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Health Insurance Regulations 1975

Authoritative Version
SR 1975 No. 80 Regulations as amended, taking into account amendments up to SLI 2007 No. 187
Administered by: Health
Registered 03 Jul 2007
Start Date 01 Jul 2007
End Date 28 Sep 2007
Date of repeal 01 Oct 2018
Repealed by Health Insurance (Repeal and Consequential Amendments) Regulations 2018
Table of contents.
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1 Name of Regulations [see Note 1]
2 Interpretation
2A General practitioners
3 Definition of professional service in Act
3A Health services not specified in an item (Act s 3C)
4 Relevant organisations and qualifications (Act s 3D)
5 Prescribed fee — subsection 3D (1) of the Act
6 Prescribed fee — subsection 3E (2) of the Act
6A Recognised Fellows of the RACGP
6B Notice to be given of certain decisions
6C Appeals
6D Eligibility pending decision on appeal
6DA Recognition of practitioners who meet ACRRM fellowship standards
6DB Eligibility for determination
6DC Revocation of determinations
6E Register of Approved Placements — specified bodies etc
6EA Register of Approved Placements — eligible applicants
6EB Register of Approved Placements — removal of name
6EF Services for which medicare benefit is 100% of Schedule fee (Act s 10 (2) (aa))
6F Circumstances in which subparagraphs 19AA (1) (b) (iv) and (2) (b) (iv) of the Act apply
6G Interns — relevant State or Territory laws
9 Reduction of amounts for purposes of subsection 16 (4) of the Act
9A Requests for pathology services by electronic means
10 Diagnostic imaging services which dental practitioners may request
11 Diagnostic imaging services that chiropractors, osteopaths, physiotherapists and podiatrists may request
12 Exemption — pre‑existing diagnostic imaging services
12A Prescribed date — paragraph 16B (11) (d) of the Act
12B Definition of radiation oncology service
13 Particulars to be recorded on accounts, receipts and bulk billing agreement
13AA Payment to general practitioner by electronic transmission (Act s 20 (5))
13B Application for approval as billing agent
14 Medicare benefit not payable in respect of certain professional services
15 Service of notice under subsection 23B (6) of the Act
16 Application for acceptance of undertaking — repayment of fee
16A Records of pathology services to be kept by approved pathology authorities
17 Application for approval of premises — prescribed fees
18 Application for approval of premises — repayment of fees
19 Information that must be included in requests for diagnostic imaging services
20 Records of diagnostic imaging services that must be kept by providing medical practitioners
20A Diagnostic imaging — information to be included in application for registration
20B Diagnostic imaging — information to be included on register
20C Primary information — types of diagnostic imaging equipment
20D Radiation oncology — information to be included in application for registration
20E Radiation oncology — information to be included on register
20F Primary information — types of radiation oncology equipment
21 Application form — application for approval as an organisation under Part IV of the Act
22 Application form — application for approval of health service
22A Prescribed bodies — Part IVA of the Act
23 Prescribed fee — subsection 61 (1A) of the Act
23A Application for a declaration that a quality assurance activity is an activity to which Part VC of the Act applies
23B Criteria in relation to quality assurance activities
23C Criteria in relation to quality assurance activities: disclosure of information
23D Criteria in relation to quality assurance activities: activities engaged in in one State or Territory
23E Criteria in relation to quality assurance activities: activities that have not been engaged in previously in Australia
23F Criteria in relation to quality assurance activities: activities that have been engaged in previously in Australia
23G Criteria in relation to quality assurance activities: review procedures
24 Allowances for witnesses at hearings before a Professional Services Review Committee
25 Professional organisation — subsection 124B (1) of the Act
25A Circumstances where fees etc cannot be charged for provision of public hospital services to public patients
26 Prescribed rate of interest — subsection 129AC (2) of the Act
27 Prescribed authorities and persons for the purposes of subsection 130 (3A) of the Act
28 Delegation
29 Referral to specialists or consultant physicians
30 Referrals: special cases
31 Validity of referrals to specialists or consultant physicians
Expand Schedule 1 FormsSchedule 1 Forms
Expand Schedule 1A Bodies to which information in the Australian Childhood Immunisation Register may be given Schedule 1A Bodies to which information in the Australian Childhood Immunisation Register may be given
Schedule 2 Witnesses’ allowances for travelling and other expenses
Expand Schedule 3 Prescribed authorities and persons — subsection 130 (3A) of the Act Schedule 3 Prescribed authorities and persons — subsection 130 (3A) of the Act
Expand Schedule 4 Relevant organisations and qualificationsSchedule 4 Relevant organisations and qualifications
Expand Schedule 5 Matters specified for Register of Approved PlacementsSchedule 5 Matters specified for Register of Approved Placements
Schedule 6 Services for which medicare benefit is 100% of Schedule fee

Health Insurance Regulations 1975

Statutory Rules 1975 No. 80 as amended

made under the

This compilation was prepared on 1 July 2007
taking into account amendments up to SLI 2007 No. 187

Prepared by the Office of Legislative Drafting and Publishing,
Attorney‑General’s Department, Canberra


Contents

                        1     Name of Regulations [see Note 1]                                     6

                        2     Interpretation                                                                   6

                        3     Definition of professional service in Act                              7

                      3A     Health services not specified in an item (Act s 3C)              8

                        4     Relevant organisations and qualifications (Act s 3D)            8

                        5     Prescribed fee — subsection 3D (1) of the Act                   9

                        6     Prescribed fee — subsection 3E (2) of the Act                   9

                      6A     Recognised Fellows of the RACGP                                   9

                      6B     Notice to be given of certain decisions                               9

                      6C     Appeals                                                                          9

                      6D     Eligibility pending decision on appeal                               10

                      6E     Register of Approved Placements — specified bodies etc  10

                    6EA     Register of Approved Placements — eligible applicants     11

                    6EB     Register of Approved Placements — removal of name       11

                    6EF     Services for which medicare benefit is 100% of Schedule fee (Act s 10 (2) (aa))            11

                      6F     Circumstances in which subparagraphs 19AA (1) (b) (iv) and (2) (b) (iv) of the Act apply 11

                      6G     Interns — relevant State or Territory laws                         12

                        9     Reduction of amounts for purposes of subsection 16 (4) of the Act       12

                      9A     Requests for pathology services by electronic means        12

                       10     Diagnostic imaging services which dental practitioners may request    13

                       11     Diagnostic imaging services that chiropractors, osteopaths, physiotherapists and podiatrists may request                                                                         15

                       12     Exemption — pre‑existing diagnostic imaging services      15

                    12A     Prescribed date — paragraph 16B (11) (d) of the Act         15

                    12B     Definition of radiation oncology service                             16

                       13     Particulars to be recorded on accounts, receipts and bulk billing agreement     16

                  13AA     Payment to general practitioner by electronic transmission (Act s 20 (5))         25

                    13A     Request for payment of medicare benefit                          26

                    13B     Application for approval as billing agent                            26

                       14     Medicare benefit not payable in respect of certain professional services           26

                       15     Service of notice under subsection 23B (6) of the Act        27

                       16     Application for acceptance of undertaking — repayment of fee 28

                    16A     Records of pathology services to be kept by approved pathology authorities     28

                       17     Application for approval of premises — prescribed fees      28

                       18     Application for approval of premises — repayment of fees  29

                       19     Information that must be included in requests for diagnostic imaging services   29

                       20     Records of diagnostic imaging services that must be kept by providing medical practitioners      31

                    20A     Diagnostic imaging — information to be included in application for registration  32

                    20B     Diagnostic imaging — information to be included on register 33

                    20C     Primary information — types of diagnostic imaging equipment 33

                    20D     Radiation oncology — information to be included in application for registration  35

                    20E     Radiation oncology — information to be included on register 35

                     20F     Primary information — types of radiation oncology equipment 36

                       21     Application form — application for approval as an organisation under Part IV of the Act  36

                       22     Application form — application for approval of health service 36

                    22A     Prescribed bodies — Part IVA of the Act                          37

                       23     Prescribed fee — subsection 61 (1A) of the Act                37

                    23A     Application for a declaration that a quality assurance activity is an activity to which Part VC of the Act applies                                                                    37

                    23B     Criteria in relation to quality assurance activities               38

                    23C     Criteria in relation to quality assurance activities: disclosure of information       38

                    23D     Criteria in relation to quality assurance activities: activities engaged in in one State or Territory  38

                    23E     Criteria in relation to quality assurance activities: activities that have not been engaged in previously in Australia                                                                    39

                     23F     Criteria in relation to quality assurance activities: activities that have been engaged in previously in Australia                                                                       40

                    23G     Criteria in relation to quality assurance activities: review procedures     41

                       24     Allowances for witnesses at hearings before a Professional Services Review Committee            42

                       25     Professional organisation — subsection 124B (1) of the Act 42

                    25A     Circumstances where fees etc cannot be charged for provision of public hospital services to public patients                                                                         42

                       26     Prescribed rate of interest — subsection 129AC (2) of the Act 43

                       27     Prescribed authorities and persons for the purposes of subsection 130 (3A) of the Act  43

                       28     Delegation                                                                     47

                       29     Referral to specialists or consultant physicians                 47

                       30     Referrals: special cases                                                 48

                       31     Validity of referrals to specialists or consultant physicians 49

Schedule 1             Forms                                                                          51

Form 1                     Application for approval as an organization under Part IV   51

Form 2                     Application for approval of a health service                        52

Schedule 1A           Bodies to which information in the Australian Childhood Immunisation Register may be given                                                                           53

Part 1                      New South Wales                                                          53

Part 2                      Victoria                                                                         55

Part 3                      Queensland                                                                   56

Part 4                      Western Australia                                                          57

Part 5                      South Australia                                                              58

Part 6                      Tasmania                                                                      59

Part 7                      Australian Capital Territory                                              59

Part 8                      Northern Territory                                                           59

Schedule 2             Witnesses’ allowances for travelling and other expenses            61

Schedule 3             Prescribed authorities and persons — subsection 130 (3A) of the Act       62

Part 1                      Interpretation of Schedule                                               62

Part 2                      Prescribed persons of the Commonwealth: Department of Veterans’ Affairs, Executive Officers  65

Part 3                      Prescribed persons of the Commonwealth: Department of Veterans’ Affairs, Health Program      66

Part 4                      Prescribed authority and persons of New South Wales      87

Part 5                      Prescribed authorities of other States and Territories         88

Schedule 4             Relevant organisations and qualifications                   89

Part 1                      Current organisations and qualifications                           89

Part 2                      Former organisations and qualifications                            94

Schedule 5             Matters specified for Register of Approved Placements 97

Part 1                      Specified bodies and courses                                          97

Part 2                      Specified bodies and programs                                        98

Part 3                      Participatory eligibility programs                                      99

Schedule 6             Services for which medicare benefit is 100% of Schedule fee      101

Notes                                                                                                        102

 

 


  

  

1              Name of Regulations [see Note 1]

                These Regulations are the Health Insurance Regulations 1975.

2              Interpretation

                In these Regulations, unless the contrary intention appears:

Appeal Committee means the General Practice Recognition Appeal Committee established under the Health Insurance (Vocational Registration of General Practitioners) Regulations.

approved collection centre has the same meaning as in Part IIA of the Act.

Complaints Unit means the Complaints Unit of the Department of Health of New South Wales.

identification number, in relation to a licensed collection centre, means the identification number allocated to the centre under section 23DNF of the Act.

investigation means:

                (a)    in relation to the Medicare Australia CEO — the investigation by the Medicare Australia CEO of:

                          (i)    a contravention, or possible contravention, of the Act or these regulations; or

                         (ii)    the provision, or possible provision, of:

                                   (A)     excessive pathology services; or

                                   (B)     services that are excessive services within the meaning of Division 3 or 3A of Part V of the Act; or

               (b)    in relation to the Complaints Unit — the investigation by the Unit of a complaint under the Medical Practitioners Act 1938 of New South Wales.

Medical Board means an authority specified in Part 4 or 5 of Schedule 3.

patient episode means a pathology service, or pathology services whether listed in 1 or more items in the Pathology Services Table, for a single patient whose need for which was determined under subsection 16A (1) of the Act on the same day, whether rendered by 1 or more approved pathology practitioners on 1 or more days.

provider number means the number that:

                (a)    is allocated by the Medicare Australia CEO to a practitioner, an approved pathology practitioner or an optometrist; and

               (b)    identifies the person and the places where the person practises his or her profession.

RACGP means the Royal Australian College of General Practitioners.

referring practitioner, in relation to a referral, means:

                (a)    in the case of all referrals — a medical practitioner; and

               (b)    if the referral is given to a specialist who is an ophthalmologist — an optometrist; and

                (c)    if the referral:

                          (i)    arises out of a dental service given by a dental practitioner; and

                         (ii)    is to a specialist (but not a consultant physician):

                        a dental practitioner.

requester number means the identification number allocated by the Medicare Australia CEO to a chiropractor, osteopath, physiotherapist or podiatrist.

servicing provider means a treatment provider rendering treatment on behalf of another treatment provider.

the Act means the Health Insurance Act 1973.

treatment provider means:

                (a)    a practitioner; or

               (b)    an approved pathology practitioner; or

                (c)    an optometrist.

3              Definition of professional service in Act

                A medical service specified in an item in items 51700 to 53460 (inclusive) of the general medical services table is a prescribed medical service for the purposes of paragraph (b) of the definition of professional service in subsection 3 (1) of the Act.

3A           Health services not specified in an item (Act s 3C)

                For paragraph (b) of the definition of health service in subsection 3C (8) of the Act, a service is prescribed if it is a service of a kind mentioned in the following table.

Item

Service

1

Aboriginal or Torres Strait Islander health

2

Audiology

3

Chiropractic

4

Diabetes education

5

Dietetics

6

Exercise physiology

7

Focussed psychological strategies

8

Mental health

9

Non‑directive pregnancy support counselling

10

Occupational therapy

11

Osteopathy

12

Physiotherapy

13

Podiatry

14

Psychological therapy

15

Psychology

16

Speech pathology

4              Relevant organisations and qualifications (Act s 3D)

         (1)   For the definition of relevant organisation in subsection 3D (5) of the Act, the organisation specified in column 2 of an item in Schedule 4 is declared to be a professional organisation in relation to each specialty specified in column 3 of that item.

         (2)   For the definition of relevant qualification in subsection 3D (5) of the Act, the qualification specified in column 4 of an item in Schedule 4 is declared to be a relevant qualification in relation to the organisation specified in column 2 of that item.

5              Prescribed fee — subsection 3D (1) of the Act

                For the purposes of subsection 3D (1) of the Act, the prescribed fee is $30.

6              Prescribed fee — subsection 3E (2) of the Act

                For the purposes of subsection 3E (2) of the Act, the prescribed fee is $30.

6A           Recognised Fellows of the RACGP

         (1)   An applicant is eligible for a determination under paragraph 3EA (2) (b) of the Act if the RACGP certifies that the applicant meets the minimum requirements of the RACGP for taking part in continuing medical education and quality assurance.

         (2)   For subparagraph 3EB (1) (b) (ii) of the Act, a determination under section 3EA of the Act in respect of a medical practitioner must be revoked if the RACGP certifies that
the practitioner does not meet the minimum requirements of the RACGP for continuing medical education and quality assurance.

6B           Notice to be given of certain decisions

         (1)   The RACGP must give the Medicare Australia CEO written notice if it declines to certify under subregulation 6A (1).

         (2)   The Medicare Australia CEO must give a medical practitioner written notice if it receives notice under subregulation (1).

6C           Appeals

         (1)   A medical practitioner who receives notice under:

                (a)    subregulation 6B (2); or

               (b)    subsection 3EB (2) of the Act because the RACGP
has given the Medicare Australia CEO notice under subparagraph 3EB (1) (b) (ii) of the Act;

may appeal to the Appeal Committee within 28 days after the day the notice is given.

         (2)   The Appeal Committee must hear and decide the appeal.

         (3)   If the Committee allows the appeal, the practitioner is eligible for a determination.

         (4)   If the Committee dismisses the appeal it must give the practitioner written notice with:

                (a)    the result of the appeal; and

               (b)    the terms of the decision; and

                (c)    a statement to the effect that a copy of the reasons for the decision may be obtained from the Committee on written request made within 28 days after the notice is given.

6D           Eligibility pending decision on appeal

         (1)   A medical practitioner remains eligible for a determination if:

                (a)    the Medicare Australia CEO gives the practitioner notice that a determination under section 3EA of the Act in respect of the practitioner is to be revoked; and

               (b)    the practitioner’s appeal is received by the Appeal Committee before the date specified in the notice for removal.

         (2)   The practitioner ceases to be eligible under subregulation (1) when the practitioner’s appeal is finalised.

6E           Register of Approved Placements — specified bodies etc

                For paragraph 3GA (5) (a) of the Act, the following bodies, courses and programs are specified:

                (a)    a body mentioned in an item in Part 1 or 2 of Schedule 5;

               (b)    a course that leads to a qualification in an item in Part 1 of Schedule 5 from the body specified in the item;

                (c)    a program in an item in Part 2 of Schedule 5 approved by the body specified in the item.

