Health Insurance Regulations 1975 (Cth)

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Health Insurance Regulations 1975

Statutory Rules No. 80, 1975

made under the

Health Insurance Act 1973

Compilation No. 89

Compilation date: 1 July 2018

Includes amendments up to: F2018L00768

Registered: 27 July 2018

About this compilation

This compilation

This is a compilation of the Health Insurance Regulations 1975 that shows the text of the law as amended and in force on 1 July 2018 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register ( The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self‑repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

      

Contents

  Part 1General  1Name of Regulations

 These Regulations are the Health Insurance Regulations 1975.

2Interpretation
  • (1)

    In these Regulations:

    ACRRM means the Australian College of Rural and Remote Medicine.

    Appeal Committee means the General Practice Recognition Appeal Committee established under the Health Insurance (Vocational Registration of General Practitioners) Regulations.

    approved collection centre has the same meaning as in Part IIA of the Act.

    collaborative arrangement:

    • (a)

      for a participating midwife—means a collaborative arrangement mentioned in regulation 2C; or

    • (b)

      for a participating nurse practitioner—means a collaborative arrangement mentioned in regulation 2F.

    Complaints Unit means the Complaints Unit of the Department of Health of New South Wales.

    Health Departmentmeans the Department administered by the Minister responsible for administering these regulations.

    identification number, in relation to a licensed collection centre, means the identification number allocated to the centre under section 23DNF of the Act.

    investigation means:

    • (a)

      in relation to the Chief Executive Medicare—the investigation by the Chief Executive Medicare of:

      • (i)

        a contravention, or possible contravention, of the Act or these regulations; or

      • (ii)

        the provision, or possible provision, of:

        • (A)

          excessive pathology services; or

        • (B)

          services that are excessive services within the meaning of Division 3 or 3A of Part V of the Act; or

    • (b)

      in relation to the Complaints Unit—the investigation by the Unit of a complaint under the Medical Practitioners Act 1938 of New South Wales.

    (K) item means an item of the diagnostic imaging services table that includes the symbol (K) at the end of the item.

    Medical Board means an authority specified in Part 4 or 5 of Schedule 3.

    National Law means the Health Practitioner Regulation National Law set out in the Schedule to the Health Practitioner Regulation National Law Act 2009 (Qld).

    (NK) item means an item of the diagnostic imaging services table that includes the symbol (NK) at the end of the item.

    Nursing and Midwifery Board means the Nursing and Midwifery Board of Australia established under section 31 of the National Law.

    obstetrician means a medical practitioner who is a specialist in the specialty of obstetrics and gynaecology (however described).

    obstetric specified medical practitioner means a medical practitioner mentioned in paragraph 2B(1)(a) or (b).

    paediatrician means a medical practitioner who is a specialist in the specialty of paediatrics and child health (however described).

    patient episode means a pathology service, or pathology services whether listed in 1 or more items in the Pathology Services Table, for a single patient whose need for which was determined under subsection 16A(1) of the Act on the same day, whether rendered by 1 or more approved pathology practitioners on 1 or more days.

    provider number means the number that:

    • (a)

      is allocated by the Chief Executive Medicare to a practitioner, approved pathology practitioner, optometrist, participating midwife or participating nurse practitioner; and

    • (b)

      identifies the person and the places where the person practises his or her profession.

    RACGP means the Royal Australian College of General Practitioners.

    referring practitioner, in relation to a referral, means:

    • (a)

      in the case of all referrals—a medical practitioner; and

    • (b)

      if the referral is given to a specialist who is an ophthalmologist—an optometrist; and

    • (c)

      if the referral:

      • (i)

        arises out of a dental service given by a dental practitioner; and

      • (ii)

        is to a specialist (but not a consultant physician):

     a dental practitioner; and

    • (d)

      if the referral:

      • (i)

        arises out of a midwifery service provided by a participating midwife; and

      • (ii)

        is to an obstetrician or paediatrician;

     a participating midwife; and

    • (e)

      if the referral:

      • (i)

        arises out of a nurse practitioner service provided by a participating nurse practitioner; and

      • (ii)

        is to a specialist or consultant physician;

     a participating nurse practitioner.

    requester number means the identification number allocated by the Chief Executive Medicare to a chiropractor, osteopath, physiotherapist or podiatrist.

    servicing provider means a treatment provider rendering treatment on behalf of another treatment provider.

    specified medical practitioner:

    • (a)

      for a participating midwife—means a medical practitioner mentioned in regulation 2B; or

    • (b)

      for a participating nurse practitioner—means a medical practitioner mentioned in regulation 2F.

    the Act means the Health Insurance Act 1973.

    treatment provider means:

    • (a)

      a practitioner; or

    • (b)

      an approved pathology practitioner; or

    • (c)

      an optometrist; or

    • (d)

      a participating midwife; or

    • (e)

      a participating nurse practitioner.

    upgraded, for equipment, has the meaning given by the diagnostic imaging services table.

    usual general practitioner, for a patient, includes a medical practitioner nominated by the patient.

