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Health Insurance Regulations (Amendment)

Authoritative Version
  • - F1996B02826
  • No longer in force
SR 1993 No. 106 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 HR17-Aug-1993
Tabled Senate17-Aug-1993
Gazetted 03 Jun 1993
Date of repeal 19 Mar 2014
Repealed by Health (Spent and Redundant Instruments) Repeal Regulation 2014

Statutory Rules 1993   No. 1061

__________________

Health Insurance Regulations2 (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 27 May 1993.

 

                                                                                    BILL HAYDEN

                                                                                   Governor-General

         By His Excellency’s Command,

 

 

GRAHAM RICHARDSON

Minister for Health

____________

1.   Amendment

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

[NOTE:  These Regulations commence on gazettal: see Acts Interpretation Act 1901, s. 48.]


2.    New regulations 23a to 23g (inclusive)

2.1   After regulation 23, insert:

Application for a declaration that a quality assurance activity is an activity to which Part Vc of the Act applies

        “23a.   (1)    A person who wants the Minister to declare that a quality assurance activity is an activity to which Part Vc of the Act applies must apply to the Minister using the form approved by the Minister for the purposes of this regulation.

           “(2)   The form must require the applicant to give:

             (a)   an undertaking that the applicant will inform the Minister of a change to the purposes of the quality assurance activity to which the application relates as soon as practicable after the change occurs; and

             (b)   if the quality assurance activity to which the application relates is to be engaged in by a body of persons—an undertaking that the applicant will inform the Minister of any significant change to the composition or purposes of the body that is likely to affect the activity as soon as practicable after the change occurs.

Criteria in relation to quality assurance activities

        “23b.   For the purposes of paragraph 106l (3) (b) of the Act, the criteria stated in regulations 23c to 23g (inclusive) are prescribed.

Criteria in relation to quality assurance activities: disclosure of information

        “23c.   (1)    A quality assurance activity must include the disclosure of information that concerns:

             (a)   the quality of service assessed, evaluated or studied; or

             (b)   the factors affecting the quality of the service.

           “(2)   Disclosure of information:


             (a)   must not identify, expressly or by implication, a particular individual or particular individuals; and

             (b)   must take place:

                          (i)   at times that are acceptable to the Minister; and

                         (ii)   in a manner that is acceptable to the Minister.

           “(3)   Subregulations (1) and (2) do not apply if the Minister is satisfied on reasonable grounds that it is not appropriate to disclose the information.

Criteria in relation to quality assurance activities: activities engaged in in one State or Territory

        “23d.   (1)    The criterion stated in subregulation (2) applies if a quality assurance activity is engaged in in only one State or Territory.

           “(2)   The Minister must be satisfied on reasonable grounds that at least one of the following paragraphs is relevant to a quality assurance activity engaged in in one State or Territory:

             (a)   the government of the State or Territory has advised the Minister that:

                          (i)   the activity is not subject to legislation of the State or Territory that is similar to Part Vc of the Act; and

                         (ii)   in the opinion of the government of the State or Territory, it is in the public interest that Part Vc of the Act should apply to the activity;

             (b)   the activity includes a methodology that has not been used previously in Australia;

             (c)   the activity is a pilot study for the purpose of investigating whether a methodology of a particular kind can be used in Australia;

             (d)   the activity addresses a subject matter that has not previously been addressed in Australia;

             (e)   the activity has the potential to affect the quality of health care on a national scale;


              (f)   the activity is a pilot study for the purpose of investigating whether the activity has the potential to affect the quality of health care on a national scale;

             (g)   the activity is of national importance.

Criteria in relation to quality assurance activities: activities that have not been engaged in previously in Australia

        “23e.   (1)    The criterion stated in subregulation (2) applies if the Minister:

             (a)   is considering whether to make a declaration under subsection 106l (1) of the Act in relation to a quality assurance activity; and

             (b)   is satisfied on reasonable grounds that quality assurance activities of that kind have not been engaged in in Australia before he or she considers whether to make the declaration.

