Statutory Rules 1994   No. 4041

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Health Insurance Commission Regulations2 (Amendment)

I, The Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Commission Act 1973.

Dated 6 December 1994.

 BILL HAYDEN

 Governor-General

By His Excellency’s Command,

CARMEN LAWRENCE

Minister for Human Services and Health

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1.   Amendment

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

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

2.   New regulation 3P

2.1   After regulation 3N, insert:

Additional functions of the Commission: the Better Practice Program

 “3P. (1) For the purposes of subsection 8E (1) of the Act, the following functions are prescribed:

 (a) to receive and process applications, in the form approved by the Commission, from the nominated persons in respect of a general medical practice for the participation of the general medical practice in the Department’s Better Practice Program (‘the Program’);

 (b) to make decisions:

 (i) on the eligibility of general medical practices, in relation to which applications of that kind that are lodged with the Commission, to participate in the Program; and

 (ii) to make decisions concerning the amount payable from time to time to each general medical practice participating in the Program;

 (c) to make payments, on behalf of the Commonwealth, in accordance with decisions under subparagraph (b) (ii);

 (d) to provide information in writing to the Minister in relation to the Commission’s performance of the functions stated in paragraphs (a) and (b);

 (e) the functions mentioned in subregulations (3), (4) and (5).

 “(2) In performing its function of making decisions under paragraph (1) (b), the Commission must:

 (a) make the decisions in accordance with the relevant criteria stated in the document known as ‘Eligibility Criteria and Payment Arrangements for the Better Practice Program, 1994-95’ published by the Department in November 1994; and

 (b) promptly on making each decision give a notice of the decision to the nominated persons who lodged the application to which the decision relates, being a notice that contains:

 (i) the terms of the decision; and

 (ii) statements to the effect that:

 (A) a copy of the reasons for the decision may be obtained from the Commission on request in writing; and

 (B) application may be made under subregulation (3) for internal review of the decision.

 “(3) Application may be made, in respect of a general medical practice affected by a decision under paragraph (1) (b), for internal review of the decision by lodging with the Commission, within 28 days of receipt of the notice in respect of the decision, a notice in writing that states:

 (a) the general medical practice, and the decision, to which the application relates; and

 (b) the name and address of the person lodging the application; and

 (c) the grounds of the application.

 “(4) On receiving an application lodged in accordance with subregulation (3) for review of a decision, the Commission must:

 (a) review the decision in accordance with the criteria mentioned in paragraph (2) (a); and

 (b) consistently with that review, make a decision (a ‘reconsidered decision’) that:

 (i) affirms the decision under review; or

 (ii) replaces the decision under review.

 “(5) Where the Commission makes a reconsidered decision, the Commission must promptly give a notice of the decision to the person or persons who lodged the application to which the decision relates, being a notice that contains:

 (a) the terms of the decision; and

 (b) statements to the effect that:

 (i) a copy of the reasons for the decision may be obtained from the Commission on request in writing; and

 (ii) application may be made under subregulation (7) for review of the decision by the Administrative Appeals Tribunal.

 “(6) The validity of a decision under paragraph (1) (b) or a reconsidered decision is not affected by failure to include in a notice in respect of the decision:

 (a) in the case of a decision under paragraph (1) (b)—a statement of the kind referred to in sub-subparagraph (2) (b) (ii) (A) or (B); or

 (b) in the case of a reconsidered decision—a statement of the kind referred to in subparagraph (5) (b) (i) or (ii).

 “(7) Application may be made under the Administrative Appeals Tribunal Act 1975 to the Administrative Appeals Tribunal for review of a reconsidered decision.

 “(8) An application under subregulation (3) or (7) may only be made by the proprietors of the relevant general medical practice or their authorised representative (who need not be a medical practitioner).”.

3.   Regulation 4A (Modification of Part V of the Act)

3.1   Omit “3H and 4:”, substitute “3H, 3P and 4:”.

3.2   Paragraph 4A (a):

Omit from inserted paragraph 32A (1) (c) “3G and 3H”, substitute “3G, 3H and 3P”.

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NOTES

1. Notified in the Commonwealth of Australia Gazette on 8 December 1994.

2. Statutory Rules 1975 No. 27 as amended by 1976 Nos. 21 and 146: 1982 No. 249: 1983 Nos. 88 and 152; Act No. 54, 1983; Statutory Rules 1984 No. 321; 1985 Nos. 41 and 70; 1986 No. 127; 1987 No. 165; 1989 Nos. 55, 96 and 195; 1991 No. 443; 1992 No. 241; 1993 Nos. 81, 89, 197 and 217; 1994 Nos. 102 and 257.