    Note: Several other words and expressions used in these Regulations have a meaning given by subsection 3(1) of the Act. For example:

    · consultant physician

    · eligible midwife

    · eligible nurse practitioner

    · general practitioner

    · hospital‑substitute treatment

    · hospital treatment

    · medical practitioner

    · midwife

    · nurse practitioner

    · participating midwife

    · participating nurse practitioner

    · practitioner

    · private health insurer

    · specialist.

     (2) For subsection 3(20) of the Act, specialist trainee means a medical practitioner who is enrolled in and undertaking a training program with a medical college, within the meaning of section 3GC of the Act.

2AGeneral practitioners

 For paragraph (c) of the definition of general practitioner in subsection 3(1) of the Act, a medical practitioner for whom a determination is in force under regulation 6DA recognising that he or she meets fellowship standards of the ACRRM is specified.

2BSpecified medical practitioners
  • (1)

    For the definition of participating midwife in subsection 3(1) of the Act, the following kinds of medical practitioner are specified:

    • (a)

      an obstetrician;

    • (b)

      a medical practitioner who provides obstetric services;

    • (c)

      a medical practitioner employed or engaged by a hospital authority and authorised by the hospital authority to participate in a collaborative arrangement.

  • (2)

    For the definition of participating nurse practitioner in subsection 3(1) of the Act, all kinds of medical practitioner are specified.

  • (3)

    In this regulation:

    hospital authority has the meaning given by subsection 84(1) of the National Health Act 1953.

2CCollaborative arrangements – participating midwives
  • (1)

    For the definition of participating midwife in subsection 3(1) of the Act, each of the following is a kind of collaborative arrangement for an eligible midwife:

    • (a)

      an arrangement under which the midwife:

      • (i)

        is employed or engaged by one or more obstetric specified medical practitioners, or by an entity that employs or engages one or more obstetric specified medical practitioners; or

      • (ii)

        has an agreement, in writing, with an entity, other than a hospital, that employs or engages one or more obstetric specified medical practitioners;

    • (b)

      a patient is referred in writing to the midwife for midwifery treatment by a specified medical practitioner;

    • (c)

      an agreement mentioned in regulation 2D for the midwife;

    • (d)

      an arrangement mentioned in regulation 2E for the midwife;

    • (e)

      an arrangement mentioned in regulation 2EA for the midwife.

  • (2)

    For subregulation (1), the arrangement must provide for:

    • (a)

      consultation between the midwife and an obstetric specified medical practitioner; and

    • (b)

      referral of a patient to a specified medical practitioner; and

    • (c)

      transfer of a patient’s care to an obstetric specified medical practitioner.

  • (3)

    A collaborative arrangement, other than an arrangement mentioned in regulation 2E, may apply to more than 1 patient.

  • (4)

    However, an acknowledgement mentioned in paragraph 2E(1)(c) may apply for more than 1 patient.

  • (5)

    To avoid doubt, a collaborative arrangement may involve a specified medical practitioner who is in private practice or in the public sector.

2DAgreement between eligible midwife and 1 or more specified medical practitioners
  • (1)

    An agreement may be made between:

    • (a)

      an eligible midwife; and

    • (b)

      1 or more specified medical practitioners.

  • (2)

    The agreement must be in writing and signed by the eligible midwife and the other parties mentioned in paragraph (1)(b).

2EArrangement – midwife’s written records
  • (1)

    An eligible midwife must record the following for a patient in the midwife’s written records:

    • (a)

      the name of at least 1 specified medical practitioner who is, or will be, collaborating with the midwife in the patient’s care (a named medical practitioner);

    • (b)

      that the midwife has told the patient that the midwife will be providing midwifery services to the patient in collaboration with 1 or more specified medical practitioners in accordance with this regulation;

    • (c)

      acknowledgement by a named medical practitioner that the practitioner will be collaborating in the patient’s care;

    • (d)

      plans for the circumstances in which the midwife will do any of the following:

      • (i)

        consult with an obstetric specified medical practitioner;

      • (ii)

        refer the patient to a specified medical practitioner;

      • (iii)

        transfer the patient’s care to an obstetric specified medical practitioner.