           “(2)   The Minister must be satisfied on reasonable grounds that the application of Part Vc of the Act to a quality assurance activity is necessary to make the activity effective by encouraging:

             (a)   the full participation in the activity of persons who provide health services; and

             (b)   if the activity involves the making of a recommendation to improve or maintain the quality of health services—the acceptance and implementation of the recommendation by persons who provide health services; and

             (c)   if the activity involves the making of a recommendation to improve or maintain the quality of health services—the participation of persons who provide health services in monitoring the implementation of the recommendation.


Criteria in relation to quality assurance activities: activities that have been engaged in previously in Australia

        “23f.   (1)    The criteria stated in this regulation apply if the Minister:

             (a)   is considering whether to make a declaration under subsection 106l (1) of the Act in relation to a quality assurance activity (in this regulation called ‘the activity’); and

             (b)   is satisfied on reasonable grounds that a quality assurance activity of that kind (in this regulation called a ‘previous activity’) has been engaged in in Australia.

           “(2)   The Minister must be satisfied on reasonable grounds that the application of Part Vc of the Act to the activity is necessary to make the activity effective by encouraging participation in the activity:

             (a)   by persons who provide health services; and

             (b)   to a greater extent than the participation, by persons who provide health services, in the previous activity.

           “(3)   If the activity involves the making of a recommendation to improve or maintain the quality of health services, the Minister must be satisfied on reasonable grounds that the application of Part Vc of the Act to the activity is necessary to make the activity effective by encouraging acceptance and implementation of the recommendation:

             (a)   by persons who provide health services; and

             (b)   to a greater extent than the acceptance and implementation, by persons who provide health services, of recommendations made during the previous activity.

           “(4)   If the activity involves the making of a recommendation to improve or maintain the quality of health services, the Minister must be satisfied on reasonable grounds that the application of Part Vc of the Act to the activity is necessary to make the activity effective by encouraging participation in monitoring the implementation of the recommendation:

             (a)   by persons who provide health services; and


             (b)   to a greater extent than the participation, by persons who provide health services, in monitoring the implementation of recommendations made during the previous activity.

Criteria in relation to quality assurance activities: review procedures

        “23g.   (1)    The criterion stated in subregulation (2) applies if a quality assurance activity includes:

             (a)   the assessment or evaluation by a person of the services, skill or performance of a health care practitioner for the purpose of determining the health care practitioner’s clinical practising rights; and

             (b)   the making of findings on material questions of fact or law.

           “(2)   The purposes of the quality assurance activity must include:

             (a)   the giving of reasons to the health care practitioner for findings:

                          (i)   that the person makes; and

                         (ii)   with which the health care practitioner is dissatisfied; and

             (b)   an entitlement for the health care practitioner to appeal to another person or body against an adverse finding made by the person; and

             (c)   the disclosure, by the person, of information that:

                          (i)   is about the health care practitioner’s clinical practising rights; and

                         (ii)   identifies the health care practitioner.

           “(3)   In this regulation:

‘clinical practising rights’ means:

             (a)   a health care practitioner’s right to practise a particular profession or use particular skills in:

                          (i)   premises at which health services are provided; or

                         (ii)   an authority of a State or Territory; or


             (b)   a health care practitioner’s right to hold himself or herself out as having been certified by an association of health professionals as possessing a particular skill or competency;

‘health care practitioner’ means a person referred to in paragraph (a) of the definition of ‘quality assurance activity’ in subsection 106k (1) of the Act.”.

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NOTES

1.   Notified in the Commonwealth of Australia Gazette on  3 June 1993.

2.   Statutory Rules 1975 Nos.80 as amended by 1975 Nos. 118,125 and 135; 1976 Nos. 202, 214 and 215; 1977 Nos. 26 ans 44; 1978 Nos. 95 ans 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; 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; 1991 Nos. 82, 314, 365 and 441; 1992 Nos. 42, 111, 239, 335 and 431.