Health Insurance Amendment Bill (No. 2) 1996
First Reading
1996
The Parliament of the
Commonwealth of Australia
HOUSE OF REPRESENTATIVES
Presented and read a first time
Health Insurance Amendment Bill (No. 2) 1996
No. , 1996
(Health and Family Services)
A Bill for an Act to amend the Health Insurance Act 1973, and for related purposes
9614020--1,0000/15.10.1996--(140/96) Cat. No. 96 5269 8 ISBN 0644 482397
Contents
1 Short title
2 Commencement
3 Schedule(s)
Schedule 1--Amendments relating to medical practitioners
Health Insurance Act 1973
Schedule 2--Amendments relating to the level of medicare benefit
Health Insurance Act 1973
Schedule 3--Amendments relating to temporary resident doctors
Health Insurance Act 1973
A Bill for an Act to amend the Health Insurance Act 1973, and for related purposes
The Parliament of Australia enacts:
This Act may be cited as the
Health Insurance Amendment Act (No. 2) 1996.
(1) Subject to this section, this Act commences on the day on which it receives the Royal Assent.
(2) Subject to subsections (3) and (4), if this Act receives the Royal Assent before 1 November 1996, Schedules 1 and 2 commence on 1 November 1996.
(3) Subject to subsection (4), items 5, 6, 7 and 9 of Schedule 2 commence on a day to be fixed by Proclamation.
(4) If a provision of this Act referred to in subsection (3) does not commence within 6 months after the day on which this Act receives the Royal Assent, it commences on the first day after the end of that period.
(5) Schedule 3 commences on 1 November 1997.
Subject to section 2, each Act that is specified in a Schedule to this Act is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this Act has effect according to its terms.
Health Insurance Act 1973 1 Subsection 3(1)
Insert:
general practitioner means:
(a) a medical practitioner in respect of whom a determination under section 3EA is in force; or
(b) a person registered under section 3F as a vocationally registered general practitioner; or
(c) a medical practitioner of a kind specified in the regulations.
2 Subsection 3(17)
Repeal the subsection, substitute:
(17) For the purposes of this Act and the regulations, a service is taken to be rendered on behalf of a medical
Back to Top practitioner if, and only if:
(a) it is rendered by another person who is not a medical practitioner, and who provides the service, in accordance with accepted medical practice, under the supervision of the medical practitioner; and
(b) it is not a service of a kind specified in regulations made for the purposes of this paragraph.
3 After section 3E
Insert:
(1) A medical practitioner may apply to the Commission for a determination under this section.
(2) After receiving an application, the Managing Director of the Commission must, within the required period under subsection (3), determine that the applicant is a recognised Fellow of the Royal Australian College of General Practitioners if the Royal Australian College of General Practitioners gives the Managing Director written notice stating that the applicant:
(a) is a Fellow of the Royal Australian College of General Practitioners; and
(b) is eligible, in accordance with the regulations, for a determination under this section.
(3) The required period for the purposes of subsection (2) is:
(a) the period of 14 days after the notice under subsection (2) was received by the Commission; or
(b) if the application was made after the notice was received--the period of 14 days after the application was received by the Commission.
(4) The Managing Director must give the applicant written notice of the day on which the determination will enter into force.
(5) The Commission may give the Royal Australian College of General Practitioners information about whether or not determinations under this section are in force in respect of particular persons.
(6) The Managing Director or an authorised officer may make available to members of the public, on request:
(a) the names of medical practitioners in respect of whom determinations under this section are in force; and
(b) the addresses at which they practise.
(7) In this section:
authorised officer means a Commission staff member authorised by the Managing Director as an authorised officer for the purposes of this section.
Commission staff member means a member of the staff of the Commission referred to in subsection 28(1) of the Health Insurance Commission Act 1973.
(1) The Managing Director of the Commission must revoke a determination under section 3EA in respect of a medical practitioner if:
(a) the medical practitioner requests the Managing Director to do so; or
(b) the Royal Australian College of General Practitioners gives the Managing Director written notice that:
(i) the medical practitioner is not a Fellow of the Royal Australian College of General Practitioners; or
(ii) the regulations require that the determination be revoked; or
(c) the regulations require that the determination be revoked.