  • (2)

    The midwife must also record the following in the midwife’s written records:

    • (a)

      any consultation or other communication between the midwife and an obstetric specified medical practitioner about the patient’s care;

    • (b)

      any referral of the patient by the midwife to a specified medical practitioner;

    • (c)

      any transfer by the midwife of the patient’s care to an obstetric specified medical practitioner;

    • (d)

      when the midwife gives a copy of the hospital booking letter (however described) for the patient to a named medical practitioner—acknowledgement that the named medical practitioner has received the copy;

    • (e)

      when the midwife gives a copy of the patient’s maternity care plan prepared by the midwife to a named medical practitioner—acknowledgement that the named medical practitioner has received the copy;

    • (f)

      if the midwife requests diagnostic imaging or pathology services for the patient—when the midwife gives the results of the services to a named medical practitioner;

    • (g)

      that the midwife has given a discharge summary (however described) at the end of the midwife’s care for the patient to:

      • (i)

        a named medical practitioner; and

      • (ii)

        the patient’s usual general practitioner.

2EAArrangement – midwife credentialed for a hospital
  • (1)

    For paragraph 2C(1)(e), in relation to a hospital, an eligible midwife is:

    • (a)

      credentialed to provide midwifery services after successfully completing a formal process to assess the midwife’s competence, performance and professional suitability; and

    • (b)

      given clinical privileges for a defined scope of clinical practice for the hospital; and

    • (c)

      permitted to provide midwifery care to his or her own patients at the hospital.

  • (2)

    The hospital must employ or engage one or more obstetric specified medical practitioners.

2FCollaborative arrangements – participating nurse practitioners
  • (1)

    For the definition of participating nurse practitioner in subsection 3(1) of the Act, each of the following is a kind of collaborative arrangement for an eligible nurse practitioner:

    • (a)

      the nurse practitioner is employed or engaged by 1 or more specified medical practitioners, or by an entity that employs or engages 1 or more specified medical practitioners;

    • (b)

      a patient is referred in writing to the nurse practitioner for treatment by a specified medical practitioner;

    • (c)

      an agreement mentioned in regulation 2G for the nurse practitioner;

    • (d)

      an arrangement mentioned in regulation 2H for the nurse practitioner.

  • (2)

    For subregulation (1), the arrangement must provide for:

    • (a)

      consultation between the nurse practitioner and a medical practitioner; and

    • (b)

      referral of a patient to a medical practitioner; and

    • (c)

      transfer of a patient’s care to a medical practitioner.

  • (3)

    A collaborative arrangement, other than an arrangement mentioned in regulation 2H, may apply to more than 1 patient.

  • (4)

    However, an acknowledgement mentioned in paragraph 2H(1)(c) may apply for more than 1 patient.

2GAgreement between eligible nurse practitioner and 1 or more specified medical practitioners
  • (1)

    An agreement may be made between:

    • (a)

      an eligible nurse practitioner; and

    • (b)

      1 or more specified medical practitioners.

  • (2)

    The agreement must be in writing and signed by the eligible nurse practitioner and the other parties mentioned in paragraph (1)(b).

2HArrangement – nurse practitioner’s written records
  • (1)

    An eligible nurse practitioner must record the following for a patient in the nurse practitioner’s written records:

    • (a)

      the name of at least 1 specified medical practitioner who is, or will be, collaborating with the nurse practitioner in the patient’s care (a named medical practitioner);

    • (b)

      that the nurse practitioner has told the patient that the nurse practitioner will be providing services to the patient in collaboration with 1 or more specified medical practitioners in accordance with this regulation;

    • (c)

      acknowledgement by a named medical practitioner that the practitioner will be collaborating in the patient’s care;

    • (d)

      plans for the circumstances in which the nurse practitioner will do any of the following:

      • (i)

        consult with a medical practitioner;

      • (ii)

        refer the patient to a medical practitioner;

      • (iii)

        transfer the patient’s care to a medical practitioner;

    • (e)

      any consultation or other communication between the nurse practitioner and a medical practitioner about the patient’s care;

    • (f)

      any transfer by the nurse practitioner of the patient’s care to a medical practitioner;

    • (g)

      any referral of the patient by the nurse practitioner to a medical practitioner;

    • (h)

      if the nurse practitioner gives a copy of a document mentioned in subregulation (2) or (3) to a named medical practitioner—when the copy is given;

    • (i)

      if the nurse practitioner gives a copy of a document mentioned in subregulation (4) or (5) to the patient’s usual general practitioner—when the copy is given.