6EA        Register of Approved Placements — eligible applicants

                For paragraph 3GA (5) (b) of the Act, a medical practitioner who makes application under subsection 3GA (4) of the Act, and to whom subitem 1 (2) in Part 3 of Schedule 5 applies, is eligible for registration under section 3GA of the Act.

6EB        Register of Approved Placements — removal of name

                For paragraph 3GB (1) (c) of the Act, a medical practitioner registered under section 3GA of the Act because of the operation of regulation 6EA must have his or her name removed from the Register of Approved Placements when the earliest of the following events occurs:

                (a)    a determination under section 3D, 3EA or 61 of the Act, recognising the practitioner’s qualification, takes effect;

               (b)    the Medicare Australia CEO receives written notice from the appropriate Australian medical college, of its refusal to recognise the practitioner’s qualification;

                (c)    12 months elapses since registration of the practitioner under section 3GA of the Act began.

6EF         Services for which medicare benefit is 100% of Schedule fee (Act s 10 (2) (aa))

                For paragraph 10 (2) (aa) of the Act, a service described in an item of the general medical services table mentioned in column 3 of Schedule 6 is prescribed.

6F           Circumstances in which subparagraphs 19AA (1) (b) (iv) and (2) (b) (iv) of the Act apply

                For paragraph 19AA (3) (b) of the Act, subparagraphs 19AA (1) (b) (iv) and (2) (b) (iv) of the Act only apply to a professional service that was rendered by a person, registered under subsection 3GA (5) of the Act, not more than:

                (a)    2 weeks after the period for which the person was registered; or

               (b)    if the Medicare Australia CEO approves — 6 weeks after the period for which the person was registered.

6G           Interns — relevant State or Territory laws

                For subsection 19AA (5) of the Act, the following laws are specified:

                (a)    Medical Practice Act 1992 of New South Wales;

               (b)    Medical Practice Act 1994 of Victoria;

                (c)    Medical Act 1939 of Queensland;

               (d)    Medical Practitioners Act 1983 of South Australia;

                (e)    Medical Act 1894 of Western Australia;

                (f)    Medical Act 1959 of Tasmania;

                (g)    Medical Practitioners Act 1930 of the Australian Capital Territory;

                (h)    Northern Territory of Australia Medical Act 1995 of the Northern Territory.

9              Reduction of amounts for purposes of subsection 16 (4) of the Act

         (1)   Where, under paragraph 16 (4) (a) of the Act, one amount only shall be deemed to be reduced, that amount shall be deemed to be reduced by 80 per cent.

         (2)   Where, under paragraph 16 (4) (a) of the Act, 2 or more amounts shall be deemed to be reduced, the greater or greatest of those amounts shall be deemed to be reduced by 80 per cent and each other such amount shall be deemed to be reduced by 90 per cent.

         (3)   For the purposes of subregulation (2), where 2 or more of the amounts that shall be deemed to be reduced are equal, one of those amounts shall be treated as being greater than the other amount or the greatest of those amounts.

9A           Requests for pathology services by electronic means

                If:

                (a)    for the purposes of section 16A of the Act, a request for a pathology service is made or confirmed by electronic means; and

               (b)    a practitioner is identified:

                          (i)    by name, number or other means in the request or confirmation; or

                         (ii)    by the electronic system used to make the request or confirmation;

                        as the practitioner who made the request or confirmation;

then, for the purposes of the Act, the request or confirmation is taken to have been made by that practitioner unless the practitioner shows that he or she did not make the request or confirmation.

10            Diagnostic imaging services which dental practitioners may request

         (1)   For subsection 16B (2) of the Act, a service of each of the following kinds is specified:

                (a)    if the dental practitioner who requests the service is approved by the Minister under paragraph (b) of the definition of professional service in subsection 3 (1) of the Act — a service described in any of items 55028, 55030, 55032, 56001 to 56220 (inclusive), 56224, 56227, 56230, 56259, 56301 to 56507 (inclusive), 56541, 56547, 56801 to 57007 (inclusive), 57041, 57047, 57341, 57345, 57703, 57709, 57712, 57715, 58103 to 58115 (inclusive), 58306, 58506, 58521 to 58527 (inclusive), 58909, 59103, 59703, 60000 to 60009 (inclusive), 60506, 60509, 61109, 61372, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 63007 and 63334;

               (b)    if the dental practitioner who requests the service is a prosthodontist — a service described in any of items 55028, 56013, 56016, 56022, 56028, 56053, 56056, 56062, 56068, 58306, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462 and 63334;

                (c)    if the dental practitioner who requests the service is a dental specialist — a service described in any of items 56022, 56062, 58306, 61421, 61454, 61457 and 63334;

               (d)    if the dental practitioner who requests the service is an oral medicine specialist or oral pathology specialist — a service described of any of items 55028, 55030, 55032, 56001, 56007, 56010, 56013, 56016, 56022, 56028, 56041, 56047, 56050, 56053, 56056, 56062, 56068, 56101, 56107, 56141, 56147, 56301, 56307, 56341, 56347, 56401, 56407, 56441, 56447, 57341, 57345, 58306, 58506, 58909, 59103, 59703, 60000, 60003, 60006, 60009, 60506, 60509, 61109, 61372, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 63007 and 63334;

                (e)    in any case — a service described in any of items 57509, 57515, 57521, 57527, 57901 to 57969 (inclusive), 58100, 58300, 58503, 58903, 59733, 59739, 59751, 60100, 60500 and 60503.

         (2)   In paragraph (1) (b), prosthodontist means a person who is:

                (a)    registered or licensed as a prosthodontist under a law of a State or Territory; or

               (b)    registered or licensed as a dentist or dental practitioner under a law of a State or Territory and recognised by the registering or licensing authority as a person who practises in the specialty of prosthodontics.

         (3)   In paragraph (1) (c), dental specialist means a person who is:

                (a)    registered or licensed as a periodontist, endodontist, pedeodontist, or orthodontist under a law of a State or Territory; or

               (b)    registered or licensed as a dental specialist under a law of a State or Territory and recognised by the registering or licensing authority as a person who practices in the speciality of periodontics, endodontics, pedeodontics, or orthodontics.

         (4)   In paragraph (1) (d):

oral medicine specialist means a person who is:

                (a)    registered or licensed as an oral medicine specialist under a law of a State or Territory; or

               (b)    registered or licensed as a dental specialist under a law of a State or Territory and recognised by the registering or licensing authority as a person who practices in the speciality of oral medicine.

oral pathology specialist means a person who is:

                (a)    registered or licensed as an oral pathology specialist under a law of a State or Territory; or

               (b)    registered or licensed as a dental specialist under a law of a State or Territory and recognised by the registering or licensing authority as a person who practices in the speciality of oral pathology.

11            Diagnostic imaging services that chiropractors, osteopaths, physiotherapists and podiatrists may request

         (1)   For the purposes of subsection 16B (3), (3A) or (3C) of the Act, the services are those mentioned in the diagnostic imaging services table in items 57712, 57715 and 58100 to 58115 (inclusive).

         (2)   For the purposes of subsection 16B (3B) of the Act, the services are those mentioned in the diagnostic imaging services table in items 57521 and 57527.

12            Exemption — pre‑existing diagnostic imaging services

                For the purposes of subsection 16B (11) of the Act, the services are those mentioned in the diagnostic imaging services table
in items 57712, 57715, 57901, 57902, 57903, 57912, 57915, 57921, 58100 to 58115 (inclusive), 58521, 58524, 58527, 58700, 58924 and 59103.

12A         Prescribed date — paragraph 16B (11) (d) of the Act

                For paragraph 16B (11) (d) of the Act, the prescribed date is 1 January 2001.

12B         Definition of radiation oncology service

                For subsection 16F (2) of the Act, a radiation oncology service is a service to which an item in subgroup 3, 4 or 5 of Group T2 in the general medical services table relates.

13            Particulars to be recorded on accounts, receipts and bulk billing agreement

         (1)   For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services generally:

                (a)    the name of the patient to whom the service was given;

               (b)    the date on which the service was given;

                (c)    the amount charged in respect of the service;

               (d)    the total amount paid in respect of the service;

                (e)    any amount outstanding in respect of the service.

      (1A)   For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services rendered by a person who has been determined to be a medical practitioner under subsection 3J (1) of the Act:

                (a)    the name and the address of the medical practitioner;

               (b)    the provider number of the medical practitioner.

      (1B)   For the purposes of subsection 19 (6) of the Act, the particulars prescribed in relation to professional services rendered by a medical practitioner other than a medical practitioner referred to in subregulation (1A) are:

                (a)    the name and the address of the medical practitioner; and

               (b)    the provider number of the medical practitioner;

either or both of which may be given.

         (2)   For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services of the kind referred to in paragraph (ea) of Schedule 1 to the National Health Act 1953:

                (a)    a description of the professional service and the item number of the item that relates to the professional service followed by an asterisk; or

               (b)    in lieu of the particulars referred to in paragraph (a) — a description of the professional service sufficient to identify the item that relates to the professional service preceded by the word ‘patient’.

         (3)   For the purposes of subsection 19 (6) of the Act, the following particular is prescribed in relation to professional services other than professional services referred to in subregulation (2), namely, a description of the professional service sufficient to identify the item that relates to the service.

         (4)   For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services rendered by a consultant physician, or a specialist, in the practice of his or her specialty to a patient who was referred to that consultant physician or specialist in the manner prescribed in regulation 29 by a referring practitioner:

                (a)    the name of the referring practitioner;

               (b)    the address of the place of practice, or the provider number in respect of the place of practice, of the referring practitioner;

                (c)    the date on which the patient was referred by the referring practitioner to the consultant physician or specialist;

               (d)    the period of validity of the referral applicable under regulation 31.

         (5)   For the purposes of subsection 19 (6) of the Act, if a referral is given under subregulation 30 (1) the words, ‘referral within (insert the name of the hospital in which the referral was given)’ are prescribed.

         (6)   For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services rendered by a consultant physician, or a specialist, in the practice of his or her specialty to a patient who has declared to the consultant physician or specialist that a referral referring the patient to that consultant physician or specialist has been completed by a referring practitioner, the name of the referring practitioner, and that the referral has not been delivered to the consultant physician or specialist due to the referral having been lost, stolen or destroyed:

                (a)    the name of the referring practitioner;

               (b)    the words ‘lost referral’;

                (c)    the address of the place of practice, or the provider number in respect of the place of practice, of the referring practitioner (if either of these are known to the consultant physician or specialist).

         (7)   For the purposes of subsection 19 (6) of the Act, the word ‘emergency’ is prescribed if:

                (a)    a referring practitioner; or

               (b)    a specialist or consultant physician in the practice of his or her speciality;

decides in an emergency that it is necessary in the patient’s interests for a professional service to be given as soon as practicable.

         (8)   For the purposes of subsection 19 (6) of the Act, the following particular is prescribed in relation to professional services to which an item in items 3 to 10929 (inclusive) of the general medical services table relates, namely, where a practitioner or optometrist was in attendance on a person on more than one occasion on the same day and on each occasion rendered such a professional service on that person, the time at which each such attendance on that day commenced.

         (9)   For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services to which an item in the pathology services table relates:

                (a)    where the professional service is a pathology service in respect of which the payment of a medicare benefit is not prevented by the operation of subsection 16A (1), (2) or (3) of the Act:

                          (i)    the name and:

                                   (A)     where the request referred to in subsection 16A (3) of the Act in respect of which the professional service was rendered was made at the place of practice of the practitioner who determined that the professional service was necessary — the provider number in respect of that place of practice of that practitioner; or

                                   (B)     where that request was not made at the place of practice of the practitioner who determined that the professional service was necessary — the provider number in respect of any place of practice of that practitioner; and

                         (ii)    the date on which the practitioner so determined that the service was necessary;

               (b)    where the professional service is a pathologist‑determinable service that was determined to be necessary by the approved pathology practitioner by whom, or on whose behalf, the service was performed — the initials ‘s.d.’ or ‘p.d.’;

                (c)    where the professional service is a pathology service to which subsection 16A (7) of the Act applies — if the service was rendered in pursuance of a request of the kind referred to in paragraph 16A (7) (b) of the Act — the date on which the request referred to in that subparagraph was made and the surname, and the initials of the Christian or given names, of the medical practitioner who determined that the service was necessary or, where at least one other member of the group of practitioners of which he is a member has the same surname and the same initials as the medical practitioner, the surname, and such of the Christian or given names, of the medical practitioner as distinguish him from each of those other members.

       (10)   For subsection 19 (6) of the Act, if the professional service rendered is the collection of a specimen and is the initiation of a patient episode, there is to be recorded, for that pathology service, the appropriate collection point identification number as follows:

                (a)    for a collection made at an approved collection centre, the approved pathology collection centre identification number assigned by the Medicare Australia CEO to that collection centre;

               (b)    for a collection made at a recognised hospital, the recognised hospital collection point identification number assigned by the Medicare Australia CEO to that hospital;

                (c)    for a collection made under an outreach service in the class of services designated ‘initiatives for hospital outreach services for privately insured patients’, the identification number assigned by the Medicare Australia CEO to that outreach service;

               (d)    for a collection made at a location not described in paragraph (a), (b) or (c), the collection point identification number ‘A01’.

    (10A)   An identification number mentioned in paragraph (10) (a) (an approved pathology collection centre identification number) is valid only in relation to a collection made at an approved collection centre by the Approved Pathology Authority that is the owner of that collection centre.

       (11)   For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services to which any of items 12500 to 12533 (inclusive), 15000 to 15600 (inclusive) and 16003 to 16015 (inclusive) of the general medical services table or an item in the diagnostic imaging services table relates:

                (a)    if the professional service is provided by a specialist in diagnostic radiology — the name and either the address of the place of practice, or the provider number, of that specialist; or

               (b)    if the professional service is provided by a practitioner other than a specialist in diagnostic radiology — the name and either the address of the place of practice, or the provider number in respect of the place of practice, of the practitioner who:

                          (i)    is claiming, or receiving, payment of fees in respect of the professional service; or

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

       (12)   For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services to which an item in the pathology services table, other than items 73801 to 73811 (inclusive), relates, namely, the name and either the address of the place of practice, or the provider number in respect of the place of practice, of:

                (a)    the approved pathology practitioner by whom, or on whose behalf, the professional service was rendered;

               (b)    where the professional service was rendered wholly in an accredited pathology laboratory — any approved pathology practitioner by whom, or on whose behalf, professional services may be rendered in that accredited pathology laboratory; or

                (c)    where the professional service, being a professional service in respect of which a request was made:

                          (i)    to an approved pathology practitioner rendering professional services in an accredited pathology laboratory owned and controlled by a single approved pathology authority; or

                         (ii)    to the approved pathology authority owning and controlling that accredited pathology laboratory;

                        was rendered partly in that accredited pathology laboratory and partly in another accredited pathology laboratory owned and controlled by the same approved pathology authority — any approved pathology practitioner by whom, or on whose behalf, professional services may be rendered in the first‑mentioned accredited pathology laboratory.

       (13)   For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services other than professional services to which an item in the pathology services table, other than items 73801 to 73811 (inclusive), or any of items 12500 to 12533 (inclusive), 15000 to 15600 (inclusive) and 16003 to 16015 (inclusive) of the general medical services table or an item in the diagnostic imaging services table relates:

                (a)    the name of the practitioner or optometrist who rendered such a professional service, a statement that the professional service was rendered by that person and either the address of the place of practice at which the service was rendered or:

                          (i)    in a case where the service was rendered at a place of practice in respect of which the practitioner or optometrist has been allocated a provider number — that provider number;

                         (ii)    in any other case — the provider number allocated to the practitioner or optometrist in respect of any place at which he practices.

       (14)   Subject to subregulations (15) and (16), 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.

       (15)   If the person referred to in paragraph (14) (a) is a chiropractor, osteopath, physiotherapist or podiatrist, the reference in subparagraph (14) (a) (ii) to a provider number is a reference to a requester number.

       (16)   For the purposes of subsection 19 (6) of the Act, if the practitioner referred to in paragraph (14) (c) is not the practitioner who rendered the professional service referred to in subregulation (14), 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.

       (17)   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 consultant physician or 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)    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.

    (17A)   For subsection 19 (6) of the Act, if professional services to which an item in the diagnostic imaging services table relates are rendered in the circumstances mentioned in subsection 16B (10A) of the Act, the letters ‘SS’ (indicating that the services were substituted for a requested service) are a prescribed particular in relation to those services.

       (18)   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’.

       (19)   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’.

       (20)   For subsection 19 (6) of the Act, the following additional particulars are prescribed in relation to professional services to which any of items 23010 to 24136 of the general medical services table relates:

                (a)    if the service rendered is administration of anaesthesia (other than administration of anaesthesia performed in association with a service to which item 22900 or 22905 applies):

                          (i)    the name of each practitioner who performed a procedure for which the anaesthesia was administered; and

                         (ii)    if item 25025 applies to the service — when the service time began and ended, and the duration of the service time; and

               (b)    if the service rendered is perfusion to which item 25050 applies — when the service time began and ended, and the duration of the service time; and

                (c)    if the service rendered is assistance in the administration of anaesthesia:

                          (i)    the name of the principal anaesthetist; and

                         (ii)    the name of each practitioner who performed a procedure for which the anaesthesia was administered; and

                         (iii)    if item 25030 applies to the service — when the service time began and ended, and the duration of the service time.

