Health Insurance (Pathology Services) Regulations (Amendment) (Cth)

Statutory Rules 1996

No. 236 1

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Health Insurance (Pathology Services) Regulations 2(Amendment)

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

Dated 23 October 1996.

 WILLIAM DEANE

 Governor-General

By His Excellency’s Command,

MICHAEL WOOLDRIDGE

Minister for Health and Family Services

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1.   Commencement

1.1   These Regulations commence on 1 November 1996.

2.   Amendment

2.1   The Health Insurance (Pathology Services) Regulations are amended as set out in these Regulations.

3.   Regulation 4 (Requests for pathology services)

3.1   Subregulation 4 (6):

Add at the end:

• “(d)

  if the requesting practitioner forms an opinion in accordance with subregulation (6B) that the requested pathology service is a hospital-related service within the meaning of subregulation (6A)—the letter ‘A’.”.

3.2   After subregulation 4 (6), insert :

 “(6A) In paragraph (6) (d):

‘hospital-related service’ means:

• (a)

  a pathology 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 pathology 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 provision of the service; or

• (c)

  a pathology 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 pathology 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 that service.

 “(6B) In forming the opinion mentioned in paragraph (6) (d), the practitioner must have regard to the nature of the requested pathology service and all 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.”.

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NOTES

1. Notified in the Commonwealth of Australia Gazette on 30 October 1996.

2. Statutory Rules 1989 No. 75.