This instrument is the Health Insurance Amendment (Enduring Agreements) Regulations 2026.

(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information
Column 1	Column 2	Column 3
Provisions	Commencement	Date/Details
1. The whole of this instrument	Immediately after the commencement of the Health Insurance Amendment (Assignment of Medicare Benefits and Other Measures) Regulations 2025.	1 July 2026

Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3 Authority

This instrument is made under the Health Insurance Act 1973.

4 Schedules

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1—Amendments

Health Insurance Regulations 2018

1 Section 4

Insert:

enduring agreement has the same meaning as in subsection 20A(1A) of the Act.

MyMedicare means the registration program by that name administered by the Department.

responsible person: see subsection 65CA(3).

2 Section 65B

Omit all the words from and including “must be”, substitute:

must be:

(a) an episodic agreement that meets the requirements specified in section 65C of this instrument; or

(b) an enduring agreement that meets the requirements specified in section 65CB of this instrument.

3 Subsection 65C(1)

Omit “section 65B”, substitute “paragraph 65B(a)”.

4 At the end of Subdivision B of Division 7A of Part 3

Add:

65CA Enduring agreements

(1) For the purposes of subsection 20A(1A) of the Act, this section provides for and in relation to enduring agreements.

Circumstances in which enduring agreements may be entered into

(2) An enduring agreement may be entered into by an eligible person (the assignor) in respect of one or more kinds of professional services (the agreement services) only if, at the time the agreement is entered into:

(a) the assignor is at least 14 years old; and

(b) if the professional services will be rendered to a person other than the assignor:

(i) the assignor is a responsible person for the other person; and

(ii) in the case that the other person is at least 14 years old—that person has provided a written declaration in respect of the agreement that meets the requirements of subsection (4); and

(3) An assignor is a responsible person for the other person if the assignor is:

(a) a parent, stepparent or foster parent of the other person; or

(b) a spouse or de facto partner of the other person; or

(i) at least 18 years old; and

(ii) a member of the other person’s household; or

(d) a guardian of the other person; or

(e) a person exercising an enduring power of attorney granted by the other person that is exercisable in relation to decisions about the other person’s health.

(4) For the purposes of subparagraph (2)(b)(ii), a written declaration in respect of an enduring agreement meets the requirements of this subsection if the declaration includes:

(a) the agreement of the person to the enduring agreement being entered into; and

(b) if subsection (5) applies in relation to the enduring agreement:

(i) a statement that the person understands that after each occasion on which an agreement service is rendered to the person a notification will be sent to the assignor in relation to the rendering of the service; and

(ii) the agreement of the person to such notifications being sent.

(5) This subsection applies if:

(a) the person (the patient) to whom the agreement services will be rendered is registered with MyMedicare; and

(b) the professional by whom, or on whose behalf, the agreement services will be rendered:

(i) is a medical practitioner (except a consultant physician, or a specialist, in a particular speciality other than general practice); and

(ii) is registered with MyMedicare at the practice (the agreement location) at which the patient is registered with MyMedicare; and

(d) the agreement only covers agreement services to be rendered at or from the agreement location; and

(e) a provider number that is allocated to the professional identifies the agreement location as a place where the professional practices the professional’s profession; and

(f) if any other enduring agreements are in effect in respect of the patient—each of those agreements only cover professional services to be rendered to the patient at or from the agreement location for an enduring agreement to which this subsection, or subsection (6A), applies.

(6) This subsection applies if:

(a) the person (the patient) to whom the agreement services will be rendered is a patient of an Aboriginal Community Controlled Health Organisation or an Aboriginal Medical Service (the relevant ACCHO/AMS); and

(b) the agreement is to be entered into with an agent of the relevant ACCHO/AMS; and

(i) at or from the practices or clinics (collectively, the agreement location) the patient may attend as a patient of the relevant ACCHO/AMS; and

(ii) by each professional employed by the relevant ACCHO/AMS, from time to time, to render services at or from the agreement location; and

(d) if any other enduring agreements are in effect in respect of the patient—each of those agreements only cover professional services to be rendered to the patient at or from the agreement location for an enduring agreement to which this subsection, or subsection (6A), applies.

(6A) This subsection applies if:

(a) the person (the patient) to whom the agreement services will be rendered is in a residential care home (within the meaning of the Aged Care Act 2024); and

(b) the professional by whom, or on whose behalf, the agreement services will be rendered is a medical practitioner (except a consultant physician, or a specialist, in a particular speciality other than general practice); and

(c) the agreement only covers agreement services to be rendered at or from the following places (collectively, the agreement location):

(i) the residential care home;

(ii) a practice or clinic in relation to which the professional has been allocated a provider number that identifies that practice or clinic as a place where the professional practices the professional’s profession.

Termination of enduring agreements

(7) An enduring agreement may be terminated at any time by a written notice given by:

(a) a party to the agreement to the other party; or

(b) the patient to the party to the agreement who is not the assignor.

Circumstances in which enduring agreements cease to be in effect

(8) An enduring agreement ceases to be in effect as follows:

(a) if subsection (5) applied in relation to the agreement at the time the agreement was entered into—when a circumstance mentioned in paragraph (5)(a), (b), (e) or (f) ceases to exist in relation to the agreement;

(b) if subsection (6) applied in relation to the agreement at the time the agreement was entered into—when a circumstance mentioned in paragraph (6)(a) or (d) ceases to exist in relation to the agreement;

(ba) if subsection (6A) applied in relation to the agreement at the time the agreement was entered into—when a circumstance mentioned in paragraph (6A)(a) ceases to exist in relation to the agreement;

(c) if the patient is not a party to the agreement, and was under 14 years old at the time the agreement was entered into—when the patient turns 14 years old;

(d) if the agreement is terminated in accordance with subsection (7)—when the agreement is terminated;

(e) if the agreement is entered into on or before 30 June 2027 and is not registered with Services Australia before the first anniversary of the day the agreement is entered into—when the agreement has been in effect for 12 months.