  • (2)

    If the nurse practitioner refers the patient to a specialist or consultant physician, or if the nurse practitioner requests diagnostic imaging or pathology services for the patient, the nurse practitioner must give a copy of the referral, or the results of the services, to a named medical practitioner if:

    • (a)

      the nurse practitioner:

      • (i)

        consults with the named medical practitioner; or

      • (ii)

        refers the patient to the named medical practitioner; or

      • (iii)

        transfers the patient’s care to the named medical practitioner; and

    • (b)

      the named medical practitioner asks the nurse practitioner for a copy of the referral or results.

  • (3)

    Also, the nurse practitioner must give a named medical practitioner a record of the services provided by the nurse practitioner to the patient if:

    • (a)

      the nurse practitioner:

      • (i)

        consults with the named medical practitioner; or

      • (ii)

        refers the patient to the named medical practitioner; or

      • (iii)

        transfers the patient’s care to the named medical practitioner; and

    • (b)

      the named medical practitioner asks the nurse practitioner for the record.

  • (4)

    If the nurse practitioner refers the patient to a specialist or consultant physician, or requests diagnostic imaging or pathology services for the patient, and the patient’s usual general practitioner is not a named medical practitioner, the nurse practitioner must give a copy of the referral, or the results of the services, to the patient’s usual general practitioner.

  • (5)

    Also, if the patient’s usual general practitioner is not a named medical practitioner, the nurse practitioner must give the patient’s usual general practitioner a record of the services provided by the nurse practitioner to the patient.

  • (6)

    However, subregulations (4) and (5) apply only if the patient consents.

3Professional services
  • (1)

    Each medical service described in items 51700 to 53460 of the general medical services table is prescribed for paragraph (b) of the definition of professional service in subsection 3(1) of the Act.

  • (2)

    Each professional service described in the following items of the general medical services table is prescribed for subsection 3(18) of the Act:

    • (a)

      items 13015 to 16018;

    • (b)

      items 16600 to 16636;

    • (c)

      items 18213 to 18298

    • (d)

      items 20100 to 51318.

3AHealth services not specified in an item (Act s 3C)

 For paragraph (b) of the definition of health service in subsection 3C(8) of the Act, a service is prescribed if it is a service of a kind mentioned in the following table.

Item

Service

1

Aboriginal or Torres Strait Islander health

2

Audiology

3

Chiropractic

4

Diabetes education

5

Dietetics

6

Exercise physiology

7

Focussed psychological strategies

8

Mental health

8A

Midwifery

9

Non‑directive pregnancy support counselling

9A

Nurse practitioner services

10

Occupational therapy

10A

Orthoptic

11

Osteopathy

12

Physiotherapy

13

Podiatry

14

Psychological therapy

15

Psychology

16

Speech pathology

4Relevant organisations and qualifications (Act s 3D)
  • (1)

    For the definition of relevant organisation in subsection 3D(5) of the Act, the organisation specified in column 2 of an item in Schedule 4 is declared to be a professional organisation in relation to each specialty specified in column 3 of that item.

  • (2)

    For the definition of relevant qualification in subsection 3D(5) of the Act, the qualification specified in column 4 of an item in Schedule 4 is declared to be a relevant qualification in relation to the organisation specified in column 2 of that item.

5Prescribed fee – subsection 3D(1) of the Act

For the purposes of subsection 3D(1) of the Act, the prescribed fee is $30.

6Prescribed fee – subsection 3E(2) of the Act

For the purposes of subsection 3E(2) of the Act, the prescribed fee is $30.

6ARecognised Fellows of the RACGP
  • (1)

    An applicant is eligible for a determination under paragraph 3EA(2)(b) of the Act if the RACGP certifies that the applicant meets the minimum requirements of the RACGP for taking part in continuing medical education and quality assurance.

  • (2)

    For subparagraph 3EB(1)(b)(ii) of the Act, a determination under section 3EA of the Act in respect of a medical practitioner must be revoked if the RACGP certifies that the practitioner does not meet the minimum requirements of the RACGP for continuing medical education and quality assurance.

6BNotice to be given of certain decisions

(1) The RACGP must give the Chief Executive Medicare written notice if it declines to certify under subregulation 6A(1).

(2)

The Chief Executive Medicare must give a medical practitioner written notice if it receives notice under subregulation (1).

6CAppeals

(1) A medical practitioner who receives notice under:

  • (a)

    subregulation 6B(2); or

  • (b)

    subsection 3EB(2) of the Act because the RACGP has given the Chief Executive Medicare notice under subparagraph 3EB(1)(b)(ii) of the Act;

may appeal to the Appeal Committee within 28 days after the day the notice is given.

(2)

The Appeal Committee must hear and decide the appeal.

(3)

If the Committee allows the appeal, the practitioner is eligible for a determination.