       (21)   In subregulation (20):

service time has the meaning given by rule 61 in Part 2 of the general medical services table.

       (22)   For subsection 19 (6) of the Act, in relation to professional services consisting of:

                (a)    diagnostic imaging services rendered using a diagnostic imaging procedure carried out using diagnostic imaging equipment ordinarily located at registered diagnostic imaging premises or, when not in use, at a registered base for diagnostic imaging equipment; or

               (b)    radiation oncology services rendered using radiation oncology equipment ordinarily located at registered radiation oncology premises or, when not in use, at a registered base for radiation oncology equipment;

the location specific practice number for the premises or base is a prescribed particular.

13AA      Payment to general practitioner by electronic transmission (Act s 20 (5))

         (1)   This regulation applies to the payment, by the Medicare Australia CEO on behalf of the Commonwealth, of an amount under subsection 20 (3) of the Act to a general practitioner by whom, or on whose behalf, a professional service was rendered.

         (2)   For subsection 20 (5) of the Act, the payment of the amount may be made by means of electronic transmission of the amount to an account kept with a bank if:

                (a)    the general practitioner is enrolled, for the location at which the professional service was rendered, in the scheme known as the ‘90 Day Pay Doctor Cheques Scheme’, administered by the Medicare Australia CEO for the purpose of making payments, by electronic transmission, of amounts to general practitioners under subsection 20 (3) of the Act; and

               (b)    the general practitioner has given the Medicare Australia CEO written permission to give to the Reserve Bank of Australia the following information:

                          (i)    the name and number of the account into which a payment to the general practitioner under subsection 20 (3) of the Act may be made;

                         (ii)    the name and BSB number of the bank at which that account is kept.

         (3)   For the purposes of section 20 of the Act:

general practitioner includes a medical practitioner (other than a specialist or consultant physician) who practises in general practice.

13A         Request for payment of medicare benefit

                For paragraph 20A (2C) (c) of the Act, a request must be in the form approved by the Medicare Australia CEO.

13B         Application for approval as billing agent

         (1)   For paragraph 20AB (2) (a) of the Act, an application must be in the form approved by the Medicare Australia CEO.

         (2)   For paragraph 20AB (2) (b) of the Act, the fee to accompany an application is:

                (a)    if the applicant has not previously been approved as a billing agent — $1,000; or

               (b)    in any other case — $500.

14            Medicare benefit not payable in respect of certain professional services

         (1)   Unless the Minister otherwise directs, medicare benefits are not payable in respect of professional services rendered in prescribed circumstances.

         (2)   Each of the following shall be taken to be professional services rendered in prescribed circumstances:

                (a)    professional services rendered in relation to the provision of chelation therapy (that is to say, the intravenous administration of ethylenediamine tetra‑acetic acid or any of its salts) otherwise than for the treatment of heavy‑metal poisoning;

               (b)    professional services rendered in association with the injection of human chorionic gonadotrophin in the management of obesity;

                (c)    professional services rendered in relation to the use of hyperbaric oxygen therapy in the treatment of multiple sclerosis;

                (e)    professional services rendered for the purpose of, or in relation to, the removal of tattoos;

              (ea)    professional services rendered for the purposes of, or in relation to, the removal from a cadaver of kidneys for transplantation;

                (f)    professional services rendered for the purposes of, or in relation to:

                          (i)    the transplantation of a thoracic or abdominal organ, other than a kidney, or of part of an organ of that kind; or

                         (ii)    the transplantation of a kidney in conjunction with the transplantation of a thoracic or other abdominal organ, or of a part of an organ of that kind;

                        if the services are rendered to a patient of a hospital;

                (g)    professional services rendered for the purpose of administering microwave (UHF radiowave) cancer therapy, including the intravenous injection of drugs used immediately before or during the therapy.

15            Service of notice under subsection 23B (6) of the Act

                For the purposes of subsection 23B (6) of the Act, a notice of termination shall be served by being delivered personally or by pre‑paid post to:

                (a)    where the premises to which the notice relates are situated in a State — the Director of Health, in that State;

               (b)    where the premises to which the notice relates are situated in the Australian Capital Territory — the Director of Health, in the State of New South Wales; or

                (c)    where the premises to which the notice relates are situated in the Northern Territory — the Director of Health, in the State of South Australia.

16            Application for acceptance of undertaking — repayment of fee

                For the purposes of section 23DJ of the Act, the fee paid by a person who gives an undertaking under subsection 23DC (1) or 23DF (1) of the Act shall be repaid to the person, where the undertaking is not accepted, by forwarding an amount equal to the amount of the fee to the person at the address specified in the application for the Minister’s acceptance of the undertaking or at such other address as the person specifies by notice in writing to the Minister.

16A         Records of pathology services to be kept by approved pathology authorities

         (1)   For the purposes of subsection 23DKA (1) of the Act, an approved pathology authority must prepare and maintain, in accordance with subregulations (2) and (3), records of the pathology services rendered in an accredited pathology laboratory of which the authority is the proprietor.

         (2)   For each service rendered, the record in relation to the service must include a copy of a report of the service.

         (3)   The records must be kept in a manner that enables information to be retrieved from the records 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.

17            Application for approval of premises — prescribed fees

                For the purposes of paragraph 23DN (1) (b) of the Act, the prescribed fee in relation to an application for the approval of premises as an accredited pathology laboratory is:

                (a)    where the premises are accredited as a pathology laboratory under the Pathology Laboratories Accreditation Act, 1981 of the State of New South Wales or are an accredited pathology service under the Pathology Services Accreditation Act 1984 of the State of Victoria — $50; or

               (b)    in any other case — $200.

18            Application for approval of premises — repayment of fees

                For the purposes of subsection 23DN (8) of the Act, the fee paid by a person who makes an application under subsection 23DN (1) of the Act shall be repaid to the person, where the application is not granted, by forwarding an amount equal to the amount of the fee to the person at the address specified in the application or at such other address as the person specifies by notice in writing to the Minister.

19            Information that must be included in requests for diagnostic imaging services

         (1)   For the purposes of subsection 23DQ (1) of the Act, the following information must be included in a subsection 16B (1) request:

                (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;

               (d)    if the requesting practitioner forms an opinion in accordance with subregulation (1B) that the requested diagnostic imaging service is a hospital‑related service within the meaning of subregulation (1A) — the letter ‘A’.

      (1A)   In paragraph (1) (d):

hospital‑related service means:

                (a)    a diagnostic imaging service requested in relation to a person for a condition in relation to which the person will, or is likely to, receive treatment in a hospital or day hospital facility within 4 weeks of the service being provided, for example, tests performed prior to a person undergoing surgery in a hospital; or

               (b)    a diagnostic imaging service requested in relation to a person for a condition in relation to which the person had received treatment in a hospital or day hospital facility in the 4 weeks immediately before the provision of the service; or

                (c)    a diagnostic imaging service requested in relation to a person, the request for which is made in connection with a condition in relation to which, immediately before receiving the service resulting in the making of the request, the person had presented for treatment to a recognised hospital and was referred or directed to the practitioner who provided that service; or

               (d)    a diagnostic imaging service requested in connection with the provision of a professional service at a recognised hospital in relation to a person who is not admitted to that hospital in connection with the service.

      (1B)   In forming the opinion mentioned in paragraph (1) (d), the practitioner must have regard to the nature of the requested diagnostic imaging service and the circumstances in which the service is to be provided including, but not limited to:

                (a)    the results of any examination by the practitioner of the person in relation to whom the service is to be provided; and

               (b)    the results of any tests in relation to the person conducted by, or made available to, the practitioner; and

                (c)    the history and any other information given to the practitioner by the person; and

               (d)    any letter, form or document given to the practitioner in connection with the provision by the practitioner of a professional service to the person.

         (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.

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

         (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)   For 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 to whom the service was rendered, or a person acting on that person’s behalf, asserted that a medical practitioner, a dental practitioner, a chiropractor, an osteopath, a physiotherapist or a podiatrist (in this regulation called the requesting practitioner) had requested that the service 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 manner of that confirmation; and

               (d)    if the service is rendered in the circumstances mentioned in subsection 16B (10A) of the Act:

                          (i)    words indicating that the providing practitioner has consulted with the requesting practitioner and the date of that consultation; or

                         (ii)    if the providing practitioner has not consulted with the requesting practitioner, sufficient information to demonstrate that he or she has taken all reasonable steps to do so.

      (2A)   If an ultrasound service is performed by a registered sonographer under the supervision, or at the direction, of the providing practitioner, the report mentioned in paragraph (2) (a) must include the name of the registered sonographer who performed the service.

         (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.

         (4)   In this regulation:

registered sonographer means a person whose name is entered on the Register of Sonographers kept by the Medicare Australia CEO.

20A         Diagnostic imaging — information to be included in application for registration

                For paragraph 23DZP (1) (d) of the Act, the other information to be included in an application for registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment is:

                (a)    the nature of the practice; and

               (b)    details of the diagnostic imaging equipment ordinarily located at the premises or base, including:

                          (i)    the quantity of equipment of each type mentioned in regulation 20C; and

                         (ii)    for equipment of a type mentioned in paragraph 20C (c), (d), (e), (i) or (j) — the age of the equipment; and

                         (iii)    the functionality of the equipment; and

                        (iv)    if the equipment has a serial number or other identifying number — that number.

Example for paragraph (a)

The practice might be a base for mobile equipment, a specialist diagnostic imaging practice (either on a stand‑alone practice site or co‑located with a primary care practice or group), a primary care practice, a sports medicine clinic or a public hospital.

20B         Diagnostic imaging — information to be included on register

                For subparagraph 23DZQ (1) (b) (iv) of the Act, the other information to be included on the register is the information included in the application for registration.

20C         Primary information — types of diagnostic imaging equipment

                For subsection 23DZR (2) of the Act, the following types of diagnostic imaging equipment are prescribed:

                (a)    ultrasound equipment – non‑musculoskeletal — that is, equipment that:

                          (i)    is used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in Group I1 in the diagnostic imaging services table, except subgroup 6; and

                         (ii)    does not include a transducer capable of operation at a frequency of 7.5 megahertz or higher;

               (b)    ultrasound equipment – musculoskeletal — that is, equipment that:

                          (i)    is used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 6 of Group I1 in the diagnostic imaging services table; and

                         (ii)    includes a transducer capable of operation at a frequency of 7.5 megahertz or higher;

                (c)    computed tomography equipment – K‑type — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in an item in Group I2 in the diagnostic imaging services table in which the designation ‘(K)’ appears;

               (d)    computed tomography equipment – NK‑type — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in Group I2 in the diagnostic imaging services table in which the designation ‘(NK)’ appears;

                (e)    magnetic resonance imaging equipment — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in Group I5 in the diagnostic imaging services table;

                (f)    nuclear medicine imaging equipment for positron emission tomography — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service of the kind described in Health Insurance Determination HS/6/01 or Health Insurance Determination HS/3/1997, as in force on 15 May 2003;

                (g)    nuclear medicine imaging equipment for other services — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in Group I4 in the diagnostic imaging services table;

                (h)    diagnostic radiology equipment for mammography — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 10 of Group I3 in the diagnostic imaging services table;

                 (i)    diagnostic radiology equipment for angiography – K‑type — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 13 of Group I3 in the diagnostic imaging services table in which the designation ‘(K)’ appears;

                (j)    diagnostic radiology equipment for angiography – NK‑type — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 13 of Group I3 in the diagnostic imaging services table in which the designation ‘(NK)’ appears;

               (k)    diagnostic radiology equipment for fluoroscopy — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in subgroup 15 or 17 of Group I3 in the diagnostic imaging services table;

                 (l)    diagnostic radiology equipment for orthopantomography — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in an item in subgroup 3 of Group I3 in the diagnostic imaging services table in which the word ‘orthopantomography’ appears;

               (m)    diagnostic radiology equipment – x‑ray — that is, equipment used in the carrying out of a diagnostic imaging procedure used in the rendering of a service described in an item in Group I3 in the diagnostic imaging services table not mentioned in any of the preceding paragraphs of this regulation (except in subgroup 16 of that Group).

20D         Radiation oncology — information to be included in application for registration

                For paragraph 23DZZO (1) (d) of the Act, the other information to be included in an application for registration of radiation oncology premises or a base for radiation oncology equipment is:

                (a)    the nature of the practice; and

               (b)    details of the radiation oncology equipment ordinarily located at the premises or base, including:

                          (i)    the quantity of equipment of each type mentioned in regulation 20F; and

                         (ii)    the functionality of the equipment; and

                         (iii)    if the equipment has a serial number or other identifying number — that number.

Examples for paragraph (a)

The practice might be a base for mobile equipment, a specialist radiation oncology practice (either on a stand‑alone practice site or co‑located with a primary care practice or group), a primary care practice, a sports medicine clinic or a public hospital.

20E         Radiation oncology — information to be included on register

                For subparagraph 23DZZP (1) (b) (iv) of the Act, the other information to be included on the register is the information included in the application for registration.

20F         Primary information — types of radiation oncology equipment

                For subsection 23DZZQ (2) of the Act, the following types of radiation oncology equipment are prescribed:

                (a)    megavoltage equipment — that is, equipment used in the rendering of a radiation oncology service described in subgroup 3 of Group T2 in the general medical services table;

               (b)    planning equipment — that is, equipment used in the rendering of a radiation oncology service described in subgroup 5 of Group T2 in the general medical services table;

                (c)    brachytherapy equipment — that is, equipment used in the rendering of a radiation oncology service described in subgroup 4 of Group T2 in the general medical services table.

21            Application form — application for approval as an organisation under Part IV of the Act

         (1)   For the purposes of subsection 40 (1) of the Act, the prescribed form, in accordance with which an application under that subsection by an organization for approval as an organization under Part IV of the Act shall be made, is Form 1 in Schedule 1.

         (2)   An application under subsection 40 (1) of the Act by an organization shall be signed by a person, being one of the persons responsible for the management of the organization, authorized in writing by the organization to sign that application.

22            Application form — application for approval of health service

         (1)   For the purposes of subsection 41 (1) of the Act, the prescribed form, in accordance with which an application under that subsection by an organization for approval of a health service shall be made, is Form 2 in Schedule 1.

         (2)   An application under subsection 41 (1) of the Act by an organization shall be signed by a person, being one of the persons responsible for the management of the organization, authorized in writing by the organization to sign the application.

22A         Prescribed bodies — Part IVA of the Act

                For paragraph 46B (b), subparagraph 46E (1) (a) (ii), subparagraph 46E (1) (e) (ii), paragraph 46E (2) (b) and paragraph 46E (3) (c) of the Act, the bodies mentioned in Schedule 1A are prescribed.

23            Prescribed fee — subsection 61 (1A) of the Act

                For the purposes of subsection 61 (1A) of the Act, the prescribed fee is $30.

23A         Application for a declaration that a quality assurance activity is an activity to which Part VC of the Act applies

         (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.

23B         Criteria in relation to quality assurance activities

                For the purposes of paragraph 124X (3) (b) of the Act, the criteria stated in regulations 23C to 23G (inclusive) are prescribed.

23C         Criteria in relation to quality assurance activities: disclosure of information

         (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.

23D         Criteria in relation to quality assurance activities: activities engaged in in one State or Territory

         (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.

23E         Criteria in relation to quality assurance activities: activities that have not been engaged in previously in Australia

         (1)   The criterion stated in subregulation (2) applies if the Minister:

                (a)    is considering whether to make a declaration under subsection 124X (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.

23F         Criteria in relation to quality assurance activities: activities that have been engaged in previously in Australia

         (1)   The criteria stated in this regulation apply if the Minister:

                (a)    is considering whether to make a declaration under subsection 124X (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.

23G         Criteria in relation to quality assurance activities: review procedures

         (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 124W (1) of the Act.

24            Allowances for witnesses at hearings before a Professional Services Review Committee

                For the purposes of subsection 106C (1) of the Act, the allowances payable in respect of attendance by a witness at a hearing before a Professional Services Review Committee are the allowances ascertained by the Committee in accordance with Schedule 2.

25            Professional organisation — subsection 124B (1) of the Act

                For the purposes of the definition of professional organisation in subsection 124B (1) of the Act, each of the following organisations or associations is declared to be a professional organisation:

                (a)    Australian Dental Association Incorporated;

               (b)    Australian Medical Association;

                (c)    Australian Optometrical Association.

25A         Circumstances where fees etc cannot be charged for provision of public hospital services to public patients

         (1)   For section 128C of the Act, the circumstances are where a fee, payment or other consideration (however described) for the provision of an obstetric service:

                (a)    for a public patient in a public hospital; and

               (b)    by a medical practitioner, or a person acting on behalf of the medical practitioner:

                          (i)    employed on the staff of the hospital; or

                         (ii)    performing services under contract to the hospital.

