Health Insurance Regulations 1975

No longer in force

Administered by

Department of Health, Disability and Ageing

This item is authorised by the following title:

Health Insurance Act 1973

Superseded version

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F2014C00243

18 March 2014 - 31 October 2014

This instrument was backcaptured in accordance with Section 36 of the Legislative Instruments Act 2003. For transitional provisions relating to the repeal of this instrument, see section 103 of the Health Insurance Regulations 2018

Table of contents

1 Name of Regulations
2 Interpretation
2A General practitioners
2B Specified medical practitioners
2C Collaborative arrangements—participating midwives
2D Agreement between eligible midwife and 1 or more specified medical practitioners
2E Arrangement—midwife’s written records
2EA Arrangement—midwife credentialed for a hospital
2F Collaborative arrangements—participating nurse practitioners
2G Agreement between eligible nurse practitioner and 1 or more specified medical practitioners
2H Arrangement—nurse practitioner’s written records
3 Professional services
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
11A Pathology services determined to be necessary by participating midwives and participating nurse practitioners
11B Diagnostic imaging services that participating midwives and participating nurse practitioners 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))
13AB Payment to specialists or consultant physicians by electronic transmission (Act s 20(5))
13AC Manner of electronic claim (Act s 20(6))
13B Application for approval as billing agent
14 Medicare benefit not payable in respect of certain professional services
14A Eligibility requirements for midwives
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
18A Branded Pathology Request Form
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
20CA Method for determining substantial difference from market value
20CB Method for determining market value
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 Manner of patient referrals
30 Referrals: special cases
31 Period of validity for referrals
Schedule 1—Forms
- Form 1—Application for approval as an organization under Part IV
- Form 2—Application for approval of a health service
Schedule 1A—Bodies to which information in the Australian Childhood Immunisation Register may be given
- Part 1—New South Wales
  - Division 1—Divisions of General Practice
  - Division 2—Other Bodies
- Part 2—Victoria
  - Division 1—Divisions of General Practice
  - Division 2—Other Bodies
- Part 3—Queensland
  - Division 1—Divisions of General Practice
  - Division 2—Other Bodies
- Part 4—Western Australia
  - Division 1—Divisions of General Practice
  - Division 2—Other Bodies
- Part 5—South Australia
  - Division 1—Divisions of General Practice
  - Division 2—Other Bodies
- Part 6—Tasmania
  - Division 1—Divisions of General Practice
  - Division 2—Other Bodies
- Part 7—Australian Capital Territory
  - Division 1—Division of General Practice
  - Division 2—Other Bodies
- Part 8—Northern Territory
  - Division 1—Divisions of General Practice
  - Division 2—Other Bodies
Schedule 2—Witnesses’ allowances for travelling and other expenses
Schedule 3—Prescribed authorities and persons—subsection 130(3A) of the Act
- Part 1—Interpretation of Schedule
- Part 2—Prescribed persons of the Commonwealth: Department of Veterans’ Affairs, Executive Officers
- Part 3—Prescribed persons of the Commonwealth: Department of Veterans’ Affairs, Health Program
- Part 4—Prescribed authority and persons of New South Wales
- Part 5—Prescribed authorities of other States and Territories
Schedule 4—Relevant organisations and qualifications
- Part 1—Current organisations and qualifications
- Part 2—Former organisations and qualifications
Schedule 5—Matters specified for Register of Approved Placements
- Part 1—Specified bodies and qualifications
- Part 2—Specified bodies and programs
- Part 3—Participatory eligibility programs
Schedule 6—Services for which medicare benefit is 100% of Schedule fee
- Endnotes

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Health Insurance Regulations 1975

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Health Insurance Regulations 1975