(4)

If the Committee dismisses the appeal it must give the practitioner written notice with:

  • (a)

    the result of the appeal; and

  • (b)

    the terms of the decision; and

  • (c)

    a statement to the effect that a copy of the reasons for the decision may be obtained from the Committee on written request made within 28 days after the notice is given.

6DEligibility pending decision on appeal

(1) A medical practitioner remains eligible for a determination if:

  • (a)

    the Chief Executive Medicare gives the practitioner notice that a determination under section 3EA of the Act in respect of the practitioner is to be revoked; and

  • (b)

    the practitioner’s appeal is received by the Appeal Committee before the date specified in the notice for removal.

(2)

The practitioner ceases to be eligible under subregulation (1) when the practitioner’s appeal is finalised.

6DARecognition of practitioners who meet ACRRM fellowship standards
  • (1)

    A medical practitioner may apply to the Chief Executive Medicare for a determination under this regulation.

  • (2)

    After receiving an application, the Chief Executive Medicare must, within the required period, determine that the applicant is recognised as meeting the fellowship standards of the ACRRM if the ACRRM gives the Chief Executive Medicare written notice that the applicant is, under regulation 6DB, eligible for a determination.

  • (3)

    For subregulation (2), the required period is:

    • (a)

      14 days after the notice was received by the Chief Executive Medicare; or

    • (b)

      if the application was made after the notice was received—14 days after the application was received by the Chief Executive Medicare.

  • (4)

    The Chief Executive Medicare must give the applicant written notice of the day on which the determination will come into force.

  • (5)

    The Chief Executive Medicare may give the ACRRM information about whether or not determinations under this regulation are in force for particular persons.

  • (6)

    The Chief Executive Medicare or an authorised officer may make available to members of the public, on request:

    • (a)

      the names of medical practitioners for whom determinations under this regulation are in force; and

    • (b)

      the addresses at which they practise.

  • (7)

    In this regulation:

    authorised officer means a Departmental employee (within the meaning given by section 3 of the Human Services (Medicare) Act 1973) authorised in writing by the Chief Executive Medicare for this regulation.

6DBEligibility for determination
  • (1)

    An applicant who attained fellowship of the ACRRM after the requirement to undergo accredited training was first introduced is eligible for a determination only if the applicant:

    • (a)

      either:

      • (i)

        has successfully completed accredited training; or

      • (ii)

        has been assessed by the ACRRM as having training and experience equivalent to successful completion of accredited training; and

    • (b)

      meets the minimum requirements that apply to a Fellow of the ACRRM for continuing medical education and quality assurance.

  • (2)

    An applicant who attained fellowship of the ACRRM before the requirement to undergo accredited training was first introduced is eligible for a determination only if the applicant:

    • (a)

      either:

      • (i)

        has been assessed by the ACRRM, using an assessment model approved by the Department, as having training and experience equivalent to successful completion of accredited training; or

      • (ii)

        is a vocationally registered general practitioner; and

    • (b)

      meets the minimum requirements that apply to a Fellow of the ACRRM for continuing medical education and quality assurance.

  • (3)

    In this regulation:

    accredited training means a training program and assessments for fellowship of the ACRRM accredited by the Australian Medical Council.

6DCRevocation of determinations
  • (1)

    The Chief Executive Medicare must revoke a determination under regulation 6DA about a medical practitioner if:

    • (a)

      the medical practitioner requests the Chief Executive Medicare to do so; or

    • (b)

      the ACRRM gives the Chief Executive Medicare written notice that the medical practitioner has failed to meet its minimum requirements for continuing medical education and quality assurance; or

    • (c)

      the Chief Executive Medicare becomes aware that the medical practitioner is no longer a medical practitioner.

  • (2)

    A notice mentioned in paragraph (1)(b) is effective only if, before giving the notice, the ACRRM:

    • (a)

      informed the medical practitioner about the proposed notice; and

    • (b)

      gave the practitioner at least 14 days to show why the proposed notice should not be given.

  • (3)

    Before revoking the determination, the Chief Executive Medicare must give the medical practitioner written notice that the determination is to be revoked.

  • (4)

    The notice must specify the day on which the determination is to be revoked.

  • (5)

    The day specified under subregulation (4) must not be less than 14 days after the day on which the notice is given.

6ERegister of Approved Placements – specified bodies etc

For paragraph 3GA(5)(a) of the Act, the following bodies, courses and programs are specified:

  • (a)

    a body mentioned in an item in Part 1 or 2 of Schedule 5;

  • (b)

    a course that leads to a qualification in an item in Part 1 of Schedule 5 from the body specified in the item;

  • (c)

    a program in an item in Part 2 of Schedule 5 approved by the body specified in the item.