(9) To avoid doubt for the purposes of paragraph (8)(ba), a circumstance mentioned in paragraph (6A)(a) does not cease to exist in relation to an agreement if the patient is temporarily admitted for hospital treatment.

65CB Requirements for enduring agreements

(1) For the purposes of paragraph 65B(b), this section specifies the requirements that must be met in relation to an enduring agreement.

(2) Before or at the time the assignor enters into the enduring agreement, the other party to the agreement must ensure that the assignor is given the following information, in writing:

(a) that the agreement is an enduring agreement;

(b) the name of the person (the patient) to whom professional services covered by the agreement will be rendered;

(c) a description of the kinds of professional services covered by the agreement that is sufficient to identify the items in the table that specify the services;

(d) if subsection 65CA(5) applies in relation to the agreement:

(i) the name of the professional and the address of the agreement location referred to in that subsection; or

(ii) the provider number allocated to the professional that identifies the agreement location as a place where the professional practices the professional’s profession;

(e) if subsection 65CA(6) applies in relation to the agreement:

(i) the name of the agent referred to in that subsection; and

(ii) a provider number allocated to a professional that identifies at least one of the practices or clinics mentioned in subparagraph 65CA(6)(c)(i) as a place where the professional practices the professional’s profession;

(ea) if subsection 65CA(6A) applies in relation to the agreement:

(i) the name of the professional and the address or addresses of the agreement location referred to in that subsection; or

(ii) a provider number allocated to the professional that identifies at least one of the practices or clinics mentioned in subparagraph 65CA(6A)(c)(ii) as a place where the professional practices the professional’s profession;

(f) the method by which written notifications will be provided to the assignor under section 89AA in respect of professional services covered by the agreement;

(g) how the parties to the agreement, or the patient, may terminate the agreement.

(3) Without limiting paragraph (2)(c), kinds of professional services may be described by reference to the Groups or Subgroups of the table that include the items that specify the services.

(4) The information mentioned in paragraph (2)(f) may be given by providing an electronic link or website address to the assignor that the assignor can use to access the information.

(5) The enduring agreement must:

(a) include the information that was required to be given to the assignor in accordance with subsection (2); and

(b) include the name of the assignor; and

(d) if the assignor is not the patient—specify how the assignor is a responsible person for the patient; and

(e) if subparagraph 65CA(2)(b)(ii) applies in relation to the agreement—include the written declaration mentioned in that subparagraph; and

(f) be a written document; and

(g) be signed and dated by the assignor; and

(h) if the agreement is entered into on or after 1 July 2027—be registered with Services Australia.

5 Section 89A

Repeal the section, substitute:

89AA Enduring agreements—notification requirements

Scope

(1) This section is made for the purposes of paragraph 127(2)(c) of the Act.

(2) Paragraph 127(2)(e) of the Act applies in relation to this section.

Requirement to notify assignor of claim for payment of medicare benefit

(3) A professional must give a notification in accordance with subsection (4) or (5) (as applicable) to a person (the assignor) if:

(a) the professional has entered into an enduring agreement with the assignor; and

(b) subsection 65CA(5) applies in relation to the agreement; and

(c) a claim is made for the payment of medicare benefit in respect of the rendering of a professional service covered by the agreement.

(4) Within 24 hours after the professional makes such a claim (including a new claim made in substitution of an earlier claim), the professional must give notification of the making of the claim.

(5) Within 24 hours after the professional becomes aware of an error in a notification given under subsection (4), the professional must give a notification correcting the error.

(6) A notification under subsection (4) or (5) must include the following:

(a) the name of the professional;

(b) the person to whom the professional service was rendered;

(d) the amount of the medicare benefit claimed.

Requirement to notify assignor of intention to terminate enduring agreement

(7) If a professional intends to terminate an enduring agreement entered into with a person (the assignor), the professional must, at least 2 days before terminating the agreement, give the assignor notification of the intention to terminate the agreement.

Manner and form of notification

(8) A notification under this section must:

(a) be in writing; and

(b) include the date on which it is made; and

89A Record‑keeping

(1) This section specifies kinds of records that must be kept by a relevant person for the purposes of subsection 127A(1) of the Act.

Note: A relevant person may be a professional mentioned in subsection 20A(1) of the Act, an insurer or an approved billing agent.

Enduring agreements

(2) The following kinds of records are specified in relation to an enduring agreement:

(a) the enduring agreement (or copy);

(b) if the enduring agreement is not signed by the relevant person—any documents (or copies) that record the consent of the relevant person to:

(i) enter into the enduring agreement; and

(ii) the enduring agreement covering the kinds of professional services described in the agreement;

(c) any written notifications (or copies) given under section 89AA in relation to professional services covered by the enduring agreement;

(d) a written notice (or copy) that terminates the enduring agreement.

Episodic agreements

(3) The kind of record that is specified in relation to an episodic agreement in respect of which a claim for a medicare benefit assigned to the relevant person is made under section 20B of the Act is the episodic agreement (or copy).