Health Insurance (Professional Services Review) Amendment Regulations 1999 (No. 1) (Cth)

Health Insurance (Professional Services Review) Amendment Regulations 1999 (No. 1)

Statutory Rules 1999 No. 346

I, WILLIAM PATRICK DEANE, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under theHealth Insurance Act 1973.

Dated 15 December 1999.

WILLIAM DEANE

Governor-General

By His Excellency’s Command,

MICHAEL WOOLDRIDGE

Minister for Health and Aged Care

Health Insurance (Professional Services Review) Amendment Regulations 1999 (No. 1)1

Statutory Rules 1999 No. 3462

made under the

Health Insurance Act 1973

   

Contents

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1Name of Regulations

 These Regulations are the Health Insurance (Professional Services Review) Amendment Regulations 1999 (No. 1).

2Commencement

 These Regulations commence on 1 January 2000.

3Amendment of Health Insurance (Professional Services Review) Regulations 1999

 Schedule 1 amends the Health Insurance (Professional Services Review) Regulations 1999.

Schedule 1Amendments

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(regulation 3)

[1]Regulation 3, note

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Note

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Note 1

[2]Regulation 3, after the note

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Note 2    The expressions Committee, inappropriate practice, person under review, profession, referred services and service are defined in s 81 of the Act.

[3]After Part 2

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Part 3Prescribed pattern of services

7Definition

 For this Part:

professional attendance means a service of a kind mentioned in group A1, A2, A5, A6, A7, A13, A14 or A15 of Part 2 of the general medical services table.

Note    The expressions general medical services table, general practitioner and medical practitioner are defined in s 3 of the Act.

8Purpose of this Part

 This Part prescribes the circumstances in which referred services constitute a prescribed pattern of services for Part VAA of the Act.

Note   Section 106KA of the Act provides that conduct of a person under review in connection with rendering or initiating services that constitute a prescribed pattern of services may be taken to be inappropriate practice.

9Practitioners affected by these Regulations

 For subsection 106KA (3) of the Act, the following groups of practitioners in theprofession of medicine are groups to which these Regulations apply:

• (a)

  general practitioners;

• (b)

  other medical practitioners rendering professional attendances.

10Circumstances constituting a prescribed pattern

 The circumstance in which services that are professional attendances constitute a prescribed pattern of services is that 80 or more such services are rendered on each of 20 or more days in a 12 month period.

11Exceptional circumstances

 For subsection 106KA (5) of the Act, the following circumstances are declared as constituting exceptional circumstances:

• (a)

  an unusual occurrence causing an unusual level of need for professional attendances;

• (b)

  an absence of other medical services, for patients of the person under review during the relevant period, having regard to:

  • (i)

    the location of the practice of the person under review; and

  • (ii)

    characteristics of the patients of the person under review.

Note Forrelevant period, see s 106KA of the Act.

Notes

1. These Regulations amend Statutory Rules 1999 No. 258.

2. Made by the Governor-General on 15 December 1999, and notified in the Commonwealth of Australia Gazette on 22 December 1999.