6EARegister of Approved Placements – eligible applicants

For paragraph 3GA(5)(b) of the Act, a medical practitioner who makes application under subsection 3GA(4) of the Act, and to whom subitem 1(2) in Part 3 of Schedule 5 applies, is eligible for registration under section 3GA of the Act.

6EBRegister of Approved Placements – removal of name

For paragraph 3GB(1)(c) of the Act, a medical practitioner registered under section 3GA of the Act because of the operation of regulation 6EA must have his or her name removed from the Register of Approved Placements when the earliest of the following events occurs:

  • (a)

    a determination under section 3D, 3EA or 61 of the Act, recognising the practitioner’s qualification, takes effect;

  • (b)

    the Chief Executive Medicare receives written notice from the appropriate Australian medical college, of its refusal to recognise the practitioner’s qualification;

  • (c)

    12 months elapses since registration of the practitioner under section 3GA of the Act began.

6EFServices for which medicare benefit is 100% of Schedule fee (Act s 10(2)(aa))

For paragraph 10(2)(aa) of the Act, the following services are prescribed:

  • (a)

    a service prescribed by Schedule 6 to these Regulations;

  • (b)

    a service:

    • (i)

      that is described in an item of the diagnostic imaging services table; and

    • (ii)

      to which clause 1.2.9 or 1.2.10 of Schedule 1 to the diagnostic imaging services table applies.

6FCircumstances in which subparagraphs 19AA(1)(b)(iv) and (2)(b)(iv) of the Act apply

For paragraph 19AA(3)(b) of the Act, subparagraphs 19AA(1)(b)(iv) and (2)(b)(iv) of the Act only apply to a professional service that was rendered by a person, registered under subsection 3GA(5) of the Act, not more than:

  • (a)

    2 weeks after the period for which the person was registered; or

  • (b)

    if the Chief Executive Medicare approves—6 weeks after the period for which the person was registered.

6GInterns – relevant State or Territory laws

For subsection 19AA(5) of the Act, the following laws are specified:

  • (a)

    Medical Practice Act 1992 of New South Wales;

  • (b)

    Medical Practice Act 1994 of Victoria;

  • (c)

    Medical Act 1939 of Queensland;

  • (d)

    Medical Practitioners Act 1983 of South Australia;

  • (e)

    Medical Act 1894 of Western Australia;

  • (f)

    Medical Act 1959 of Tasmania;

  • (g)

    Medical Practitioners Act 1930 of the Australian Capital Territory;

  • (h)

    Northern Territory of Australia Medical Act 1995 of the Northern Territory.

9Reduction of amounts for purposes of subsection 16(4) of the Act

(1) Where, under paragraph 16(4)(a) of the Act, one amount only shall be deemed to be reduced, that amount shall be deemed to be reduced by 80 per cent.

(2) Where, under paragraph 16(4)(a) of the Act, 2 or more amounts shall be deemed to be reduced, the greater or greatest of those amounts shall be deemed to be reduced by 80 per cent and each other such amount shall be deemed to be reduced by 90 per cent.

(3) For the purposes of subregulation (2), where 2 or more of the amounts that shall be deemed to be reduced are equal, one of those amounts shall be treated as being greater than the other amount or the greatest of those amounts.

9ARequests for pathology services by electronic means
  • (1)

    For section 16A of the Act, subregulation (2) applies if:

    • (a)

      a request for a pathology service is made or confirmed by electronic means; and

    • (b)

      a practitioner, participating midwife or participating nurse practitioner is identified as the person who made the request or confirmation:

      • (i)

        by name, number or other means in the request or confirmation; or

      • (ii)

        by the electronic system used to make the request or confirmation.

  • (2)

    The request or confirmation is taken to have been made by the person unless the person shows that he or she did not make the request or confirmation.

10Diagnostic imaging services which dental practitioners may request

(1) For subsection 16B(2) of the Act, a service of each of the following kinds is specified:

  • (a)

    if the dental practitioner who requests the service is approved by the Minister under paragraph (b) of the definition of professional service in subsection 3(1) of the Act—a service described in any of items 55005, 55008, 55011, 55028, 55030, 55032, 56001 to 56220, 56224, 56227, 56230, 56259, 56301 to 56507, 56541, 56547, 56801 to 57007, 57041, 57047, 57341, 57345, 57703, 57705, 57709, 57711, 57712, 57714, 57715, 57717, 58103 to 58115, 58117, 58123, 58124, 58306, 58308, 58506, 58508, 58521 to 58527, 58529, 58909, 58911, 59103, 59104, 59703, 59704, 60000 to 60010, 60506, 60507, 60509, 60510, 61109, 61110, 61372, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 61672, 61690, 61691, 61693, 61694, 61695, 61696, 61702, 61703, 61704, 61705, 61706, 61707, 61710, 63007, 63016, 63334 and 63346;

