbaric oxygen therapy where the medical practitioner is in the chamber.....

40.00

40.00

40.00

40.00

40.00

40.00

756

Topical application of oxygen in hyperbaric chamber—as an independent procedure

15.00

15.00

15.00

15.00

15.00

15.00

757

Administration of general anaesthesia (including oxygen administration) during hyperbaric therapy where the medical practitioner is in the chamber..................

50.00

50.00

50.00

50.00

50.00

50.00

761

Perfusion of limb or organ using heart-lung machine or equivalent.............................

75.00

75.00

75.00

75.00

75.00

75.00

771

Whole body perfusion, cardiac by-pass, using heart-lung machine or equivalent...

110.00

110.00

110.00

110.00

110.00

110.00

782

Haemodialysis in hospital (where prolonged and constant medical supervision of the dialysis is required for the duration of the dialysis).............................................

60.00

60.00

60.00

60.00

60.00

60.00

784

Haemodialysis in hospital (where intermittent medical supervision of the dialysis is required).................................

30.00

30.00

30.00

30.00

30.00

30.00

786

Haemodialysis in hospital (stabilised maintenance dialysis for chronic renal failure where a separate account for an attendance is not rendered under Part 1 of this Schedule).....................................

10.00

10.00

10.00

10.00

10.00

10.00

791

Dialysis, peritoneal......................................

22.00

22.00

22.00

22.00

22.00

22.00

801

Induced controlled hypothermia—total body

18.50

18.50

18.50

18.50

18.50

18.50

831

Fluids, intravenous infusion of—Percutaneous 

5.50

5.00

5.00

5.00

5.00

5.00

841

Fluids, intravenous infusion of—by open exposure.................................................

9.00

8.00

8.50

8.00

8.00

8.00

843

Umbilical vein catheterisation with or without infusion......................................

7.50

7.50

7.50

7.50

7.50

7.50

845

Umbilical artery catheterisation with or without infusion .....................................

12.00

12.00

12.00

12.00

12.00

12.00

847

Scalp vein catheterisation with or without infusion...................................................

7.50

7.50

7.50

7.50

7.50

7.50

851

Intravenous infusion or injection of a substance incorporating a cytotoxic agent................................................................

8.50

8.50

8.50

8.50

8.50

8.50

861

Intra-arterial infusion or injection of a substance incorporating a cytotoxic agent, preparation for..............................

14.00

14.00

14.00

14.00

14.00

14.00

866

Intralymphatic infusion or injection of a fluid containing a cytotoxic agent, with or without the incorporation of an opaque medium .....................................

22.00

22.00

22.00

22.00

22.00

22.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

868

Intralymphatic insertion of needle or cannula for the purpose of introduction of radio-active material...........................

22.00

22.00

22.00

22.00

22.00

22.00

871

Blood transfusion, including collection from donor.......................................................

16.50

16.50

16.50

16.50

16.50

16.50

881

Blood transfusion, using blood already collected..................................................

11.00

12.00

10.50

11.00

11.00

10.00

891

Blood transfusion with venesection and complete replacement of blood, including collection from donor..............................

39.00

39.00

39.00

39.00

39.00

39.00

901

Blood transfusion with venesection and complete replacement of blood, using blood already collected...........................

33.00

33.00

33.00

33.00

33.00

33.00

906

Intrauterine foetal blood transfusion using blood already collected, including necessary amniocentesis..........................

39.00

39.00

39.00

39.00

39.00

39.00

911

Blood for purposes of transfusion, collection of, not covered by item 871 or 891 .........................................................

8.20

8.20

8.20

8.20

8.20

8.20

915

Blood dye—dilution indicator test ……………

20.00

20.00

20.00

20.00

20.00

20.00

921

Venesection, not covered by item 891 or 901—each attendance at which venesection is performed........................

3.10

3.10

3.10

3.10

3.10

3.10

931

Blood specimen for pathology test, intravenous collection of, for forwarding to another medical practitioner................