         (2)   In this regulation:

obstetric service means a public hospital service:

                (a)    for attendance at, or associated with, the delivery of a baby; or

               (b)    requested or required by a public patient in connection with the delivery of a baby.

Example

The circumstances described by this regulation would include a booking fee or request for payment by a medical practitioner, or a person acting on behalf of a medical practitioner, employed by, or under contract to, a public hospital, for costs or charges of the medical practitioner for performing a public hospital service:

                (a)     by attending a public patient in the hospital to deliver a baby; or

                     (b)     associated with the delivery of a baby for a public patient; or

                      (c)     requested or required by a public patient in connection with the delivery of a baby.

26            Prescribed rate of interest — subsection 129AC (2) of the Act

                For the purposes of subsection 129AC (2) of the Act, the prescribed rate is 15 per cent per annum.

27            Prescribed authorities and persons for the purposes of subsection 130 (3A) of the Act

         (1)   For the purposes of subsection 130 (3A) of the Act:

                (a)    a person holding an office specified in column 2 of an item in Part 2 or 3 of Schedule 3 is a prescribed person; and

               (b)    information may be provided to a person holding an office specified in column 2 of an item in Part 2 or 3 of Schedule 3, being information:

                          (i)    of the kind indicated in column 3 of that item;

                         (ii)    for the purpose of checking whether:

                                   (A)     a claim in respect of the same service has been made on both the Department of Veterans’ Affairs and the Medicare Australia CEO; or

                                   (B)     a claim that should have been made on the Medicare Australia CEO has been made on that Department; or

                                   (C)     a claim that should have been made on that Department has been made on the Medicare Australia CEO; or

                                   (D)     a claim that has been either paid or rejected by the Medicare Australia CEO has been made on that Department.

         (2)   For purposes of subsection 130 (3A) of the Act:

                (a)    an authority specified in Part 4 of Schedule 3 is a prescribed authority; and

               (b)    a person specified in that Part is a prescribed person; and

                (c)    an authority of a State or Territory specified in Part 5 of that Schedule is a prescribed authority.

         (3)   For the purposes of subsection 130 (3A) of the Act, if:

                (a)    a patient has complained to the Medicare Australia CEO about a medical practitioner and the Medicare Australia CEO, on reasonable grounds, considers that that complaint could be the subject of an investigation by a Medical Board or the Complaints Unit; or

               (b)    the Medicare Australia CEO believes, on reasonable grounds, that a patient has complained to a Medical Board or to the Complaints Unit about such a practitioner; or

                (c)    a patient has received a service from such a practitioner who is the subject of an investigation by the Medicare Australia CEO, a Medical Board or the Complaints Unit;

the kind of information that may be made available to a person from time to time holding, occupying or performing the duties of an office specified in Part 2 or 3 of Schedule 3 or an authority, or a person, referred to in subregulation (2) is:

               (d)    in relation to the patient — the information specified in subregulation (5); and

                (e)    in relation to the practitioner — the information specified in subregulation (7).

         (4)   Information relating to a practitioner, or to a patient of a practitioner, may not be made available to an authority, or to a person, specified in Part 4 or 5 of Schedule 3 unless:

                (a)    the authority is a prescribed authority; or

               (b)    the person is a prescribed person;

of the State or Territory:

                (c)    in relation to which the practitioner:

                          (i)    is registered or licensed; or

                         (ii)    was registered or licensed; or

                         (iii)    is applying to be registered or licensed;

                        to practice as a medical practitioner; or

               (d)    in which the practitioner is or was practising.

         (5)   For the purposes of subregulation (3), the information relating to the patient is:

                (a)    name including any former name; and

               (b)    residential address including postcode and, if the patient’s postal address is another address, that other address including postcode; and

                (c)    residential telephone number; and

               (d)    work telephone number; and

                (e)    whether male or female; and

                (f)    date of birth; and

                (g)    medicare card number; and

                (h)    if the patient is not a permanent Australian resident:

                          (i)    date of last entry into Australia;

                         (ii)    expected date of departure from Australia;

                         (iii)    name of country of residence.

         (6)   If:

                (a)    the information specified in subregulation (5) in relation to a patient may be made available to an authority or person in accordance with subregulation (3); and

               (b)    the Medicare Australia CEO, on reasonable grounds, considers that a claim by the patient for medicare benefits is relevant to an investigation;

the Medicare Australia CEO may also permit the following information relating to that claim to be made available to that authority or person:

                (c)    date on which that treatment was given; and

               (d)    item number for that treatment; and

                (e)    name and provider number of the provider giving that treatment; and

                (f)    name and provider number of the provider nominated by the servicing provider as the person to whom payment for those services should be directed; and

                (g)    date marked on the patient’s claim form as the date of that claim; and

                (h)    date on which that form was lodged with the Medicare Australia CEO.

         (7)   For the purposes of subregulation (3), the information relating to the practitioner is:

                (a)    name; and

               (b)    in respect of the practitioner’s practice or, if the practitioner has more than one practice, in respect of each practice:

                          (i)    address including postcode; and

                         (ii)    provider number; and

                         (iii)    date on which it was opened; and

                        (iv)    date (if any) on which it was closed; and

                (c)    particulars of claims for medicare benefits lodged by the practitioner that the Medicare Australia CEO, on reasonable grounds, considers are relevant to the investigation.

         (8)   For the purposes of subregulation (7), if a practitioner has a practice at more than one location, each of those locations is to be regarded as a separate practice.

         (9)   For subsection 130 (3A) of the Act:

                (a)    the authority known as General Practice Education and Training Limited (ACN 095 433 140) (GPET) is a prescribed authority; and

               (b)    the following kind of information, being information relating to a medical practitioner who is undertaking the RACGP Training Program, approved by the RACGP, or the Australian General Practice Training Program, approved by GPET, may be provided to GPET:

                          (i)    the medical practitioner’s name;

                         (ii)    the medical practitioner’s provider number;

                         (iii)    the period over which, and the location in which, the medical practitioner is undertaking the Program;

 

                        (iv)    the professional services for which the medical practitioner has made a claim for payment of a medicare benefit and the amount of the benefit claimed.

       (10)   Information relating to the rendering of a professional service must not be provided under subparagraph (9) (b) (iv) in a manner that would allow the identity of the person to whom that service was rendered to be reasonably ascertained.

28            Delegation

                The Medicare Australia CEO may, by writing, delegate to a member of the staff of Medicare Australia referred to in subsection 20 (1) of the Medicare Australia Act 1973 all or any of the powers and functions of the Medicare Australia CEO under regulation 27.

29            Referral to specialists or consultant physicians

         (1)   This regulation and regulations 30 and 31 apply for the purposes of subsection 133 (2) of the Act if the general medical services table provides for a professional service mentioned in an item to be given by a specialist, or consultant physician, in the practice of his or her speciality, on referral of the patient by a referring practitioner.

         (2)   The referring practitioner must consider the need for the referral.

         (3)   The referral must give the specialist, or consultant physician, any information about the patient’s condition that the referring practitioner considers necessary.

         (4)   Unless subregulation 30 (1) or (2) applies, a referral must be:

                (a)    given in writing; and

               (b)    signed by the referring practitioner; and

                (c)    dated.

      (4A)   If the referring practitioner is a specialist, or consulting physician, the referral must:

                (a)    be endorsed with the name of the general practitioner nominated by the patient; or

               (b)    if the patient is unwilling or unable to nominate a general practitioner for the purposes of paragraph (a) — contain a statement to that effect.

         (5)   Unless subregulation 30 (3) applies, the specialist or consultant physician must receive the referral before giving the service to the patient.

30            Referrals: special cases

         (1)   A referral is given for a professional service to a patient in a hospital who is not a public patient if the hospital records record the referring practitioner’s signature approving the referral.

         (2)   A referral need not be given in writing if the referring practitioner decides in an emergency that it is necessary in the patient’s interests for the patient to be referred to the specialist or consultant physician as soon as practicable without a written referral.

         (3)   Subregulation 29 (5) does not apply if a written referral is lost, stolen or destroyed.

         (4)   If, in an emergency, a specialist or consultant physician:

                (a)    decides that it is necessary in the patient’s interest to give a professional service as soon as practicable and without a referral otherwise than under this subregulation; and

               (b)    gives that service to the patient;

the specialist or consultant physician is taken to have been the referring practitioner and to have given a referral for the service.

         (5)   For the purposes of subregulations (2) and (4), an emergency is a situation where the patient is treated by a medical practitioner within 30 minutes of presentation and that patient is:

                (a)    at risk of serious morbidity or mortality requiring urgent assessment and resuscitation; or

               (b)    suffering from suspected acute organ or system failure; or

                (c)    suffering from an illness or injury where the viability or function of a body part or organ is acutely threatened; or

               (d)    suffering from a drug overdose, toxic substance or toxin effect; or

                (e)    experiencing severe psychiatric disturbance whereby the health of the patient or other people is at immediate risk; or

                (f)    suffering acute severe pain where the viability or function of a body part or organ is suspected to be acutely threatened; or

                (g)    suffering acute significant haemorrhage requiring urgent assessment and treatment.

31            Validity of referrals to specialists or consultant physicians

         (1)   Subject to subregulation (1A), a referral given under regulation 29 is valid:

                (a)    if the referral provides for it to be valid for a fixed period — for the period so provided after the first service given in accordance with the referral; or

               (b)    if the referral provides for it to be valid indefinitely — for an indefinite period; or

                (c)    if the referral does not provide for its validity — for 12 months after the first service given in accordance with the referral.

      (1A)   A referral given by a specialist, or consultant physician, is valid:

                (a)    if the referred patient is a patient in a hospital:

                          (i)    until the patient ceases to be a patient in a hospital; or

                         (ii)    until 3 months after the first service given in accordance with the referral;

whichever is the later; or

               (b)    in any other case — until 3 months after the first service given in accordance with the referral.

         (2)   A referral given under subregulation 30 (1) is valid until the patient ceases to be a patient in the hospital who is not a public patient.

         (3)   A referral given under subregulation 30 (2) or subregulation 30 (4) is valid for only 1 attendance on the patient.

         (4)   A written referral that is lost, stolen or destroyed is valid for only 1 attendance on the patient.


Schedule 1        Forms

Form 1        Application for approval as an organization under Part IV

(regulation 21)

HEALTH INSURANCE ACT

APPLICATION FOR APPROVAL AS AN ORGANIZATION UNDER PART IV

To: the Minister of State for Health.

                (Name of applicant organization)

of                                               ,

                (Address of applicant organization)

hereby makes application under subsection 40 (1) of the Health Insurance Act 1973 for approval as an organization under Part IV of that Act.

Dated this                          day of                              , 19         

                                                                                                                          

(Signature of person authorized to

sign application)

                                                                                                                          

(Position in organization)

Form 2        Application for approval of a health service

(regulation 22)

HEALTH INSURANCE ACT

APPLICATION FOR APPROVAL OF A HEALTH SERVICE

To: the Minister of State for Health.

      (Name of applicant organization)

of                                               ,

      (Address of applicant organization)

being an approved organization within the meaning of Part IV of the Health Insurance Act 1973, hereby makes application under subsection 41 (1) for approval of the health service described in the Schedule, being a health service provided, or to be provided, by the organization.

SCHEDULE

(Here insert description of health service and address or addresses at which the service is to be provided.)

Dated this                       day of                              , 19 

                                                                                                                          

(Signature of person authorized to

sign application)

                                                                                                                          

(Position in organization)

Schedule 1A      Bodies to which information in the Australian Childhood Immunisation Register may be given

(regulation 22A)

Part 1          New South Wales

Division 1       Divisions of General Practice

 

101

Bankstown GP Division Incorporated

102

Barrier Division of General Practice Limited

103

Barwon Division of General Practice Limited

104

Blue Mountains Division of General Practice Incorporated

105

Canterbury Division of General Practice Limited

106

Central Sydney Division of General Practice Limited

107

Dubbo Plains Division of General Practice Incorporated

108

Eastern Sydney Division of General Practice Limited

109

Fairfield Division of General Practice Incorporated

110

Hastings Macleay Division of General Practice Limited

111

Hawkesbury Division of General Practice Limited

112

Hornsby Ku‑Ring‑Gai Ryde Division of General Practice Limited

113

Hunter Rural Division of General Practice Limited

114

Hunter Urban Division of General Practice Limited

115

Illawarra Division of General Practice Limited

116

Liverpool Division of General Practice Incorporated

117

Macarthur Division of General Practice Incorporated

118

Manly Warringah Division of General Practice Limited

119

Mid North Coast Division of General Practice Limited

120

Murrumbidgee Division of General Practice Limited

121

Nepean Division of General Practice Incorporated

122

The New England Division of General Practice Limited

123

Northern Rivers Division of General Practice (NSW) Limited

124

The Northern Sydney Division of General Practice Incorporated

125

North West Slopes (NSW) Division of General Practice Limited

126

NSW Central Coast Division of General Practice Limited

127

NSW Central West Division of General Practice Limited

128

NSW Outback Division of General Practice Limited

129

Riverina Division of General Practice Incorporated

130

The Shoalhaven Division of General Practice Incorporated

131

South Eastern Sydney Division of General Practice Limited

132

South East NSW Division of General Practice Limited

133

Southern Highlands Division of General Practice Incorporated

134

St George Division of General Practice Incorporated

135

Sutherland Division of General Practice Incorporated

136

Tweed Valley Division of General Practice (GENPRAC Limited)

137

The Western Sydney Division of General Practice Incorporated

Division 2       Other Bodies

 

150

National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases

151

NSW Department of Health

152

NSW Rural Division Co‑ordinating Unit

Part 2          Victoria

Division 1       Divisions of General Practice

 

201

Ballarat and District Division of General Practice Incorporated

202

Bendigo and District Division of General Practice Incorporated

203

Border Division of General Practice Limited

204

Central Bayside Division of General Practice Limited

205

Central Highlands Division of General Practice Limited

206

Central‑West Gippsland Division of General Practice Incorporated

207

Dandenong Division of General Practice Incorporated

208

Eastern Ranges GP Association Incorporated

209

East Gippsland Division of General Practice Limited

210

The Goulburn Valley Division of General Practice Limited

211

GP Association of Geelong Limited

212

Greater South East Melbourne Division of General Practice Limited

213

Inner Eastern Melbourne Division of General Practice Limited

214

Knox Division of General Practice Limited

215

Lilydale and Yarra Valley Division of General Practice

216

Mallee Division of General Practice Limited

217

Melbourne Division of General Practice Incorporated

218

Monash Division of General Practice (Moorabbin) Incorporated

219

Mornington Peninsula Division of General Practice Limited

220

Murray Plains Division of General Practice Incorporated

221

North East Valley Division of General Practice Pty Limited

222

North East Victorian Division of General Practice Limited

223

Northern Division of General Practice — Melbourne Limited

224

North West Melbourne Division of General Practice Limited

225

Otway Division of General Practice Incorporated

226

Southcity GP Services Limited

227

South Gippsland Division of General Practice Limited

228

Western Melbourne Division of General Practice Limited

229

Westgate Division of General Practice Limited

230

West Victoria Division of General Practice Incorporated

231

Whitehorse Division of General Practice Incorporated

Division 2       Other Bodies

 

240

Department of Human Services and Health

241

Victorian Rural Divisions Co‑ordinating Unit

 

Part 3          Queensland

Division 1       Divisions of General Practice

 

301

Association of Bayside General Practice Division Brisbane Incorporated

302

The Association of the Brisbane Inner South Division of General Practice Incorporated

303

Brisbane North Division of General Practice Association Incorporated

304

Brisbane Southside Central Division of General Practice Association Incorporated

305

The Cairns Division of General Practice Limited

306

Capricornia Division of General Practice Limited

307

Central Queensland Rural Division of General Practice Association Incorporated

308

Far North Queensland Rural Division of General Practice Association Incorporated

309

Gold Coast Division of General Practice Limited

310

Ipswich and West Moreton Division of General Practice Limited

311

Logan Area Division of General Practice Limited

312

Mackay Division of General Practice Limited

313

North and West Queensland Primary Health Care Association Incorporated

314

The Redcliffe, Bribie, Caboolture Division of General Practice Incorporated

315

Southern Queensland Rural Division of General Practice Association Incorporated

316

Sunshine Coast Division of General Practice Association Incorporated

317

Toowoomba and District Division of General Practice Limited

318

Townsville Division of General Practice Limited

319

Wide Bay Division of General Practice Association Incorporated

Division 2       Other Bodies

 

330

Aboriginal Primary Health Care Program

331

Queensland Health Department

332

Queensland Rural Divisions Co‑ordinating Unit

Part 4          Western Australia

Division 1       Divisions of General Practice

 

401

Canning Division of General Practice Limited

402

Central Wheatbelt Division of General Practice Incorporated

403

Eastern Goldfields Medical Division of General Practice Limited

404

Fremantle Regional Division of General Practice Limited

405

Greater Bunbury Division of General Practice Incorporated

406

Great Southern Division of General Practice Limited

407

Kimberley Division of General Practice Incorporated

408

Mid West Division of General Practice Incorporated

409

Osborne Division of General Practice Limited

410

Peel/South West Division of General Practice Limited

411

Perth and Hills Division of General Practice Limited

412

Perth Central Coastal Division of General Practice Limited

413

Pilbara Division of General Practice Limited

414

Rockingham Kwinana Division of General Practice Limited

415

Swan Hills Division of General Practitioners Limited

Division 2       Other Bodies

 