  • (b)

    if the dental practitioner who requests the service is a prosthodontist—a service described in any of items 55005, 55028, 56013, 56016, 56022, 56028, 56053, 56056, 56062, 56068, 57362, 57363, 58306, 58308, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 61690, 61691, 61693, 61694, 61695, 61696, 61702, 61703, 61704, 61705, 61706, 61707, 61710, 63334 and 63346;

  • (c)

    if the dental practitioner who requests the service is a dental specialist—a service described in any of items 56022, 56062, 57362, 57363, 58306, 58308, 61421, 61454, 61457, 61690, 61706, 61707, 63334 and 63346;

  • (d)

    if the dental practitioner who requests the service is an oral medicine specialist or oral pathology specialist—a service described in any of items 55005, 55008, 55011, 55028, 55030, 55032, 56001, 56007, 56010, 56013, 56016, 56022, 56028, 56041, 56047, 56050, 56053, 56056, 56062, 56068, 56101, 56107, 56141, 56147, 56301, 56307, 56341, 56347, 56401, 56407, 56441, 56447, 57341, 57345, 57362, 57363, 58306, 58308, 58506, 58508, 58909, 58911, 59103, 59104, 59703, 59704, 60000 to 60010, 60506, 60507, 60509, 60510, 61109, 61110, 61372, 61421, 61425, 61429, 61430, 61433, 61434, 61446, 61449, 61450, 61453, 61454, 61457, 61462, 61672, 61690, 61691, 61693, 61694, 61695, 61696, 61702, 61703, 61704, 61705, 61706, 61707, 61710, 63007, 63016, 63334 and 63346;

  • (e)

    in any case—a service described in any of items 57509, 57515, 57521, 57527, 57530, 57533, 57536, 57539, 57901 to 57969, 58100, 58102, 58300, 58302, 58503, 58505, 58903, 58905, 59733, 59734, 59739, 59740, 59751, 59752, 60100, 60101, 60500, 60501, 60503 and 60504.

(2) In paragraph (1)(b), prosthodontist means a person who is:

  • (a)

    registered or licensed as a prosthodontist under a law of a State or Territory; or

  • (b)

    registered or licensed as a dentist or dental practitioner under a law of a State or Territory and recognised by the registering or licensing authority as a person who practises in the specialty of prosthodontics.

(3)

In paragraph (1)(c), dental specialist means a person who is:

  • (a)

    registered or licensed as a periodontist, endodontist, pedeodontist, or orthodontist under a law of a State or Territory; or

  • (b)

    registered or licensed as a dental specialist under a law of a State or Territory and recognised by the registering or licensing authority as a person who practices in the speciality of periodontics, endodontics, pedeodontics, or orthodontics.

(4)

In paragraph (1)(d):

oral medicine specialist means a person who is:

  • (a)

    registered or licensed as an oral medicine specialist under a law of a State or Territory; or

  • (b)

    registered or licensed as a dental specialist under a law of a State or Territory and recognised by the registering or licensing authority as a person who practices in the speciality of oral medicine.

oral pathology specialist means a person who is:

  • (a)

    registered or licensed as an oral pathology specialist under a law of a State or Territory; or

  • (b)

    registered or licensed as a dental specialist under a law of a State or Territory and recognised by the registering or licensing authority as a person who practices in the speciality of oral pathology.

11R‑type diagnostic imaging services that chiropractors, osteopaths, physiotherapists and podiatrists may request

Services that chiropractors may request

(1)

For the purposes of subsection 16B(3) of the Act, the services are those mentioned in the diagnostic imaging services table in items 57712, 57714, 57715, 57717, 58100 to 58106, 58109, 58111, 58112, 58117 and 58123.

Services that physiotherapists and osteopaths may request

(2)

For the purposes of subsections 16B(3A) and (3C) of the Act, the services are those mentioned in the diagnostic imaging services table in items 57712, 57714, 57715, 57717, 58100 to 58106, 58109, 58111, 58112, 58117, 58120, 58121, 58123, 58126 and 58127.

Services that podiatrists may request

(3)

For the purposes of subsection 16B(3B) of the Act, the services are those mentioned in the diagnostic imaging services table in items 55836, 55837, 55840, 55841, 55844, 55845, 57521, 57527, 57536 and 57539.