2.20

2.50

2.10

2.00

2.00

2.00

941

Blood for pathology test, collection of, by arterial puncture......................................

3.30

3.30

3.30

3.30

3.30

3.30

943

Blood for pathology test, collection of, by femoral or external jugular vein puncture in infants.................................................

4.00

4.00

4.00

4.00

4.00

4.00

945

Collection of specimen of sweat by iontophoresis...........................................

6.00

6.00

6.00

6.00

6.00

6.00

951

Hormone or living tissue implantation—by incision....................................................

8.80

8.80

8.80

8.80

8.80

8.80

961

Hormone or living tissue implantation—by cannula....................................................

5.60

5.60

5.60

5.60

5.60

5.60

965

Oesophageal motility test, manometric........

15.00

15.00

15.00

15.00

15.00

15.00

972

Gastric hypothermia by closed circuit circulation of refrigerant in the absence of gastrointestinal haemorrhage...................

30.00

30.00

30.00

30.00

30.00

30.00

975

Gastric hypothermia by closed circuit circulation of refrigerant for upper gastrointestinal haemorrhage...................

60.00

60.00

60.00

60.00

60.00

60.00

977

Gastric lavage in the treatment of ingested poison.....................................................

7.50

7.50

7.50

7.50

7.50

7.50

981

Electroconvulsive therapy—each attendance at which treatment is given......................

10.00

10.00

8.00

9.00

9.00

9.00

985

Narcotherapy or similar psychiatric procedure involving intravenous injection—each attendance at which treatment is given....................................

12.00

12.00

12.00

12.00

12.00

12.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

s

$

$

$

$

988

Psychotherapy (including associated consultation) by a consultant physician in the practice of his recognised specialty of psychiatry where the patient is referred to him by a medical practitioner, any session of not less than 45 minutes duration subsequent to the first attendance in a single course of treatment........................

13.50

13.50

13.50

13.50

13.50

13.50

990

Group psychotherapy (including associated consultation) of not less than one hour’s duration given under the continuous direct supervision of a consultant physician in the practice of his recognised specialty of psychiatry, on a group of not more than four patients where each patient is referred to him by a medical practitioner—each patient........................

5.00

5.00

5.00

5.00

5.00

5.00

992

Group psychotherapy (including associated consultation) of not less than one hour’s duration given under the continuous direct supervision of a consultant physician in the practice of his recognised specialty of psychiatry, on a group of not less than five patients but less than ten patients where each patient is referred to him by a medical practitioner—each patient.....................................................

3.50

3.50

3.50

3.50

3.50

3.50

994

Group psychotherapy (including associated consultation) of not less than one hour’s duration given under the continuous direct supervision of a consultant physician in the practice of his recognised specialty of psychiatry, on a group of not less than ten patients where each patient is referred to him by a medical practitioner— each patient

2.00

2.00

2.00

2.00

2.00

2.00

 

PART 7—PATHOLOGY SERVICES

Division 1—Blood

Haematology—Erythrocytes

1000

Blood film, examination of.........................

2.50

3.00

2.00

2.00

2.00

2.00

1002

Blood film, examination by special stains to demonstrate; basophilic stippling, foetal haemoglobin, haemoglobin H. Heinz bodies, reticulocytes, siderocytes or similar.....................................................

3.00

3.00

3.00

2.00

2.50

2.50

1004

Malarial or other parasites, examination of blood for.................................................

4.00

4.00

3.00

2.50

2.50

2.50

1006

Sickling, examination of blood for..............

3.00

3.00

3.00

3.00

3.00

3.00

1008

Haemoglobin estimation (where patient is referred by another medical practitioner for this service).......................................

2.50

2.50

2.00

2.00

2.00

2.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

1010

Haemoglobin estimation and examination of blood film...............................................

4.50

5.00

3.50

3.50

3.50

3.50

1012

Haemoglobin estimation and examination of blood film and blood grouping A, B, O and Rh.....................................................

