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Health Insurance Regulations (Amendment)

Authoritative Version
  • - F1996B02817
  • No longer in force
SR 1991 No. 82 Regulations as made
These Regulations amend the Health Insurance Regulations.
Administered by: Health
General Comments: This instrument was backcaptured in accordance with Section 36 of the Legislative Instruments Act 2003
Registered 01 Jan 2005
Tabling HistoryDate
Tabled HR07-May-1991
Tabled Senate08-May-1991
Gazetted 30 Apr 1991
Date of repeal 19 Mar 2014
Repealed by Health (Spent and Redundant Instruments) Repeal Regulation 2014

 

 

 

 

 

 

 

Statutory  Rules  1991   No. 821

__________________

 

 

Health Insurance Regulations 2 (Amendment)

 

 

I, THE GOVERNOR-GENERAL of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.

 

          Dated 29 April 1991.

 

                                                                                        BILL HAYDEN

                                                                                        Governor-General

          By His Excellency’s Command,

 

 

B. HOWE

Minister of State for Community Services

and Health

____________

 

1.   Commencement

1.1   These Regulations commence on 1 May 1991.

 

 

2.   Amendment

2.1   The Health Insurance Regulations are amended as set out in these Regulations.

 

 

3.   Regulation 2 (Interpretation)

3.1   Insert the following definition:

 

 

‘requester number’ means the identification number allocated to a chiropractor;”.

 

 

4.   New regulations 2adaaa, 2adaab and 2adaac

4.1   After regulation 2ad, insert:

 

Dental practitioners may only request certain diagnostic imaging services

   “2adaaa.  For the purposes of subsection 16b (2) of the Act, a dental practitioner may only request a service specified in Division 3 of Part 3 of the diagnostic imaging services table.

 

 

Chiropractors may only request certain diagnostic imaging services

   “2adaab.  For the purposes of subsection 16b (3) of the Act, a chiropractor may only request a service specified in:

               (a)  item 2548, 2551 or 2554 in Division 2; or

               (b)  Division 4;

of Part 3 of the diagnostic imaging services table.

 

 

Exemption—pre-existing diagnostic imaging practices

   “2adaac.  The following services are services specified for the purposes of subsection 16(11) of the Act:

               (a)  items 2548, 2551 and 2554  in Division 2;

               (b)  items 2560, 2563, 2573, 2576 and 2581 in Division 3;

               (c)  all items in Division 4;

              (d)  items 2655, 2656 and 2657 in Division 6;

               (e)  item 2665 in Division 7;

               (f)  item 2720 in Division 8; and

               (g)  item 2732 in Division 9;

of Part 3 of the diagnostic imaging services table.”.

 

 

5.   Regulation 2ada (Prescribed particulars for purposes of subsection 19 (6) of the Act)

5.1   Subregulation 2ada (4):

Omit “Part 8, 8a, 9a or 11 of the general medical services table”, substitute “Part 8a or 11 of the general medical services table or an item in the diagnostic imaging services table”.

 

 

5.2   Subregulation 2ada (5):

Omit “table or in Part 8, 8a, 9a or 11 of the general medical services table”, substitute “table, an item in Part 8a or 11 of the general medical services table or an item in the diagnostic imaging services table”.

 

5.3   Add at the end:

             “(6)  Subject to subregulations (7) and (8), the following particulars are prescribed for the purposes of subsection 19 (6) of the Act in relation to professional services to which an item in the diagnostic imaging services table relates:

               (a)  the name and either:

                           (i)  the address of the place of practice; or

                          (ii)  the provider number in respect of the place of practice;

                     of the person who requested that professional service;

               (b)  the date on which that professional service was requested;

               (c)  the name and either:

                           (i)  the address of the place of practice; or

                          (ii)  the provider number in respect of the place of practice;

                     of the practitioner who:

                         (iii)  is claiming, or receiving, payment of fees in respect of that professional service; or

                         (iv)  if an assignment has been made, or an agreement entered into, in accordance with section 20a of the Act, in relation to the medicare benefit in respect of that professional service, is the assignee of the right to the payment of that benefit under that assignment or agreement.

 

             “(7)  If the person referred to in paragraph (6) (a) is a chiropractor, the reference in subparagraph (6) (a) (ii) to a provider number is a reference to a requester number.

 

             “(8)  For the purposes of subsection 19 (6) of the Act, if the practitioner referred to in paragraph (6) (c) is not the practitioner who rendered the professional service referred to in subregulation (6), the following additional particulars are prescribed in relation to that professional service, namely the name and either:

 

 

 

 

               (a)  the address of the place of practice; or

               (b)  the provider number in respect of the place of practice;

of the second-mentioned practitioner, unless those particulars and the date on which the professional service was requested are recorded at the place of practice of the first-mentioned practitioner.