(2) Before revoking the determination, the Managing Director must give the medical practitioner written notice that the determination is to be revoked.
(3) The notice must specify the day on which the determination is to be revoked.
(4) The day specified under subsection (3) must not be less than 14 days after the day on which the notice is given.
4 Subsection 3F(6)
Repeal the subsection, substitute:
(6) After receiving an application, the Managing Director of the Commission must, within the required period under subsection (6A), enter the applicant's name in the Register if:
(a) the Royal Australian College of General Practitioners; or
(b) a body specified in the regulations;
Back to Top gives the Managing Director written notice that the applicant is, in accordance with the regulations, eligible for registration under this section.
(6A) The required period for the purposes of subsection (6) is:
(a) the period of 14 days after the notice under subsection (6) was received by the Commission; or
(b) if the application was made after the notice was received--the period of 14 days after the application was received by the Commission.
5 At the end of paragraph 3G(1)(a)
Add "or".
6 Paragraph 3G(1)(b)
Repeal the paragraph, substitute:
(b) the Royal Australian College of General Practitioners, or a body specified in the regulations, gives the Managing Director written notice that the regulations require that the medical practitioner's name be removed from the Register; or
7 Subsection 3G(2)
Repeal the subsection, substitute:
(2) Before removing the medical practitioner's name from the Register, the Managing Director shall give the medical practitioner written notice that his or her name is to be removed.
8 Subsection 3G(3)
Omit "The decision shall be made in writing and", substitute "The notice".
9 Subsection 3G(4)
Omit "the decision is made", substitute "the notice is given".
10 After section 3G
Insert:
(1) The purpose of this section is to provide for registration of certain medical practitioners in approved placements.
(2) The Commission is to establish and maintain a Register of Approved Placements.
(3) The Register may be maintained in any form, including as a computer record.
(4) A medical practitioner may apply to the Commission for registration under this section.
(5) If a medical practitioner makes an application and:
(a) a body specified in the regulations gives the Managing Director of the Commission written notice stating:
(i) that the applicant is enrolled in, or undertaking, a course or program of a kind specified in the regulations; and
(ii) the period over which, and the location in which, the applicant will be undertaking the course or program; or
(b) the applicant is, in accordance with the regulations, eligible for registration under this section;
the Managing Director must, within the required period under subsection (6), enter the applicant's name in the Register, together with the period in respect of which and the location in respect of which the applicant is registered.
(6) The required period for the purposes of subsection (5) is:
(a) if a notice was given to the Managing Director of the Commission under paragraph (5)(a) in connection with the application:
(i) the period of 14 days after the notice was received by the Commission; or
(ii) if the application was made after the notice was received--the period of 14 days after the application was received by the Commission; or
(b) if no such notice was given--the period of 14 days after the application was received by the Commission.
(7) The Managing Director must give the applicant written notice of the day on which the applicant's name is to be entered in the Register.
(8) The Commission may give a body specified in regulations made for the purposes of paragraph (5)(a) information about the following matters, to the extent that those matters relate to persons about whom the body has given a notice under paragraph (5)(a):
(a) the current state of the Register;
(b) additions to the Register;
(c) deletions from the Register.
(1) The Managing Director of the Commission must remove a medical practitioner's name from the Register of Approved Placements if:
Back to Top (a) the medical practitioner requests the Managing Director to do so; or
(b) a body specified in regulations made for the purposes of paragraph 3GA(5)(a) gives the Managing Director written notice that the medical practitioner (being a person about whom the body gave a notice under paragraph (5)(a)) is not enrolled in, or undertaking, the course or program in relation to which he or she was registered; or
(c) the regulations require that the medical practitioner's name be removed from the Register.
(2) Before removing the medical practitioner's name from the Register, the Managing Director must give the medical practitioner written notice that his or her name is to be removed.
(3) The notice must specify the day on which the medical practitioner's name is to be removed from the Register.
(4) The day specified under subsection (3) must not be less than 14 days after the day on which the notice is given.