10.00

11.00

9.00

8.50

8.50

8.50

1014

Haemoglobin estimation, leucocyte count, and differential leucocyte count..............

7.50

7.00

5.50

5.00

6.00

5.50

1016

Haemoglobin estimation, haematocrit (packed cell volume) estimation, leucocyte count and differential leucocyte count.......................................................

8.00

8.50

7.50

7.00

8.50

8.00

1018

Haemoglobin estimation, haemotocrit (packed cell volume) estimation, leucocyte count and differential leucocyte count, and erythrocyte sedimentation rate................................................................

12.00

13.00

10.50

9.00

11.00

11.00

1019

Haemoglobin estimation, erythrocyte count, haematocrit (packed cell volume) estimation, leucocyte count; one or more of these estimations or counts, when performed on a single specimen of blood simultaneously or consecutively on an automated haematology system...............

2.50

2.50

2.50

2.50

2.50

2.50

1020

Haemoglobin estimation, blood grouping, A, B, O and Rh, indirect Coombs’ test, total bilirubin and compatibility testing ..........

23.50

20.00

20.50

19.00

21.00

21.00

1022

Erythrocyte count 

2.50

2.50

2.00

2.00

2.00

2.00

1024

Erythrocyte sedimentation rate (where patient is referred by another medical practitioner for this service) ....................

4.00

4.00

3.00

2.00

2.50

2.50

1026

Haematocrit (packed cell volume) estimation

3.00

2.50

3.00

2.00

2.50

2.50

1028

Erythrocyte fragility test, to hypotonic saline

8.00

8.00

7.50

5.00

6.50

6.00

1030

Erythrocyte fragility test, mechanical fragility

8.00

8.00

7.50

5.00

6.50

6.00

1032

Erythrocyte, autohaemolysis test.................

8.00

8.00

7.50

5.00

6.50

6.00

1034

Erythrocytes, estimation of mean cell diameter 

5.00

5.00

5.00

5.00

5.00

5.00

1036

Erythrocytes, tests for enzymes, acid phosphatase or similar, each enzyme......

7.00

7.00

7.00

7.00

7.00

7.00

1038

Erythrocytes, estimation of glutathione........

8.00

8.00

8.00

8.00

8.00

8.00

1040

Erythrocytes, glutathione stability test..........

8.00

8.00

8.00

8.00

8.00

8.00

1042

Erythrocytes, glucose-6-phosphate dehydrogenase, pyruvate kinase deficiency, or similar, screening test........

7.00

7.50

5.00

5.00

4.50

4.50

1044

Erythrocytes, glucose-6-phosphate dehydrogenase, pyruvate kinase deficiency, or similar, quantitative estimation ...............................................

10.00

10.00

10.00

10.00

10.00

10.00


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

1046

Erythrocytes, test for paroxysmal nocturnal haemoglobinuria—screening test (sucrose water test)................................................

4.00

4.00

4.00

4.00

4.00

4.00

1048

Erythrocytes, test for paroxysmal nocturnal haemoglobinuria-acid haemolysin test.....

14.00

14.00

14.00

14.00

14.00

14.00

1050

Erythrocytes, folate estimation of................

10.00

10.00

10.00

7.50

6.50

7.00

1054

Erythrocytes, direct Coombs’test.................

4.00

3.00

3.00

2.50

2.50

2.50

Haematology—Leucocytes

1060

Leucocyte count..........................................

2.50

3.00

2.00

2.00

2.00

2.00

1062

Leucocyte count and differential count.......

4.50

4.50

3.50

3.00

4.00

3.50

1063

Differential leucocyte count........................

2.00

2.00

2.00

2.00

2.00

2.00

1064

Eosinophil count, wet..................................

2.50

3.00

2.50

2.50

2.50

2.50

1066

Leucocyte agglutinins, detection of.............

6.00

6.00

6.00

6.00

6.00

6.00

1068

Lupus erythematosus cells, examination of blood film for..........................................