420

Health Department of Western Australia

421

West Australian Rural Divisions of General Practice Co‑ordinating Unit

Part 5          South Australia

Division 1       Divisions of General Practice

 

501

Adelaide Central and Eastern Division of General Practice Limited

502

Adelaide Hills Division of General Practice Incorporated

503

Adelaide North East Division of General Practice Incorporated

504

Adelaide Northern Division of General Practice Limited

505

Adelaide Southern Division of General Practice Incorporated

506

Adelaide Western Division of General Practice Incorporated

507

The Barossa Division of General Practice Incorporated

508

Eyre Peninsula Division of General Practice

509

Flinders and Far North Division of General Practice Incorporated

510

Limestone Coast Division of General Practice Incorporated

511

Mid North Rural SA Division of General Practice Incorporated

512

Murray Mallee Division of General Practice Incorporated

513

Riverland Division of General Practice Incorporated

514

Yorke Peninsula Division of General Practice Incorporated

Division 2       Other Bodies

 

520

SA Health Commission

521

South Australian Rural Divisions Co‑ordinating Unit (SARDCU)

Part 6          Tasmania

Division 1       Divisions of General Practice

 

601

Division of General Practice Northern Tasmania Incorporated

602

North West Tasmania Division of General Practice Incorporated

603

Southern Division of General Practice Tasmania Incorporated

Division 2       Other Bodies

 

610

Department of Community and Health Services

611

Tasmanian Rural Divisions Co‑ordinating Unit

Part 7          Australian Capital Territory

Division 1       Division of General Practice

 

701

ACT Division of General Practice Incorporated

Division 2       Other Bodies

 

710

ACT Department of Health and Community Care

Part 8          Northern Territory

Division 1       Divisions of General Practice

 

801

Central Australian Division of Primary Health Care Incorporated

802

Top End Division of General Practice Incorporated

Division 2       Other Bodies

 

810

Central Australian Aboriginal Primary Health Care Network Project

811

Territory Health Services

812

Top End Aboriginal and Torres Strait Islander Primary Health Care Network

Schedule 2        Witnesses’ allowances for travelling and other expenses

(regulation 24)

  

1.             A witness attending, because of his or her professional, scientific or other special skill or knowledge, a hearing before a Committee shall be paid the allowance that the witness would be paid under the scale in the Second Schedule to the Federal Court Rules, as in force from time to time, if called before the Federal Court of Australia.

2.             A witness, other than a witness referred to in item 1, attending a hearing before a Committee shall be paid the allowance that the witness would be paid under the scale in the Second Schedule to the Federal Court Rules, as in force from time to time, if called before the Federal Court of Australia.

3.             A witness attending a hearing before a Committee who is remunerated in his or her occupation by wages, salary or fees shall, in addition to an allowance payable to the witness under item 1 or 2, be paid an allowance equal to the amount of wages, salary or fees lost because of the attendance.

4.             A witness appearing before a Committee to give evidence shall be paid a reasonable amount:

                (a)    in respect of his conveyance to and from the place at which he so attends; and

               (b)    if he is required to be absent overnight from his usual place of residence, for meals and accommodation.

5.             In this Schedule, Committee means a Professional Services Review Committee.

Schedule 3        Prescribed authorities and persons — subsection 130 (3A) of the Act

(regulation 27)

Part 1          Interpretation of Schedule

1.             In this Schedule:

Inv means:

                (a)    the name and address of persons who have been, or are, under investigation by the Medicare Australia CEO; and

               (b)    the present status of any such investigation.

TP, in relation to a treatment provider, means:

                (a)    name; and

               (b)    if a specialist — qualification and the date when it was recognised for the purposes of payment of medicare benefits; and

                (c)    if the provider is a pathologist — whether the provider is approved by the Medicare Australia CEO for the purposes of payment of medicare benefits; and

               (d)    if the provider operates a pathology laboratory — the approval number allocated by the Department in respect of that laboratory; and

                (e)    in respect of the provider’s practice or, if the provider has more than one practice, in respect of each practice:

                          (i)    address including postcode; and

                         (ii)    provider number; and

                         (iii)    date on which it was opened; and

                        (iv)    date (if any) on which it was closed; and

                         (v)    any pay group number allocated by the Medicare Australia CEO; and

                        (vi)    name and address of any person nominated by the treatment provider in respect of services as being the person to whom payment for those services should be directed.

VP, in respect of a veterans’ patient, means the following information:

                (a)    name; and

               (b)    address including postcode; and

                (c)    date of birth; and

               (d)    sex; and

                (e)    personal identification number allocated by the Medicare Australia CEO; and

                (f)    automatch or Department of Veterans’ Affairs personal identification number allocated by the Medicare Australia CEO; and

                (g)    in relation to treatment given or claimed to have been given by a treatment provider to the patient:

                          (i)    date or dates on which that treatment was given; and

                         (ii)    number of services provided; and

                         (iii)    item number for that treatment; and

                        (iv)    location at which that treatment was given; and

                         (v)    if treatment is provided by a servicing provider — the provider number or numbers of the servicing provider; and

                        (vi)    if the services provided on an occasion are related — the medicare abatement number that relates to those services; and

                        (vii)    if the services provided on an occasion are the subject of a single fee with no indication of the proportion payable for each service — the medicare notional charge indicator number that relates to those services; and

                       (viii)    number of the treatment provider or of each treatment provider giving that treatment; and

                        (ix)    number of any treatment provider who requested services from another provider for the patient in connection with that treatment; and

                         (x)    means of payment for the treatment; and

                        (xi)    fees charged for the treatment; and

                        (xii)    the medicare claim identification number (if any) appearing on the medicare claim form; and

                       (xiii)    date on which the medicare claim for the treatment was logged into the Medicare Australia’s computer system for processing; and

                       (xiv)    the place at which the medicare claim was approved for payment; and

                       (xv)    date upon which the medicare claim was approved for payment; and

                       (xvi)    the reason code (if any) used by the person processing the medicare claim; and

                      (xvii)    the processing indicator (if any) used by the person processing the medicare claim; and

                     (xviii)    benefits paid by medicare.

Veterans’ patient means a person entitled to treatment under:

                (a)    Part V of the Veterans’ Entitlements Act 1986; or

               (b)    the Seamen’s War Pensions and Allowances Act 1940; or

                (c)    the Papua New Guinea (Members of the Forces) Benefits Act 1957; or

               (d)    Chapter 6 of the Military Rehabilitation and Compensation Act 2004.

2.             A reference in the definition of TP in clause 1 to a provider who has more than one qualification, practice or pathology laboratory is a reference to each of those qualifications, practices or laboratories.

3.             For the purposes of this Schedule, if a treatment provider has a practice at more than one location, each of those locations is to be regarded as a separate practice.

Part 2          Prescribed persons of the Commonwealth: Department of Veterans’ Affairs, Executive Officers

 

Column 1
Item

Column 2
Person

Column 3
Kind of Information

1

Secretary to the Department,
Central Office

Inv, TP, VP

2

Deputy President,
Senior Executive Service Officer,
Band 3, position number 9001,
Central Office

Inv, TP, VP

3

Senior Executive Service Officer,
Band 2, position number 1,
New South Wales

Inv, TP, VP

4

Senior Executive Service Officer
Band 2, position number 1, Victoria

Inv, TP, VP

5

Senior Executive Service Officer,
Band 1, position number 1, Queensland

Inv, TP, VP

6

Senior Executive Service Officer,
Band 1, position number 1,
Western Australia

Inv, TP, VP

7

Senior Executive Service Officer,
Band 1, position number 1,
South Australia

Inv, TP, VP

8

Senior Executive Service Officer,
Band 1, position number 653, Tasmania

Inv, TP, VP

Part 3          Prescribed persons of the Commonwealth: Department of Veterans’ Affairs, Health Program

 