11 Subsection 3H(1)
Omit "section 3F or 3G", substitute "paragraph (6) of the definition of general practitioner in subsection 3(1), section 3EA, 3EB, 3F or 3G.
12 Subsection 3H(2)
Omit "section 3F or 3G", substitute "the provision concerned".
13 After subsection 3J(4)
Insert:
(4A) If a person to whom a determination under subsection (1) applies ceases to have the right to remain in Australia, the determination ceases to apply to the person.
14 After section 19A
Insert:
(1) A medicare benefit is not payable in respect of a professional service if the person who rendered the service:
(a) first became a medical practitioner on or after 1 November 1996; and
(b) was not, at the time the service was rendered:
(i) a specialist (whether or not the service was rendered in the performance of the specialist's specialty); or
(ii) a consultant physician (whether or not the service was rendered in the performance of the consultant physician's specialty); or
(iii) a general practitioner; or
Note: For general practitioner, see subsection 3(1).
(iv) subject to subsection (3), a person registered under section 3GA; or
(v) a person to whom a determination under subsection 3J(1) applied.
Note: Subsection (5) gives a restricted meaning to the term professional service for the purposes of this section.
(2) A medicare benefit is not payable in respect of a professional service if the medical practitioner on whose behalf the service was rendered:
(a) first became a medical practitioner on or after 1 November 1996; and
(b) was not, at the time the service was rendered:
(i) a specialist (whether or not the service was rendered in the performance of the specialist's specialty); or
(ii) a consultant physician (whether or not the service was rendered in the performance of the consultant physician's specialty); or
(iii) a general practitioner; or
Note: For general practitioner, see subsection 3(1).
(iv) subject to subsection (3), a person registered under section 3GA; or
(v) a person to whom a determination under subsection 3J(1) applied.
Note 1: An effect of subsection 3(17) is that a service cannot be taken to be rendered on behalf of a medical practitioner if it is rendered by another medical practitioner.
Note 2: Subsection (5) gives a restricted meaning to the term professional service for the purposes of this section.
(3) Subparagraphs (1)(b)(iv) and (2)(b)(iv) only apply in relation to a professional service that was rendered:
(a) during the period in respect of which, and in the location in respect of which, the person is registered under section 3GA; or
Back to Top (b) in such other circumstances (which may include circumstances relating to the period during which, or the location in which, services are rendered) as are specified in the regulations.
(4) For the purposes of this section, a medical practitioner who, on 1 November 1996:
(a) was a medical practitioner who had not commenced, or who had not completed, training as an intern; or
(b) was not an Australian citizen or a permanent resident within the meaning of the Migration Act 1958;
is taken to have first become a medical practitioner on 1 November 1996.
(5) In this section:
intern means a medical practitioner who is undertaking:
(a) a period of internship (by whatever name called); or
(b) a period of supervised training (by whatever name called);
under a law of a State or Territory specified in the regulations (whether or not the medical practitioner is a resident in a hospital for some or all of that period).
professional service does not include a service of a kind referred to in paragraph (b), (ba) or (c) of the definition of professional service in subsection 3(1).
15 After section 19CB
Insert:
A medical practitioner, or a person acting on behalf of the medical practitioner, is guilty of an offence if:
(a) he or she renders to another person a professional service in respect of which a medicare benefit is not payable because of section 19AA; and
(b) before the service is rendered, such steps as are reasonable in all the circumstances have not been taken to inform:
(i) the other person; or
(ii) if the other person is in the care of someone else--that person;
that a medicare benefit would not be payable.
Penalty: 1 penalty unit.
16 After subsection 130(5B)
Insert:
(5C) This section does not prohibit a person providing to:
(a) the Royal Australian College of General Practitioners; or
(b) a body specified in regulations made for the purposes of paragraph 3F(6)(b);
information to assist the Royal Australian College of General Practitioners or that body to decide whether a medical practitioner is, in accordance with the regulations, eligible for registration under section 3F.
(5D) This section does not prohibit a person providing to:
(a) the Royal Australian College of General Practitioners; or
(b) a body specified in regulations made for the purposes of paragraph 3G(1)(b);
information to assist the Royal Australian College of General Practitioners or that body to decide whether regulations made for the purposes of that paragraph require that a medical practitioner's name be removed from the Vocational Register of General Practitioners referred to in section 3F.