6.50

6.50

6.00

5.00

5.00

5.00

1070

Cytological sex determination from blood film

6.00

6.00

5.00

5.00

5.00

5.00

1072

Leucocyte (neutrophil) alkaline phosphatase determination..........................................

7.00

7.00

7.00

7.00

7.00

7.00

1074

Leucocyte tests for phagocytic activity........

22.00

22.00

22.00

22.00

22.00

22.00

1076

Blood film examination using special stains (P.A.S., Sudan black or similar) for leucocytes...............................................

3.00

3.00

3.00

3.00

3.00

3.00

Haematology—Platelets

1080

Platelet count...............................................

3.00

3.00

3.00

2.00

2.50

2.50

1082

Platelet agglutinin test..................................

6.00

6.00

6.00

6.00

6.00

6.00

1084

Platelet survival or life—radio-active technique 

25.00

25.00

25.00

25.00

20.00

20.00

Haematology—Blood Transfusion Procedures

1090

Blood grouping, A, B, O and Rh (D antigen)

5.00

5.00

5.00

4.50

4.50

4.50

1091

Blood grouping, Rh phenotyping, examination for C, D, E, c,e and other Rh antigens (five or more antigens)..............

7.00

7.00

7.00

7.00

7.00

7.00

1092

Blood grouping, MN or other, each system, not covered by item 1090 or 1091..........

5.00

5.00

5.00

5.00

5.00

5.00

1094

Compatability testing—for each bottle tested up to five bottles.....................................

5.00

4.50

5.00

4.50

5.00

5.00

1096

Compatability testing—for each subsequent bottle tested in excess of five..................

4.00

3.50

3.50

3.50

3.50

3.50

1098

Examination of serum for Rh or other blood group antibodies—screening test ............

5.50

4.50

4.50

4.50

4.50

4.50

1100

Examination of serum for Rh or other blood group antibodies—quantitative estimation

6.50

5.50

5.50

5.50

5.50

5.50


 

 

 

Fees

 

 

 

 

 

Item No.

Medical service

N.S.W.

Vic.

Qld

S.A.

W.A.

Tas.

 

 

$

$

$

$

$

$

1102

Examination of serum for Rh or other blood group antibodies-screening and quantitative estimation.............................

10.00

9.00

9.00

9.00

9.00

9.00

1104

Coombs’ test—direct...................................

4.00

3.00

3.00

2.50

2.50

2.50

1106

Coombs’ test-indirect (if not part of Items 1094, 1096, 1098, 1100 or 1102)...........

5.00

3.50

3.50

3.50

4.50

4.00

1108

Examination of serum for blood group haemolysins............................................

6.50

5.50

5.50

5.50

5.50

5.50

Haematology—Haemostasis

1110

Antihaemophilic globulin, assay of, or other blood coagulation factor— quantitative...

15.00

15.00

15.00

12.00

12.00

12.00

1112

Bleeding time...............................................

2.50

2.50

2.50

2.00

2.00

2.00

1114

Coagulation time (including qualitative clot retraction)................................................

3.00

3.00

2.50

2.00

2.00

2.00

1116

Bleeding time, coagulation time (including qualitative clot retraction), prothrombin estimation and platelet count...................

14.00

13.00

12.50

10.00

11.00

11.00

1118

Clot retraction, quantitative..........................

5.00

5.00

5.00

3.50

4.00

4.00

1120

Euglobulinlysis time, or similar....................

12.00

12.00

12.00

12.00

12.00

12.00

1122

Fibrinogen estimation..................................

7.00

7.00

5.50

5.00

4.50

5.00

1124

Fibrinogen titre, determination of................

5.00

5.00

5.00

5.00

5.00

5.00

1126

Kaolin clotting time.....................................

6.00

6.00

6.00

6.00

6.00

6.00

1128

Platelet count...............................................

3.00

3.20

3.00

2.00

2.50

2.50

1130

Platelet adhesion test....................................