Column 1
Item

Column 2
Person

Column 3
Kind of Information

1

Senior Executive Service Officer, Band 1, position number 641,
Central Office

Inv, TP

2

Senior Officer Grade B, position number 3768, Central Office

Inv, TP

3

Senior Officer Grade C, position number 3434, Central Office

Inv, TP

4

Administrative Service Officer,
Class 6, position number 3772,
Central Office

Inv, TP

5

Administrative Service Officer,
Class 5, position number 3774,
Central Office

Inv, TP

6

Administrative Service Officer,
Class 5, position number 3778,
Central Office

Inv, TP

7

Senior Executive Service Officer, Band 2, position number 632,
Central Office

Inv, TP, VP

8

Senior Executive Service Officer, Band 2, position number 636,
Central Office

Inv, TP, VP

9

Senior Executive Service Officer, Band 1, position number 642,
Central Office

Inv, TP, VP

10

Senior Officer Grade B, position number 3691, Central Office

Inv, TP, VP

11

Senior Officer Grade C, position number 3692, Central Office

Inv, TP, VP

12

Senior Officer Grade C, position number 825, Central Office

Inv, TP, VP

13

Senior Officer Grade C, position number 690, Central Office

Inv, TP, VP

14

Administrative Service Officer,
Class 6, position number 3693,
Central Office

Inv, TP, VP

15

Administrative Service Officer,
Class 4, position number 1230,
Central Office

Inv, TP, VP

16

Administrative Service Officer,
Class 4, position number 3775,
Central Office

Inv, TP, VP

17

Administrative Service Officer,
Class 2, position number 3720,
Central Office

Inv, TP, VP

18

Administrative Service Officer,
Class 6, position number 1465,
New South Wales

TP, VP

19

Administrative Service Officer,
Class 3, position number 30,
New South Wales

TP, VP

20

Administrative Service Officer,
Class 3, position number 354,
New South Wales

TP, VP

21

Administrative Service Officer,
Class 3, position number 1294,
New South Wales

TP, VP

22

Administrative Service Officer,
Class 3, position number 2039,
New South Wales

TP, VP

23

Administrative Service Officer,
Class 2, position number 347,
New South Wales

TP, VP

24

Administrative Service Officer,
Class 2, position number 355,
New South Wales

TP, VP

25

Administrative Service Officer,
Class 2, position number 367,
New South Wales

TP, VP

26

Administrative Service Officer,
Class 2, position number 621,
New South Wales

TP, VP

27

Administrative Service Officer,
Class 2, position number 1295,
New South Wales

TP, VP

28

Administrative Service Officer,
Class 2, position number 1296,
New South Wales

TP, VP

29

Administrative Service Officer,
Class 2, position number 1297,
New South Wales

TP, VP

30

Administrative Service Officer,
Class 2, position number 1298,
New South Wales

TP, VP

31

Administrative Service Officer,
Class 2, position number 1299,
New South Wales

TP, VP

32

Administrative Service Officer,
Class 2, position number 1300,
New South Wales

TP, VP

33

Administrative Service Officer,
Class 2, position number 1301,
New South Wales

TP, VP

34

Administrative Service Officer,
Class 2, position number 1473,
New South Wales

TP, VP

35

Administrative Service Officer,
Class 2, position number 1477,
New South Wales

TP, VP

36

Administrative Service Officer,
Class 2, position number 1534,
New South Wales

TP, VP

37

Administrative Service Officer,
Class 2, position number 1550,
New South Wales

TP, VP

38

Administrative Service Officer,
Class 2, position number 4530,
New South Wales

TP, VP

39

Administrative Service Officer,
Class 2, position number 5076,
New South Wales

TP, VP

40

Administrative Service Officer,
Class 2, position number 1511,
New South Wales

TP, VP

41

Administrative Service Officer,
Class 4, position number 4147,
New South Wales

TP, VP

42

Administrative Service Officer,
Class 2, position number 362,
New South Wales

TP, VP

43

Senior Executive Service Officer, Band 1, position number 3,
New South Wales

Inv, TP, VP

44

Administrative Service Officer,
Class 3, position number 1273,
New South Wales

TP, VP

45

Administrative Service Officer,
Class 2, position number 1271,
New South Wales

TP, VP

46

Senior Officer Grade C,
position number 4424,
New South Wales

Inv, TP, VP

47

Medical Officer Grade 3, position number 4429, New South Wales

Inv, TP, VP

48

Science Officer 2, position number 4430, New South Wales

Inv, TP, VP

49

Science Officer 2, position number 3974, New South Wales

Inv, TP, VP

50

Administrative Service Officer,
Class 6, position number 4425,
New South Wales

Inv, TP, VP

51

Administrative Service Officer,
Class 5, position number 4426,
New South Wales

Inv, TP, VP

52

Administrative Service Officer,
Class 4, position number 2117,
New South Wales

Inv, TP, VP

53

Administrative Service Officer,
Class 4, position number 336,
New South Wales

Inv, TP, VP

54

Administrative Service Officer,
Class 3, position number 4428,
New South Wales

Inv, TP, VP

55

Administrative Service Officer,
Class 1, position number 4017,
New South Wales

Inv, TP, VP

56

Administrative Service Officer,
Class 5, position number 1537,
New South Wales

Inv, TP, VP

57

Administrative Service Officer,
Class 5, position number 1538,
New South Wales

Inv, TP, VP

58

Administrative Service Officer,
Class 5, position number 1539,
New South Wales

Inv, TP, VP

59

Administrative Service Officer,
Class 5, position number 3964,
New South Wales

Inv, TP, VP

60

Administrative Service Officer,
Class 4, position number 1544,
New South Wales

Inv, TP, VP

61

Administrative Service Officer,
Class 3, position number 3963,
New South Wales

Inv, TP, VP

62

Administrative Service Officer,
Class 3, position number 1253,
New South Wales

Inv, TP, VP

63

Administrative Service Officer,
Class 3, position number 3962,
New South Wales

Inv, TP, VP

64

Administrative Service Officer,
Class 3, position number 4000,
New South Wales

Inv, TP, VP

65

Administrative Service Officer,
Class 3, position number 1263,
New South Wales

Inv, TP, VP

66

Administrative Service Officer,
Class 2, position number 687,
New South Wales

Inv, TP, VP

67

Administrative Service Officer,
Class 2, position number 1549,
New South Wales

Inv, TP, VP

68

Administrative Service Officer,
Class 2, position number 1557,
New South Wales

Inv, TP, VP

69

Administrative Service Officer,
Class 2, position number 1265,
New South Wales

Inv, TP, VP

70

Administrative Service Officer,
Class 2, position number 1274,
New South Wales

Inv, TP, VP

71

Administrative Service Officer,
Class 2, position number 1275,
New South Wales

Inv, TP, VP

72

Administrative Service Officer,
Class 2, position number 1276,
New South Wales

Inv, TP, VP

73

Administrative Service Officer,
Class 2, position number 1261,
New South Wales

Inv, TP, VP

74

Administrative Service Officer,
Class 3, position number 582,
New South Wales

Inv, TP, VP

75

Administrative Service Officer,
Class 2, position number 4874,
New South Wales

Inv, TP, VP

76

Administrative Service Officer,
Class 2, position number 5761,
New South Wales

Inv, TP, VP

77

Administrative Service Officer,
Class 2, position number 5762,
New South Wales

Inv, TP, VP

78

Administrative Service Officer,
Class 4, position number 5659,
New South Wales

Inv, TP, VP

79

Administrative Service Officer,
Class 5, position number 599,
New South Wales

Inv, TP VP

80

Administrative Service Officer,
Class 5, position number 3686, Victoria

TP, VP

81

Administrative Service Officer,
Class 3, position number 3687, Victoria

TP, VP

82

Administrative Service Officer,
Class 3, position number 3707, Victoria

TP, VP

83

Administrative Service Officer,
Class 3, position number 780,
Victoria

TP, VP

85

Administrative Service Officer,
Class 2, position number 3705, Victoria

TP, VP

86

Administrative Service Officer,
Class 2, position number 3706, Victoria

TP, VP

87

Administrative Service Officer,
Class 2, position number 3688, Victoria

TP, VP

88

Administrative Service Officer,
Class 2, position number 3689, Victoria

TP, VP

89

Administrative Service Officer,
Class 2, position number 3690, Victoria

TP, VP

90

Administrative Service Officer,
Class 2, position number 3691, Victoria

TP, VP

91

Administrative Service Officer,
Class 2, position number 3692, Victoria

TP, VP

92

Administrative Service Officer,
Class 2, position number 781,
Victoria

TP, VP

93

Administrative Service Officer,
Class 2, position number 782,
Victoria

TP, VP

94

Administrative Service Officer,
Class 2, position number 784,
Victoria

TP, VP

95

Administrative Service Officer,
Class 2, position number 785,
Victoria

TP, VP

96

Administrative Service Officer,
Class 2, position number 786,
Victoria

TP, VP

97

Administrative Service Officer,
Class 1, position number 3693, Victoria

TP, VP

98

Administrative Service Officer,
Class 1, position number 3763, Victoria

TP, VP

99

Administrative Service Officer,
Class 1, position number 772,
Victoria

TP, VP

100

Administrative Service Officer,
Class 1, position number 266,
Victoria

TP, VP

101

Administrative Service Officer,
Class 1, position number 673,
Victoria

TP, VP

102

Administrative Service Officer,
Class 1, position number 3694, Victoria

TP, VP

103

Administrative Service Officer,
Class 1, position number 3695, Victoria

TP, VP

104

Administrative Service Officer,
Class 1, position number 3696, Victoria

TP, VP

105

Administrative Service Officer,
Class 1, position number 3697, Victoria

TP, VP

106

Administrative Service Officer,
Class 1, position number 3698, Victoria

TP, VP

107

Administrative Service Officer,
Class 1, position number 3699, Victoria

TP, VP

108

Administrative Service Officer,
Class 1, position number 3700, Victoria

TP, VP

109

Administrative Service Officer,
Class 1, position number 3701, Victoria

TP, VP

110

Administrative Service Officer,
Class 1, position number 3702, Victoria

TP, VP

111

Administrative Service Officer,
Class 1, position number 3703, Victoria

TP, VP

112

Senior Executive Officer, Band 1, position number 7, Victoria

Inv, TP, VP

113

Senior Officer Grade C, position number 3420, Victoria

Inv, TP, VP

114

Senior Officer Grade B, position number 3650, Victoria

Inv, TP, VP

115

Medical Officer, Grade 3, position number 3427, Victoria

Inv, TP, VP

116

Medical Officer, Grade 2, position number 4357, Victoria

Inv, TP, VP

117

Science Officer 3, position number 2609, Victoria

Inv, TP, VP

118

Science Officer 2, position number 3141, Victoria

Inv, TP, VP

119

Science Officer 2, position number 3428, Victoria

Inv, TP, VP

120

Administrative Service Officer,
Class 6, position number 3020, Victoria

Inv, TP, VP

121

Administrative Service Officer,
Class 6, position number 3421, Victoria

Inv, TP, VP

122

Administrative Service Officer,
Class 5, position number 3422, Victoria

Inv, TP, VP

123

Administrative Service Officer,
Class 4, position number 3424, Victoria

Inv, TP, VP

124

Administrative Service Officer,
Class 3, position number 3426, Victoria

Inv, TP, VP

125

Senior Officer Grade B, position number 1337, Queensland

Inv, TP, VP

126

Medical Officer, Grade 3, position number 2112, Queensland

Inv, TP, VP

127

Senior Officer Grade C, position number 2106, Queensland

Inv, TP, VP

128

Senior Officer Grade C, position number 107, Queensland

Inv, TP, VP

129

Administrative Service Officer,
Class 6, position number 2107, Queensland

Inv, TP, VP

130

Administrative Service Officer,
Class 6, position number 1725, Queensland

Inv, TP, VP

131

Administrative Service Officer,
Class 5, position number 2104, Queensland

TP, VP

132

Administrative Service Officer,
Class 5, position number 2214, Queensland

TP, VP

133

Administrative Service Officer,
Class 5, position number 2215, Queensland

TP, VP

134

Administrative Service Officer,
Class 5, position number 2072, Queensland

TP, VP

135

Administrative Service Officer,
Class 4, position number 424, Queensland

TP, VP

136

Administrative Service Officer,
Class 4, position number 1552, Queensland

TP, VP

137

Administrative Service Officer,
Class 3, position number 2076, Queensland

TP, VP

138

Administrative Service Officer,
Class 3, position number 2298, Queensland

TP, VP

139

Administrative Service Officer,
Class 3, position number 2001, Queensland

TP, VP

140

Administrative Service Officer,
Class 3, position number 2097, Queensland

TP, VP

141

Administrative Service Officer,
Class 3, position number 410, Queensland

TP, VP

142

Administrative Service Officer,
Class 3, position number 394, Queensland

TP, VP

143

Administrative Service Officer,
Class 3, position number 435, Queensland

TP, VP

144

Administrative Service Officer,
Class 2, position number 118, Queensland

TP, VP

145

Administrative Service Officer,
Class 2, position number 124, Queensland

TP, VP

146

Administrative Service Officer,
Class 2, position number 754, Queensland

TP, VP

147

Administrative Service Officer,
Class 2, position number 755, Queensland

TP, VP

148

Administrative Service Officer,
Class 2, position number 756, Queensland

TP, VP

149

Administrative Service Officer,
Class 2, position number 2300, Queensland

TP, VP

150

Administrative Service Officer,
Class 2, position number 2301, Queensland

TP, VP

151

Administrative Service Officer,
Class 2, position number 2302, Queensland

TP, VP

152

Administrative Service Officer,
Class 2, position number 2303, Queensland

TP, VP

153

Administrative Service Officer,
Class 2, position number 2304, Queensland

TP, VP

154

Administrative Service Officer,
Class 2, position number 2133, Queensland

TP, VP

155

Administrative Service Officer,
Class 2, position number 2143, Queensland

TP, VP

156

Administrative Service Officer,
Class 2, position number 2299, Queensland

TP, VP

157

Administrative Service Officer,
Class 2, position number 2497, Queensland

TP, VP

158

Administrative Service Officer,
Class 2, position number 428, Queensland

TP, VP

159

Administrative Service Officer,
Class 2, position number 451, Queensland

TP, VP

160

Administrative Service Officer,
Class 2, position number 452, Queensland

TP, VP

161

Administrative Service Officer,
Class 2, position number 456, Queensland

TP, VP

162

Administrative Service Officer,
Class 2, position number 457, Queensland

TP, VP

163

Administrative Service Officer,
Class 2, position number 459, Queensland

TP, VP

164

Administrative Service Officer,
Class 2, position number 461, Queensland

TP, VP

165

Administrative Service Officer,
Class 2, position number 483, Queensland

TP, VP

166

Administrative Service Officer,
Class 2, position number 502, Queensland

TP, VP

167

Administrative Service Officer,
Class 2, position number 503, Queensland

TP, VP

168

Administrative Service Officer,
Class 2, position number 507, Queensland

TP, VP

169

Administrative Service Officer,
Class 2, position number 1199, Queensland

TP, VP

170

Administrative Service Officer,
Class 2, position number 460, Queensland

TP

171

Administrative Service Officer,
Class 1, position number 429, Queensland

TP

172

Administrative Service Officer,
Class 1, position number 489, Queensland

TP

173

Administrative Service Officer,
Class 1, position number 351, Queensland

TP

174

Administrative Service Officer,
Class 1, position number 111, Queensland

TP

175

Administrative Service Officer,
Class 1, position number 751, Queensland

TP

176

Administrative Service Officer,
Class 1, position number 752, Queensland

TP

177

Administrative Service Officer,
Class 1, position number 753, Queensland

TP

178

Administrative Service Officer,
Class 1, position number 1198, Queensland

TP

179

Administrative Service Officer,
Class 1, position number 2306, Queensland

TP

180

Administrative Service Officer,
Class 1, position number 2307, Queensland

TP

181

Administrative Service Officer,
Class 1, position number 2308, Queensland

TP

182

Administrative Service Officer,
Class 1, position number 2309, Queensland

TP

183

Administrative Service Officer,
Class 1, position number 2310, Queensland

TP

184

Administrative Service Officer,
Class 1, position number 2311, Queensland

TP

185

Administrative Service Officer,
Class 1, position number 2312, Queensland

TP

186

Administrative Service Officer,
Class 6, position number 289,
Western Australia

TP, VP

187

Administrative Service Officer,
Class 5, position number 158,
Western Australia

TP, VP

188

Administrative Service Officer,
Class 5, position number 1324, Western Australia

TP, VP

189

Administrative Service Officer,
Class 3, position number 1966, Western Australia

TP, VP

190

Administrative Service Officer,
Class 3, position number 298,
Western Australia

TP, VP

191

Administrative Service Officer,
Class 3, position number 1972, Western Australia

TP, VP

192

Administrative Service Officer,
Class 3, position number 1495, Western Australia

TP, VP

193

Administrative Service Officer,
Class 2, position number 292,
Western Australia

TP, VP

194

Administrative Service Officer,
Class 2, position number 294,
Western Australia

TP, VP

195

Administrative Service Officer,
Class 2, position number 235,
Western Australia

TP, VP

196

Administrative Service Officer,
Class 2, position number 231,
Western Australia

TP, VP

197

Administrative Service Officer,
Class 2, position number 296,
Western Australia

TP, VP

198

Administrative Service Officer,
Class 2, position number 238,
Western Australia

TP, VP

199

Administrative Service Officer,
Class 2, position number 1170, Western Australia

TP, VP

200

Administrative Service Officer,
Class 2, position number 98,
Western Australia

TP, VP

201

Administrative Service Officer,
Class 2, position number 80,
Western Australia

TP, VP

202

Administrative Service Officer,
Class 2, position number 81,
Western Australia

TP, VP

203

Administrative Service Officer,
Class 2, position number 1477, Western Australia

TP, VP

204

Administrative Service Officer,
Class 3, position number 308,
Western Australia

TP, VP

205

Administrative Service Officer,
Class 5, position number 290,
Western Australia

TP, VP

206

Senior Officer Grade B, position number 2, Western Australia

Inv, TP, VP

207

Administrative Service Officer,
Class 3, position number 291,
Western Australia

TP, VP

208

Administrative Service Officer,
Class 6, position number 12,
Western Australia

Inv, TP, VP

209

Administrative Service Officer,
Class 4, position number 1958, Western Australia

Inv, TP, VP

210

Medical Officer Grade 3, position number 5, Western Australia

Inv, TP, VP

211

Medical Officer Grade 2, position number 6, Western Australia

Inv, TP, VP

212

Science Officer Grade 2, position number 101, Western Australia

Inv, TP, VP

213

Science Officer Grade 1, position number 7, Western Australia

Inv, TP, VP

214

Administrative Service Officer,
Class 6, position number 1013,
South Australia

TP, VP

215

Administrative Service Officer,
Class 5, position number 1058,
South Australia

TP, VP

216

Administrative Service Officer,
Class 5, position number 1055,
South Australia

TP, VP

217

Administrative Service Officer,
Class 4, position number 1743,
South Australia

TP, VP

218

Administrative Service Officer,
Class 4, position number 1744,
South Australia

TP, VP

219

Administrative Service Officer,
Class 3, position number 94,
South Australia

TP, VP

220

Administrative Service Officer,
Class 3, position number 253,
South Australia

TP, VP

221

Administrative Service Officer,
Class 3, position number 1050,
South Australia

TP, VP

222

Administrative Service Officer,
Class 2, position number 73,
South Australia

TP, VP

223

Administrative Service Officer,
Class 2, position number 241,
South Australia

TP, VP

224

Administrative Service Officer,
Class 2, position number 242,
South Australia

TP, VP

225

Administrative Service Officer,
Class 2, position number 243,
South Australia

TP, VP

226

Administrative Service Officer,
Class 2, position number 244,
South Australia

TP, VP

227

Administrative Service Officer,
Class 2, position number 246,
South Australia

TP, VP

228

Administrative Service Officer,
Class 2, position number 247,
South Australia

TP, VP

229

Administrative Service Officer,
Class 2, position number 254,
South Australia

TP, VP

230

Administrative Service Officer,
Class 2, position number 962,
South Australia

TP, VP

231

Administrative Service Officer,
Class 2, position number 1017,
South Australia

TP, VP

232

Administrative Service Officer,
Class 5, position number 1053,
South Australia

TP, VP

233

Senior Officer Grade B, Class 6, position number 2, South Australia

Inv, TP, VP

234

Administrative Service Officer,
Class 3, position number 240,
South Australia

TP, VP

235

Administrative Service Officer,
Class 6, position number 1230,
South Australia

Inv, TP, VP

236

Medical Officer, Grade 3, position number 81, South Australia

Inv, TP, VP

237

Science Officer 2, position number 1166, South Australia

Inv, TP, VP

238

Senior Officer Grade C, position number 2, Tasmania

Inv, TP, VP

239

Administrative Service Officer,
Class 6, position number 118,
Tasmania

Inv, TP, VP

240

Medical Officer Grade 1, position number 8, Tasmania

Inv, TP, VP

241

Medical Officer Grade 1, position number 9, Tasmania

Inv, TP, VP

242

Medical Officer Grade 1, position number 43, Tasmania

Inv, TP, VP

243

Medical Officer Grade 1, position number 461, Tasmania

Inv, TP, VP

244

Administrative Service Officer,
Class 4, position number 584, Tasmania

Inv, TP, VP

245

Administrative Service Officer,
Class 3, position number 28,
Tasmania

TP, VP

246

Administrative Service Officer,
Class 3, position number 523,
Tasmania

TP, VP

247

Administrative Service Officer,
Class 3, position number 524,
Tasmania

TP, VP

248

Administrative Service Officer,
Class 3, position number 570,
Tasmania

TP, VP

249

Administrative Service Officer,
Class 3, position number 582,
Tasmania

TP, VP

250

Administrative Service Officer,
Class 3, position number 618,
Tasmania

TP, VP

251

Administrative Service Officer,
Class 2, position number 31,
Tasmania

TP, VP

252

Administrative Service Officer,
Class 2, position number 337,
Tasmania

TP, VP

253

Administrative Service Officer,
Class 2, position number 517,
Tasmania

TP, VP

254

Administrative Service Officer,
Class 2, position number 525,
Tasmania

TP, VP

255

Administrative Service Officer,
Class 2, position number 526,
Tasmania

TP, VP

256

Medical Officer Grade 3, position number 6, Tasmania

Inv, TP, VP

Part 4          Prescribed authority and persons of New South Wales

 

Column 1
Item

Column 2
Authority or person

1

New South Wales Medical Board

2

Commissioner, position number, 7106/01, Health Care Complaints Commission

3

Deputy Commissioner, position number 7106/61, Health Care Complaints Commission

4

Legal Co‑Ordinator, position number 7106/24, Health Care Complaints Commission

Part 5          Prescribed authorities of other States and Territories

 

Column 1
Item

Column 2
Authority

1

Medical Practitioners Board of Victoria

2

Medical Board of Queensland

3

Medical Board of Western Australia

4

Medical Board of South Australia

5

Medical Council of Tasmania

6

Medical Board of the Australian Capital Territory

7

Medical Board of the Northern Territory

 

Schedule 4        Relevant organisations and qualifications

(regulation 4)

Part 1          Current organisations and qualifications

 

Column 1
Item

Column 2
Organisation

Column 3
Specialty

Column 4
Qualification

101

Australasian College for Emergency Medicine

Emergency Medicine

Fellowship of the Australasian College for Emergency Medicine
(FACEM)

102

The Royal Australasian College of Physicians, Division of Adult Medicine and Division of Paediatric and Child Health

General Medicine

General Paediatrics

Cardiology

Clinical Genetics

Clinical Pharmacology

Endocrinology

Gastroenterology and Hepatology

Geriatric Medicine

Haematology

Immunology and Allergy

Infectious Diseases

Intensive Care

Medical Oncology

Nephrology

Neurology

Nuclear Medicine

Palliative Medicine

Respiratory and Sleep Medicine

Rheumatology

Fellowship of the Royal Australasian College of Physicians
(FRACP)

102A

The Royal Australasian College of Physicians, Australasian Chapter of Palliative Medicine

Palliative Medicine

Fellowship of the Australasian Chapter of Palliative Medicine (FAChPM)

103

The Royal Australasian College of Physicians,
Australasian Faculty of Occupational Medicine

Occupational Medicine

Fellowship of the Australasian Faculty of Occupational Medicine
(FAFOM)

104

The Royal Australasian College of Physicians,
Australasian Faculty of Rehabilitation Medicine

Rehabilitation Medicine

Fellowship of the Australasian Faculty of Rehabilitation Medicine
(FAFRM)

105

The Royal Australasian College of Physicians, Australasian Faculty of Public Health Medicine

Public Health Medicine

Fellowship of the Australasian Faculty of Public Health Medicine (FAFPHM)

106

Australian and New Zealand College of Anaesthetists

Anaesthesia Intensive Care

Fellowship of the Australian and New Zealand College of Anaesthetists
(FANZCA)

Note   This qualification has been awarded since 7 February 1992.

106A

Australian and New Zealand College of Anaesthetists, Faculty of Pain Medicine

Pain Medicine

Fellowship of the Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists (FFPMANZCA)

107

Royal Australasian College of Surgeons

Cardio‑thoracic Surgery

General Surgery

Neurosurgery

Orthopaedic Surgery

Otolaryngology — Head and Neck Surgery

Paediatric Surgery

Plastic and Reconstructive Surgery

Urology

Vascular Surgery

Fellowship of the Royal Australasian College of Surgeons
(FRACS)

108

The Australasian College of Dermatologists

Dermatology

Fellowship of the Australasian College of Dermatologists
(FACD)

109

The Royal Australasian and New Zealand College of Radiologists

Note   This organisation was formerly called by the name specified in column 2 of item 205.

Diagnostic Radiology

Diagnostic Ultrasound

Nuclear Medicine

Radiation Oncology

Fellowship of the Royal Australasian and New Zealand College of Radiologists (FRANZCR)

Note   This qualification has been awarded since 27 October 1998.