Health Insurance Act 1973 1 After section 4
Insert:
(1) This section does not limit the generality of section 4.
(2) A regulation under section 4 may provide for a reduction in the fee applicable to a medical service (other than a diagnostic imaging service or a pathology service), where:
(a) that service; and
(b) at least one other service, which may be a
Back to Top diagnostic imaging service or a pathology service;
are provided to the same patient.
2 After section 4AA
Insert:
(1) This section does not limit the generality of section 4AA.
(2) A regulation under section 4AA may provide for a reduction in the fee applicable to a diagnostic imaging service, where:
(a) that service; and
(b) at least one other medical service, which may be a service other than a diagnostic imaging service;
are provided to the same patient.
3 Subsection 10(5) (definition of greatest permissible gap)
Omit "$26.80", substitute "$50.00".
4 Subsection 10(5) (definition of patient)
Repeal the definition.
5 Sections 11 and 12
Repeal the sections.
6 Paragraphs 67(1)(a) and (aa)
Add at the end "and".
7 Paragraphs 67(1)(b) and (c)
Repeal the paragraphs.
8 Saving provision--greatest permissible gap
Subsection 10(5) of the Health Insurance Act 1973, as in force before the commencement of this item, continues to apply after that commencement in relation to a professional service rendered before that commencement.
9 Saving provision--increased fee in complex cases
(1) Despite the repeal of section 11 of the Health Insurance Act 1973 by this Act, that section continues to apply, after the commencement of this item, in relation to a claim for a medicare benefit in respect of a professional service, if the claim is lodged with the Commission before that commencement.
(2) Despite the repeal of section 12 of the Health Insurance Act 1973 made by this Act, that section continues to apply, after the commencement of this item, in relation to a decision of the Commission under subsection 11(5) of that Act.
(3) Despite the repeal of paragraph 67(1)(b) of the Health Insurance Act 1973 by this Act, that paragraph continues to apply, after the commencement of this item, in relation to a claim for a medicare benefit in respect of a professional service, if the claim is lodged with the Commission before that commencement.
(4) Despite the repeal of paragraph 67(1)(c) of the Health Insurance Act 1973 made by this Act, that paragraph continues to apply, after the commencement of this item, in relation to an appeal under section 12 of that Act.
Health Insurance Act 1973 1 Subsection 3J(1)
Omit "unless the Minister determines otherwise", substitute:
unless:
(c) the person has qualifications of a kind that the Minister has determined in writing to be appropriate for the purposes of this section; and
(d) an exemption granted by the Minister in writing applies to the person.
2 Subsections 3J(2) and (3)
Omit "A determination under subsection (1)", substitute "An exemption under paragraph (1)(d)".
3 Subsections 3J(4) and (4A)
Omit "a determination under subsection (1)", substitute "an exemption under paragraph (1)(d)".
4 Subsections 3J(4) and (4A)
Omit "the determination" (wherever occurring), substitute "the exemption".
5 Paragraph 3J(5)(a)
Omit "a determination under subsection (1)", substitute "an exemption under paragraph (1)(d)".
6 Paragraph 3J(5)(b)
Omit "a determination", substitute "an exemption".
7 After subsection 3J(5)
Insert:
(5A) Determinations under paragraph (1)(c) are disallowable instruments for the purposes of section 46A of the Acts Interpretation Act 1901.
8 Subparagraphs 19AA(1)(b)(v) and (2)(b)(v)
Omit "a determination under subsection 3J(1)", substitute "paragraphs 3J(1)(c) and (d)".
9 Saving provision--determinations under subsection 3J(1)
If, immediately before the commencement of this item, a person was a person to whom a determination under subsection 3J(1) of the Health Insurance Act 1973 applied:
(a) the person is taken, after that commencement, to be a person to whom paragraph 3J(1)(c) of that Act applies; and
(b) the determination is taken, after that commencement, to be an exemption granted under paragraph 3J(1)(d) of that Act.