 

             “(9)  For the purposes of subsection 19 (6) of the Act, if professional services to which an item in the diagnostic imaging services table relates are rendered:

               (a)  by a specialist in circumstances specified in subsection 16b (6) of the Act; or

               (b)  within an area that is a remote area for the purposes of Division 2 of Part IIb of the Act in circumstances specified in subsection 16b (7) of the Act; or

               (c)  as an additional necessary service in circumstances specified in subsection 16b (10) of the Act; or

              (d)  before 1 January 1993 in circumstances specified in subsection 16b (11) of the Act;

the following particular is prescribed in relation to those services—the letters ‘SD’, indicating that the services were self-determined.

 

           “(10)  For the purposes of subsection 19 (6) of the Act, if professional services to which an item in the diagnostic imaging services table relates are rendered in circumstances specified in subsection 16b (8) of the Act, the following particular is prescribed in relation to those services—the word ‘emergency’.

 

           “(11)  For the purposes of subsection 19 (6) of the Act, if professional services to which an item in the diagnostic imaging services table relates are rendered in circumstances specified in subsection 16b (9) of the Act, the following particular is prescribed in relation to those services—the words ‘lost request’.”.

 

 

6.   New regulations 2ce and 2cf

6.1   After regulation 2cd, insert:

 

Information that must be included in requests for diagnostic imaging services

          “2ce.  (1)   For the purposes of subsection 23dq (1) of the Act, the following information must be included in a subsection 16b (1) request by a medical practitioner:

 

               (a)  the name and either:

                           (i)  the address of the place of practice; or

                          (ii)  the provider number in respect of the place of practice;

                     of the requesting practitioner;

               (b)  the date of the request;

               (c)  a description of the requested diagnostic imaging service.

 

             “(2)  For the purposes of subregulation (1), a description of the requested diagnostic imaging service must provide, in terms that are generally understood throughout the medical profession, sufficient information to identify the item of the diagnostic imaging services table that relates to the requested service but it need not specify the item number.

 

 

Records of diagnostic imaging services that must be kept by providing medical practitioners

          “2cd.  (1)   For the purposes of subsection 23ds (1) of the Act, a medical practitioner who provides diagnostic imaging services (in this regulation called the ‘providing practitioner’) must prepare and maintain records of those services.

 

             “(2)  In relation to each service rendered, the providing practitioner’s records must include:

               (a)  a copy of the report by the providing practitioner; and

               (b)  if the service is rendered in circumstances specified in subsection 16b (8) of the Act, sufficient information to indicate the nature of the emergency; and

               (c)  if the service is rendered in circumstances specified in subsection 16b (9) of the Act, words indicating:

                           (i)  that the person in relation to whom the service was rendered, or a person acting on that person’s behalf, claimed that a medical practitioner, dental practitioner or chiropractor (in this regulation called the ‘requesting practitioner’) had made a request for the service to be rendered but that the request had been lost; and

 

 

 

 

 

                          (ii)  that the providing practitioner, or an employee or agent of the providing practitioner, had sought and received from the requesting practitioner, or from an employee or agent of the requesting practitioner, confirmation that the request had been made; and

                         (iii)  the date and the manner of that confirmation.

 

             “(3)  The providing practitioner’s records must be kept in a manner that enables retrieval of information on the basis of:

               (a)  the name of the person to whom the service was rendered; and

               (b)  the date on which the service was rendered.”.

 

____________________________________________________________

NOTES

 

1.      Notified in the Commonwealth of Australia Gazette on 30 April 1991.

 

2.      Statutory Rules 1975 No. 80 as amended by 1975 Nos. 118, 125 and 135 (commenced 3 July 1975; disallowed 4 September 1975); 1976 Nos. 202, 214 and 215; 1977 Nos. 26 and 24; 1978 Nos. 95 and 177; 1979 No. 230; 1981 Nos. 198 and 317; 1982 Nos. 157, 251 and 287; 1983 Nos. 106, 231, 253 and 255; 1984 Nos. 5 and 162; 1985 Nos. 36, 50, 95, 205 and 290 (commenced 7 November 1985; disallowed 15 April 1986); 1986 Nos. 19, 20, 87 and 326; 1987 Nos. 32, 163 and 166; 1988 No. 314; 1989 Nos. 6, 54, 117 and 293; 1990 No. 25.