110

The Royal Australian and New Zealand College of Psychiatrists

Psychiatry

Fellowship of the Royal Australian and New Zealand College of Psychiatrists (FRANZCP)

111

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Note   This organisation was formerly called by the name specified in column 2 of item 206.

Obstetrics and Gynaecology

Gynaecological Oncology

Maternal‑fetal Medicine

Obstetrics and Gynaecological Ultrasound

Reproductive Endocrinology and Infertility

Urogynaecology

Fellowship of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (FRANZCOG)

Note   This qualification has been awarded since 23 October 1998.

112

The Royal Australian and New Zealand College of Ophthalmologists

Note   This organisation was formerly called by the name specified in column 2 of item 207.

Ophthalmology

Fellowship of the Royal Australian and New Zealand College of Ophthalmologists
(FRANZCO)

Note   This qualification has been awarded since 21 December 2000.

113

The Royal College of Pathologists of Australasia

General Pathology

Anatomical Pathology (including Cytopathology and Forensic Pathology)

Chemical Pathology

Haematology

Immunology

Microbiology

Fellowship of the Royal College of Pathologists of Australasia
(FRCPA)

114

The Royal Australasian College of Dental Surgeons

Oral and Maxillofacial Surgery

Fellowship of the Royal Australasian College of Dental Surgeons (Oral and Maxillofacial Surgery)
(FRACDS (OMS))

115

Australian and New Zealand College of Anaesthetists and Royal Australasian College of Physicians, Joint Faculty of Intensive Care Medicine

Intensive Care Medicine

Fellowship of the Joint Faculty of Intensive Care Medicine (FJFICM)

Part 2          Former organisations and qualifications

Note   The organisations and qualifications specified in this Part are the former names of relevant organisations and relevant qualifications specified in Part 1. The organisations and qualifications specified in this Part are relevant organisations and relevant qualifications for the purposes of subsection 3D (5) of the Act.

 

Column 1
Item

Column 2
Organisation

Column 3
Specialty

Column 4
Qualification

201

Australasian College of Rehabilitation Medicine

Rehabilitation Medicine

Fellowship of the Australasian College of Rehabilitation Medicine
(FACRM)

Note   This qualification has not been awarded since 28 April 1993.

202

Australian and New Zealand College of Anaesthetists, Faculty of Intensive Care

Anaesthesia Intensive Care

Fellowship of the Faculty of Intensive Care, Australian and New Zealand College of Anaesthetists
(FFICANZCA)

Note   This qualification has not been awarded since 22 February 2002.

203

The Royal Australasian College of Physicians

Note   This organisation is now called by the name specified in column 2 of item 102.

General Medicine

Cardiology

Clinical Haematology

Clinical Immunology (including Allergy)

Clinical Pharmacology

Endocrinology

Gastroenterology

Geriatrics

Fellowship of the Royal Australasian College of Physicians
(FRACP)

Note   Although this qualification is still awarded, the name of the relevant organisation has changed (see column 2 of item 102). The specialties in relation to which this qualification is currently awarded are specified in column 3 of item 102.

 

 

Infectious Diseases

Intensive Care

Medical Oncology

Neurology

Nuclear Medicine

Paediatric Medicine

Renal Medicine

Rheumatology

Thoracic Medicine

 

204

Royal Australasian College of Surgeons, Faculty of Anaesthetists

Anaesthesia Intensive Care

Fellowship of the Faculty of Anaesthetists, Royal Australasian College of Surgeons (FFARACS)

Note   This qualification has not been awarded since 7 February 1992.

205

The Royal Australasian College of Radiologists

Note   This organisation is now called by the name specified in column 2 of item 109.

Diagnostic Radiology

Nuclear Medicine

Radiation Oncology

Fellowship of the Royal Australasian College of Radiologists (FRACR)

Note   This qualification has not been awarded since 26 October 1998.

206

The Royal Australian College of Obstetricians and Gynaecologists

Note   This organisation is now called by the name specified in column 2 of item 111.

Obstetrics and Gynaecology

Gynaecological Oncology

Maternal‑fetal Medicine

Obstetrics and Gynaecological Ultrasound

Reproductive Endocrinology and Infertility

Urogynaecology

Fellowship of the Royal Australian College of Obstetricians and Gynaecologists (FRACOG)

Note   This qualification has not been awarded since 22 October 1998.

207

The Royal Australian College of Ophthalmologists

Note   This organisation is now called by the name specified in column 2 of item 112.

Ophthalmology

Fellowship of the Royal Australian College of Ophthalmologists
(FRACO)

Note   This qualification has not been awarded since 20 December 2000.

Schedule 5        Matters specified for Register of Approved Placements

(regulations 6E and 6EA)

Part 1          Specified bodies and courses

 

Item

Body

Qualification

1

Australasian College of Dermatologists

FACD

2

Australasian College for Emergency Medicine

FACEM

3

Royal Australian College of Obstetricians & Gynaecologists

FRACOG

4

Australasian Faculty of Occupational Medicine

FACOM

5

Royal Australian College of Ophthalmologists

FRACO

6

Royal College of Pathologists of Australasia

FRCPA

7

Royal Australasian College of Physicians

FRACP
FAFOM

8

Royal Australian and New Zealand College of Psychiatrists

FRANZCP

9

Australasian Faculty of Public Health Medicine

FAFPHM

10

Royal Australasian College of Radiologists

FRACR
DRACR

11

Australasian Faculty of Rehabilitation Medicine

FAFRM

12

Royal Australasian College of Surgeons

FRACS

Part 2          Specified bodies and programs

 

Item

Body

Program

1

Queensland Department of Health

Queensland Country Relieving Program

2

RACGP

RACGP Training Program

3

Commonwealth Department of Health and Ageing

Rural Locum Relief Program

4

NSW Rural Doctors Network Ltd.

Rural Locum Relief Program

 

5

Rural Workforce Agency Victoria Ltd.

Rural Locum Relief Program

 

6

Queensland Rural Divisions Coordinating Unit Inc.

Rural Locum Relief Program

 

7

South Australian Rural and Remote Medical Support Agency Inc.

Rural Locum Relief Program

 

8

University of Western Australia — West Australian Centre for Remote and Rural Medicine

Rural Locum Relief Program

 

9

Tasmanian General Practice Divisions Inc.

Rural Locum Relief Program

 

10

NT Remote Workforce Agency Inc.

Rural Locum Relief Program

 

12

Commonwealth Department of Health and Ageing

Assistance at Operations Program

13

Australasian College of Sports Physicians

Australasian College of Sports Physicians Training Program

14

Commonwealth Department of Health and Ageing

Approved Medical Deputising Service Program

15

Australian College of Rural and Remote Medicine

Rural and Remote Area Placement Program

16

Commonwealth Department of Health and Ageing

Approved Private Emergency Department Program

17

Commonwealth Department of Health and Ageing

Temporary Resident Other Medical Practitioner Program

18

General Practice Education and Training Limited (ACN 095 433 140)

Australian General Practice Training Program

19

Commonwealth Department of Health and Ageing

Metropolitan Workforce Support Program

20

Commonwealth Department of Health and Ageing

Special Approved Placements Program

21

Commonwealth Department of Health and Ageing

Approved Placements for Sports Physicians Program

22

Australian College of Rural and Remote Medicine

Pre‑vocational General Practice Placements Program

23

Royal Australian College of General Practitioners

Pre‑vocational General Practice Placements Program

24

General Practice Education and Training Limited (ACN 095 433 140)

Pre‑vocational General Practice Placements Program

 

Part 3          Participatory eligibility programs

1              Specific Workforce Shortage Program

         (1)   This item relates to:

                (a)    the Specific Workforce Shortage Program established by the Minister for the placement of medical practitioners in locations otherwise underprovided with medical practitioners qualified to provide services in demand; and

               (b)    the associated registration of medical practitioners, under section 3GA of the Act, in the Register of Approved Placements.

         (2)   A medical practitioner who is an applicant under subsection 3GA (5) of the Act is eligible for registration if he or she:

                (a)    is awaiting:

                          (i)    recognition, by the appropriate Australian medical college, of an acquired overseas specialist qualification; or

                         (ii)    if he or she is an overseas trained doctor or former overseas medical student, within the meaning of section 19AB of the Act, who has an exemption under subsection 19AB (3) of the Act — recognition, by the Royal Australian College of General Practitioners, of his or her post‑graduate general practice qualifications; and

               (b)    because of the circumstance mentioned in paragraph (a), has been accepted for participation in the Program to provide professional services.

Schedule 6        Services for which medicare benefit is 100% of Schedule fee

(regulation 6EF)

  

 

Item

Group

Item of the general medical services table

1

A1

1, 2, 3, 4, 13, 20, 23, 24, 25, 35, 36, 37, 38, 43, 44, 47, 48, 51

2

A2

52, 53, 54, 57, 58, 59, 60, 65, 81, 83, 84, 86, 92, 93, 95, 96, 97, 98

3

A5

160, 161, 162, 163, 164

4

A6

170, 171, 172

5

A7

173, 193, 195, 197, 199

6

A11

601, 602, 697, 698

7

A14

700, 702, 704, 706, 708, 710, 712, 714, 716, 717, 718, 719

8

A15

721, 723, 725, 727, 729, 731, 734, 736, 738, 740, 742, 744, 759, 762, 765, 775, 778, 779

9

A17

900, 903

10

A18

2497, 2501, 2503, 2504, 2506, 2507, 2509, 2517, 2518, 2521, 2522, 2525, 2526, 2546, 2547, 2552, 2553, 2558, 2559, 2574, 2575, 2577, 2578

11

A19

2598, 2600, 2603, 2606, 2610, 2613, 2616, 2620, 2622, 2624, 2631, 2633, 2635, 2664, 2666, 2668, 2673, 2675, 2677, 2704, 2705, 2707, 2708

12

A20

2710, 2712, 2713, 2721, 2723, 2725, 2727

13

A22

5000, 5003, 5007, 5010, 5020, 5023, 5026, 5028, 5040, 5043, 5046, 5049, 5060, 5063, 5064, 5067

14

A23

5200, 5203, 5207, 5208, 5220, 5223, 5227, 5228, 5240, 5243, 5247, 5248, 5260, 5263, 5265, 5267

14AA

A27

4001

14A

M5

10988, 10989, 10994, 10995

15

M2

10993, 10996,10997, 10998, 10999


Notes to the Health Insurance Regulations 1975

Note 1

The Health Insurance Regulations 1975 (in force under the Health Insurance Act 1973) as shown in this compilation comprise Statutory Rules 1975 No. 80 amended as indicated in the Tables below.

All relevant information pertaining to application, saving or transitional provisions prior to 16 May 2003 is not included in this compilation. For subsequent information see Table A.

Under the Legislative Instruments Act 2003, which came into force on 1 January 2005, it is a requirement for all non‑exempt legislative instruments to be registered on the Federal Register of Legislative Instruments.  From 1 January 2005 the Statutory Rules series ceased to exist and was replaced with Select Legislative Instruments (SLI series). Numbering conventions remain the same, ie Year and Number.

Table of Instruments

Year and
number

Date of
notification
in Gazette or FRLI registration

Date of
commencement

Application, saving or
transitional provisions

1975 No. 80

16 May 1975

16 May 1975

 

1975 No. 118

13 June 1975

13 June 1975

1975 No. 125

27 June 1975

1 July 1975

1975 No. 135 (a)

3 July 1975

3 July 1975

1976 No. 202

23 Sept 1976

23 Sept 1976

1976 No. 214

30 Sept 1976

1 Oct 1976

1976 No. 215

30 Sept 1976

30 Sept 1976

1977 No. 26

15 Mar 1977

R. 2 (2): 1 Apr 1977
Remainder: 15 Mar 1977

1977 No. 44

15 Apr 1977

15 Apr 1977

1978 No. 95

29 June 1978

1 July 1978

1978 No.177

26 Sept 1978

26 Sept 1978

1979 No. 230

31 Oct 1979

31 Oct 1979

1981 No. 198

17 July 1981

25 June 1981

1981 No. 317

4 Nov 1981

1 Sept 1981

1982 No. 157

30 June 1982

1 July 1982

1982 No. 251

1 Oct 1982

1 Oct 1982

1982 No. 287

29 Oct 1982

R. 1: 1 Nov 1982
Remainder: 29 Oct 1982

1983 No. 106

22 July 1983

22 July 1983

1983 No. 231

28 Oct 1983

1 Nov 1983

1983 No. 253

31 Oct 1983

1 Feb 1984

1983 No. 255

31 Oct 1983

1 Feb 1984

1984 No. 5

26 Jan 1984

1 Mar 1984

1984 No. 162

25 July 1984

1 Mar 1984

1985 No. 36

4 Apr 1985

4 Apr 1985

1985 No. 50

29 Apr 1985

29 Apr 1985

1985 No. 95

7 June 1985

7 June 1985

1985 No. 205

29 Aug 1985

29 Aug 1985

1985 No. 290 (b)

7 Nov 1985

7 Nov 1985

1986 No. 19

21 Feb 1986

22 Feb 1986

1986 No. 20

21 Feb 1986

22 Feb 1986

1986 No. 87

9 May 1986

9 May 1986

1986 No. 326

6 Nov 1986

1 Aug 1987

1987 No. 32

6 Mar 1987

7 Mar 1987

1987 No. 163

29 July 1987

1 Aug 1987

1987 No. 166

31 July 1987

1 Aug 1987

1988 No. 314

2 Dec 1988

R. 2: 1 Aug 1987
R. 3: 1 Aug 1988
Remainder: 2 Dec 1988

1989 No. 6

31 Jan 1989

31 Jan 1989

1989 No. 54

14 Apr 1989

14 Apr 1989

1989 No. 117

21 June 1989

21 June 1989

1989 No. 293

31 Oct 1989

31 Oct 1989

1990 No. 25

13 Feb 1990

13 Feb 1990

1991 No. 82

30 Apr 1991

1 May 1991

1991 No. 314

16 Oct 1991

1 Nov 1991

1991 No. 365

27 Nov 1991

1 Dec 1991

1991 No. 441

19 Dec 1991

1 Feb 1992

1992 No. 42

28 Feb 1992

R. 6.2: 1 Apr 1992
Remainder: 1 Mar 1992

1992 No. 111

28 Apr 1992

Rr. 4‑6: 1 May 1992
Remainder: 28 Apr 1992

1992 No. 239

29 July 1992

(c)

1992 No. 335

27 Oct 1992

1 Nov 1992

1992 No. 431

24 Dec 1992

24 Dec 1992

1993 No. 106

3 June 1993

3 June 1993

1993 No. 130

17 June 1993

17 June 1993

1993 No. 154

29 June 1993

1 July 1993

1994 No. 20

18 Feb 1994

1 Mar 1994

1994 No. 27

25 Feb 1994

25 Feb 1994

1994 No. 111

29 Apr 1994

1 May 1994

1994 No. 137

23 May 1994

23 May 1994

1994 No. 138

23 May 1994

1 July 1994

R. 5

1994 No. 328

23 Sept 1994

23 Sept 1994

1994 No. 413

13 Dec 1994

13 Dec 1994

1995 No. 9

3 Feb 1995

3 Feb 1995

1995 No. 25

28 Feb 1995

28 Feb 1995

1995 No. 287

10 Oct 1995

10 Oct 1995

1995 No. 300

26 Oct 1995

1 Nov 1995

1995 No. 409

19 Dec 1995

1 Jan 1996 (see r. 1)

1996 No. 231

30 Oct 1996

1 Nov 1996

1996 No. 234

30 Oct 1996

1 Nov 1996

1996 No. 235

30 Oct 1996

1 Nov 1996

1996 No. 335

24 Dec 1996

24 Dec 1996

1996 No. 336

24 Dec 1996

1 Jan 1997

1997 No. 61

26 Mar 1997

26 Mar 1997

1997 No. 287

8 Oct 1997

8 Oct 1997

1997 No. 300

31 Oct 1997

1 Nov 1997

1997 No. 319

17 Nov 1997

17 Nov 1997

1997 No. 395

24 Dec 1997

1 Jan 1998

1998 No. 44

25 Mar 1998

1 Feb 1998

1998 No. 125

9 June 1998

1 July 1998

1998 No. 138

25 June 1998

1 July 1998

1998 No. 204

1 July 1998

1 July 1998

1998 No. 220

7 July 1998

7 July 1998

1998 No. 253

6 Aug 1998

6 Aug 1998

1998 No. 268

26 Aug 1998

1 Sept 1998

1998 No. 370

22 Dec 1998

22 Dec 1998

1998 No. 371

22 Dec 1998

22 Dec 1998

1998 No. 372

22 Dec 1998

1 Jan 1999

1999 No. 48

24 Mar 1999

24 Mar 1999

1999 No. 88

4 June 1999

4 June 1999

1999 No. 157

28 July 1999

28 July 1999

1999 No. 176

1 Sept 1999

1 Sept 1999

1999 No. 254

27 Oct 1999

1 Nov 1999

1999 No. 343

22 Dec 1999

1 Jan 2000

1999 No. 344

22 Dec 1999

1 Feb 2000

2000 No. 146

28 June 2000

28 June 2000

2000 No. 290

1 Nov 2000

1 Nov 2000

2001 No. 272

5 Oct 2001

5 Oct 2001

2001 No. 273

5 Oct 2001

5 Oct 2001

2001 No. 274

5 Oct 2001

1 Nov 2001

2001 No. 275

5 Oct 2001

1 Nov 2001

2001 No. 290

1 Dec 2001

1 Dec 2001

2001 No. 342

21 Dec 2001

21 Dec 2001

2002 No. 246

24 Oct 2002

Rr. 1–3 and Schedule 1: 1 Nov 2001
Remainder: 1 Nov 2002

2002 No. 261

6 Nov 2002

Schedule 2: (d)
Remainder: 1 Mar 1999

2003 No. 87

16 May 2003

16 May 2003

R. 4 [see Table A]

2003 No. 254

16 Oct 2003

1 Nov 2003

2003 No. 356

23 Dec 2003

23 Dec 2003

2003 No. 357

23 Dec 2003

23 Dec 2003

2004 No. 46

30 Mar 2004

30 Mar 2004

2004 No. 75

30 Apr 2004

30 Apr 2004

2004 No. 110

3 June 2004

3 June 2004

2004 No. 125

18 June 2004

18 June 2004

2004 No. 180

1 July 2004

1 July 2004

2004 No. 181

1 July 2004

1 July 2004

2004 No. 305

29 Oct 2004

1 Nov 2004

2004 No. 306

29 Oct 2004

1 Nov 2004

2004 No. 324

25 Nov 2004

25 Nov 2004

2004 No. 383

23 Dec 2004

1 Jan 2005

2005 No. 9

14 Feb 2005 (see F2005L00169)

R. 1, 2, 3 (1) and Schedule 1: 30 Apr 1997
R. 3 (2) and Schedule 2: 31 May 1997
R. 4 (1) and Schedule 3: 23 Oct 1998
R. 4 (2) and Schedule 4: 27 Oct 1998
R. 4 (3) and Schedule 5: 21 Dec 2000
R. 4 (4) and Schedule 6: 22 Feb 2002
R. 4 (5) and Schedule 7: 14 Feb 2005

2005 No. 64

27 Apr 2005 (see F2005L00938)

1 May 2005

2005 No. 128

21 June 2005 (see F2005L01451)

1 July 2005

2005 No. 207

19 Sept 2005 (see F2005L02673)

1 Oct 2005 (see r. 2)

2005 No. 236

27 Oct 2005 (see F2005L03104)

28 Oct 2005

2005 No. 237

27 Oct 2005 (see F2005L03124)

1 Nov 2005

2005 No. 286

2 Dec 2005 (see F2005L03869)

1 Jan 2006

2006 No. 69

31 Mar 2006 (see F2006L00966)

1 Apr 2006

2006 No. 84

28 Apr 2006 (see F2006L01209)

1 May 2006

2006 No. 269

20 Oct 2006 (see F2006L03311)

1 Nov 2006

2007 No. 187

29 June 2007 (see F2007L01519)

1 July 2007

(a)    Statutory Rules 1975 No. 135 was disallowed by the Senate on 4 September 1975.

(b)    Statutory Rules 1985 No. 290 was disallowed by the Senate on 10 April 1986.

(c)     Subregulation 1.1 of Statutory Rules 1992 No. 239 provides as follows:

1.1     These Regulations are taken to have commenced immediately after the commencement of Regulation 4 of Statutory Rules 1992 No. 111.

         Regulation 4 commenced on 1 May 1992.

(d)    Regulation 2 (b) of Statutory Rules 2002 No. 261 provides as follows:

(b)     on 1 September 1999, immediately before the commencement of Statutory Rules 1999 No. 176 — Schedule 2.

Table of Amendments

The amendment history of the Health Insurance Regulations 1975 after renumbering by the Health Insurance Regulations (Amendment) (1992 No. 111) appears in the Table below.

ad. = added or inserted      am. = amended      rep. = repealed      rs. = repealed and substituted

Provision affected

How affected

R. 1..........................................

rs. 1998 No. 268

R. 2..........................................

rs. 1983 No. 253

 

am. 1989 No. 54; 1991 No. 82

 

rs. 1991 No. 365

 

am. 1991 No. 441; 1992 Nos. 42 and 111; 1996 Nos. 235 and 335; 2001 No. 290; 2003 No. 87; 2005 No. 207

R. 3..........................................

ad. 1975 No. 125

 

am. 1991 No. 365; 1999 No. 157

R. 3A.......................................

ad. 2004 No. 125

 

am. 2004 No. 305; 2005 No. 286; 2006 No. 69

 

rs. 2006 No. 269

R. 4..........................................

ad. 1986 No. 20

 

rs. 2005 No. 9

R. 5..........................................

ad. 1986 No. 20

R. 6..........................................

ad. 1986 No. 20

R. 6A.......................................

ad. 1996 No. 335

R. 6B.......................................

ad. 1996 No. 335

 

am. 2005 No. 207

R. 6C.......................................

ad. 1996 No. 335

 

am. 2005 No. 207

R. 6D.......................................

ad. 1996 No. 335

 

am. 2005 No. 207

Heading to r. 6E....................

rs. 1999 No. 344

R. 6E.......................................

ad. 1996 No. 335

 

am. 1998, No. 44; 1999 No. 344

R. 6EA.....................................

ad. 1999 No. 344

 

am. 2001 No. 272

R. 6EB....................................

ad. 1999 No. 344

 

am. 2005 No. 207

R. 6EF.....................................

ad. 2004 No. 383

R. 6F.......................................

ad. 1996 No. 335

 

am. 2005 No. 207

R. 6G.......................................

ad. 1996 No. 335

R. 7..........................................

ad. 1989 No. 293

 

rep. 2001 No. 273

R. 8..........................................

ad. 1988 No. 314

 

am. 1988 No. 314

 

rep. 1994 No. 111

R. 9..........................................

ad. 1975 No. 125

R. 9A.......................................

ad. 1994 No. 413

R. 10.......................................

ad. 1991 No. 82

 

rs. 1991 No. 365

 

am. 1992 Nos. 111 and 239

 

rs. 1993 No. 130

 

am. 1993 No. 154; 1994 No. 111; 1996 No. 231; 1997 No. 300; 1998 No. 268; 1999 Nos. 157, 176 and 343; 2000 No. 290; 2002 Nos. 246 and 261; 2003 No. 254; 2004 No. 306

Heading to r. 11....................

rs. 2003 No. 87

R. 11.......................................

ad. 1991 No. 82

 

rs. 1991 No. 365

 

am. 1992 Nos. 42, 111 and 239; 1996 No. 231; 2003 No. 87

R. 12.......................................

ad. 1991 No. 82

 

rs. 1991 No. 365

 

am. 1992 Nos. 111 and 239; 1996 No. 231; 1999 No. 157

R. 12A.....................................

ad. 1996 No. 336

 

am. 1997 No. 395; 1998 No. 372; 1999 No. 343

R. 12B.....................................

ad. 2003 No. 87

R. 13.......................................

ad. 1983 No. 255

 

am. 1986 No. 19; 1987 Nos. 32 and 166; 1991 Nos. 82, 365 and 441; 1992 Nos. 42 and 431; 1995 Nos. 9, 287 and 409; 1996 Nos. 231 and 234; 1998 No. 371; 1999 No. 157; 2001 Nos. 274 and 290; 2003 No. 87; 2004 No. 46; 2005 No. 207

R. 13AA...................................

ad. 2001 No. 272

 

am. 2005 No. 207

R. 13A.....................................

ad. 1998 No. 204

 

am. 2005 No. 207

R. 13B.....................................

ad. 1998 No. 204

 

am. 2004 No. 110; 2005 No. 207

R. 14.......................................

ad. 1985 No. 36

 

am. 1985 No. 205; 1986 No. 87; 1989 No. 117; 1990 No. 25; 1991 No. 314; 1992 Nos. 111 and 335; 1994 No. 20; 1995 No. 9; 2005 No. 236; 2006 No. 84

R. 15.......................................

ad. 1975 No. 125

 

am. 1976 No. 215

R. 16.......................................

ad. 1986 No. 326

R. 16A.....................................

ad. 1994 No. 328

R. 17.......................................

ad. 1986 No. 326

R. 18.......................................

ad. 1986 No. 326

R. 19.......................................

ad. 1991 No. 82

 

am. 1996 Nos. 231 and 234

R. 20.......................................

ad. 1992 No. 42

 

am. 2001 No. 275; 2003 No. 87; 2005 No. 207

R. 20A.....................................

ad. 2003 No. 87

R. 20B.....................................

ad. 2003 No. 87

R. 20C....................................

ad. 2003 No. 87

R. 20D....................................

ad. 2003 No. 87

R. 20E.....................................

ad. 2003 No. 87

R. 20F.....................................

ad. 2003 No. 87

R. 21.......................................

ad. 1975 No. 118

 

am. 1976 No. 202

R. 22.......................................

ad. 1975 No. 118

 

am. 1976 No. 202

R. 22A.....................................

ad. 1997 No. 287

R. 23.......................................

ad. 1977 No. 44

 

rep. 1982 No. 251

 

ad. 1986 No. 20

R. 23A.....................................

ad. 1993 No. 106

R. 23B.....................................

ad. 1993 No. 106

 

am. 1994 No. 27

R. 23C....................................

ad. 1993 No. 106

R. 23D....................................

ad. 1993 No. 106

R. 23E.....................................

ad. 1993 No. 106

 

am. 1994 No. 27

R. 23F.....................................

ad. 1993 No. 106

 

am. 1994 No. 27

R. 23G....................................

ad. 1993 No. 106

 

am. 1994 No. 27

R. 24.......................................

ad. 1976 No. 202

 

rs. 1989 No. 54

 

am. 1994 No. 138

R. 25.......................................

ad. 1986 No. 20

R. 25A.....................................

ad. 1998 No. 220

R. 26.......................................

ad. 1986 No. 20

R. 27.......................................

ad. 1979 No. 230

 

am. 1983 No. 106; 1985 Nos. 50, 95 and 290

 

rs. 1992 No. 111

 

am. 1996 No. 235; 2001 No. 342; 2005 No. 207

R. 28.......................................

ad. 1992 No. 111

 

rs. 2005 No. 207

R. 29.......................................

ad. 1975 No. 125

 

am. 1976 No. 215; 1978 No. 95; 1987 No. 32

 

rs. 1991 No. 365

 

am. 1996 No. 235

R. 30.......................................

ad. 1975 No. 125

 

am. 1978 No. 177

 

rep. 1982 No. 251

 

ad. 1991 No. 365

 

am. 1995 Nos. 9 and 300

R. 31.......................................

ad. 1975 No. 125

 

am. 1976 No. 215

 

rep. 1982 No. 251

 

ad. 1991 No. 365

 

am. 1995 Nos. 9 and 300; 1996 No. 235; 1999 No. 157

Schedule 1A..........................

ad. 1996 No. 335

 

am. 1997 Nos. 61 and 319

 

rep. 1998 No. 44

Schedule................................

am. 1975 No. 118

Schedule 1

 

Heading to Schedule 1.......

ad. 1976 No. 202

Schedule 1............................

am. 1976 Nos. 202, 214 and 215; 1982 No. 251; 1992 No. 111

... Form 1................................

ad. 1975 No. 118

 

am. 1976 No. 215

... Form 2................................

ad. 1975 No. 118

 

am. 1976 No. 215

Schedule 1A

 

Schedule 1A..........................

ad. 1997 No. 287

 

rs. 1998 No. 253; 2004 No. 324

Schedule 2

 

Schedule 2............................

ad. 1976 No. 202

 

am. 1989 No. 54; 1994 No. 138

Schedule 3

 

Schedule 3............................

ad. 1979 No. 230

 

rs. 1992 No. 111

 

am. 1995 No. 25; 1996 No. 235; 2004 No. 180; 2005 No. 207

Schedule 4

 

Schedule 4............................

ad. 1986 No. 20

 

am. 1992 No. 111

 

rs. 1994 No. 137

 

am. 1998 No. 125; 1999 Nos. 157 and 254; 2005 No. 9

 

rs. 2005 No. 9

 

am. 2006 No. 69

Schedule 5

 

Heading to Schedule 5.......

rs. 1999 No. 344

Schedule 5............................

ad. 1998 No. 44

 

am. 1998 Nos. 138 and 370; 1999 Nos. 48 and 344; 2000 No. 146; 2001 Nos. 272 and 342; 2003 Nos. 356 and 357; 2004 Nos. 75 and 181

Schedule 6

 

Schedule 6............................

ad. 2004 No. 383

 

am. 2005 Nos. 64, 128 and 237; 2006 Nos. 84 and 269;
 2007 No. 187

 

Repeal Table

Certain provisions of the Health Insurance Regulations 1975, as amended, were repealed prior to renumbering by the Health Insurance Regulations (Amendment) (1992 No. 111) or by that Regulation. The amendment history of the repealed provisions appears in the Table below.

ad. = added or inserted    am. = amended     rep. = repealed     rs. = repealed and substituted

Provision affected

How affected

R. 2AA...................................

ad. 1975 No. 125

 

rep. 1982 No. 251

R. 2AAB................................

ad. 1976 No. 202

 

am. 1977 No. 26

 

rep. 1982 No. 251

R. 2AC..................................

ad. 1975 No. 125

 

am. 1987 No. 163

 

rep. 1989 No. 6

 

ad. 1991 No. 365

 

rep. 1992 No. 42

R. 2ADAA..............................

ad. 1984 No. 5

 

rep. 1992 No. 111

R. 2AE...................................

ad. 1982 No. 287

 

rep. 1992 No. 111

R. 2A.....................................

ad. 1975 No. 118

 

rs. 1976 No. 202

 

rep. 1982 No. 251

R. 2B.....................................

ad. 1975 No. 118

 

rs. 1976 No. 202

 

am. 1976 No. 214

 

rep. 1982 No. 251

R. 2C.....................................

ad. 1975 No. 118

 

rs. 1976 No. 202

 

rep. 1982 No. 251

R. 2CD..................................

ad. 1991 No. 82

 

rep. 1992 No. 42

Rr. 3, 4..................................

rs. 1976 No. 202

 

rep. 1992 No. 111

R. 4A.....................................

ad. 1981 No. 198

 

rep. 1992 No. 111

R. 5........................................

ad. 1975 No. 118

 

am. 1976 No. 202

 

rep. 1982 No. 251

Rr. 6, 7..................................

ad. 1975 No. 118

 

am. 1976 No. 202; 1982 No. 251

 

rep. 1992 No. 111

R. 7A.....................................

ad. 1976 No. 202

 

rep. 1992 No. 111

Heading to Schedule.........

rep. 1976 No. 202

Schedule 4..........................

ad. 1981 No. 198

 

am. 1981 No. 317; 1982 No. 157; 1983 No. 231; 1984 No. 5

 

rep. 1992 No. 111

Schedule 5..........................

ad. 1984 No. 5

 

rs. 1984 No. 162

 

rep. 1992 No. 111

Table A                  Application, saving or transitional provisions

Statutory Rules 2003 No. 87

4              Transitional

                The amendments made by items 6 and 7 of Schedule 1 apply only to:

                 (a)     in relation to diagnostic imaging services — services described in item 12 of Schedule 1 to the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003; and

                (b)     in relation to radiation oncology services — services described in item 13 of Schedule 2 to the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003.

Note 1   Item 12 of Schedule 1 to the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003 provides that certain amendments made by that Schedule (broadly amendments that enforce the registration provisions contained elsewhere in that Schedule) apply to diagnostic imaging services rendered using diagnostic imaging procedures carried out after the earlier of:

(a)   a day fixed by proclamation; and

(b)   the first day after the end of the period of 6 months beginning on the day on which the Act receives the Royal Assent.

Note 2   Item 13 of Schedule 2 to the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003 provides that certain amendments made by that Schedule (broadly amendments that enforce the registration provisions contained elsewhere in that Schedule) apply to radiation oncology services rendered after the earlier of:

(a)   a day fixed by proclamation; and

(b)   the first day after the end of the period of 6 months beginning on the day on which the Act receives the Royal Assent.

Renumbering Table

Table showing new Regulation numbers of the Health Insurance Regulations 1975 after renumbering by the Health Insurance Regulations (Amendment) (1992 No. 111).

Note   This Table does not form part of the Health Insurance Regulations 1975 and is printed for convenience of reference only.


Old
number

New
number

Regulation

Regulation

1

1

2

2

2AB

3

2ABA

4

2ABB

5

2ABC

6

2ABD

7

2ACA

8

2AD

9

2ADAAA

10

2ADAAB

11

2ADAAC

12

2ADA

13

2ADB

14

2CA

15

2CB

16

2CC

17

2CD

18

2CE

19

2CF

20

8

21

9

22

9AA

23

9A

24

9AB

25

9AC

26

9B

27

9C

28

10

29

11

30

12

31

Schedule 1

Schedule 1

Form 6

Form 1

Form 7

Form 2

Schedule 2

Schedule 2

Schedule 3

Schedule 3

Schedule 6

Schedule 4