11APathology services determined to be necessary by participating midwives and participating nurse practitioners
  • (1)

    For subparagraph 16A(1)(aa)(ii) of the Act, the services in relation to a participating midwife are those mentioned in the pathology services table in items 65060, 65070, 65090 to 65099 (inclusive), 65114, 66500 to 66512 (inclusive), 66545, 66548, 66566, 66743, 66750, 66751, 69303 to 69317 (inclusive), 69324, 69384 to 69415 (inclusive), 73070, 73071, 73075, 73076 and 73529.

  • (2)

    For subparagraph 16A(1)(ab)(ii) of the Act, the services in relation to a participating nurse practitioner are those mentioned in the pathology services table in items 65060 to 73810 (inclusive).

11BDiagnostic imaging services that participating midwives and participating nurse practitioners may request
  • (1)

    For subsection 16B(3D) of the Act, the services in relation to a participating midwife are those mentioned in the diagnostic imaging services table in items 55700, 55701, 55704, 55706, 55707, 55710, 55713, 55714, 55718 and 55722.

  • (2)

    For subsection 16B(3E) of the Act, the services in relation to a participating nurse practitioner are those mentioned in the diagnostic imaging services table in items 55014, 55036, 55059, 55061, 55070, 55076, 55600, 55601, 55769, 55800, 55801, 55804, 55805, 55808, 55809, 55812, 55813, 55816, 55817, 55820, 55821, 55824, 55825, 55828, 55829, 55832, 55833, 55836, 55837, 55840, 55841, 55844, 55845, 55848, 55849, 55850, 55851, 55852, 55853, 57509, 57515, 57521, 57530, 57533, 57536, 58503 to 58527 and 58529.

12Exemption – pre‑existing diagnostic imaging services

For subsection 16B(11) of the Act, the services are those mentioned in the diagnostic imaging services table in items 57712, 57714, 57715, 57717, 57901, 57902, 57903, 57911, 57912, 57914, 57915, 57917, 57921, 57926, 57929, 57935, 58100 to 58115, 58117, 58123, 58124, 58521, 58523, 58524, 58526, 58527, 58529, 58700, 58702, 58924 58926, 59103 and 59104.

12APrescribed date – paragraph 16B(11)(d) of the Act

For paragraph 16B(11)(d) of the Act, the prescribed date is 1 January 2001.

12BDefinition of radiation oncology service

For subsection 16F(2) of the Act, a radiation oncology service is a service to which an item in subgroup 3, 4 or 5 of Group T2 in the general medical services table relates.

13Particulars to be recorded on accounts, receipts and bulk billing agreement

(1) For the purposes of subsection 19(6) of the Act, the following particulars are prescribed in relation to professional services generally:

  • (a)

    the name of the patient to whom the service was given;

  • (b)

    the date on which the service was given;

  • (c)

    the amount charged in respect of the service;

  • (d)

    the total amount paid in respect of the service;

  • (e)

    any amount outstanding in respect of the service.

(1A) For the purposes of subsection 19(6) of the Act, the following particulars are prescribed in relation to professional services rendered by a person who has been determined to be a medical practitioner under subsection 3J(1) of the Act:

  • (a)

    the name and the address of the medical practitioner;

  • (b)

    the provider number of the medical practitioner.

(1B) For the purposes of subsection 19(6) of the Act, the particulars prescribed in relation to professional services rendered by a medical practitioner other than a medical practitioner referred to in subregulation (1A) are:

  • (a)

    the name and the address of the medical practitioner; and

  • (b)

    the provider number of the medical practitioner;

either or both of which may be given.

(1C) For subsection 19(6) of the Act, either or both of the following particulars are prescribed for professional services provided by a participating midwife or participating nurse practitioner:

  • (a)

    the name and address of the participating midwife or participating nurse practitioner;

  • (b)

    the provider number of the participating midwife or participating nurse practitioner.

(2)

For subsection 19(6) of the Act, the following particulars are prescribed in relation to professional services rendered as part of an episode of hospital treatment:

  • (a)

    a description of the professional service and the item number of the item that relates to the professional service, followed by an asterisk; or

  • (b)

    a description of the professional service sufficient to identify the item that relates to the professional service, preceded by the word ‘patient’.

(2A)

For subsection 19(6) of the Act, if professional services are rendered as part of an episode of hospital‑substitute treatment and the person who receives the treatment chooses to receive a benefit from a private health insurer, the following particulars are prescribed for those services:

  • (a)

    a description of the professional service and the item number of the item that relates to the professional service, followed by the words ‘hospital‑substitute treatment’; or

  • (b)

    a description of the professional service sufficient to identify the item that relates to the professional service, preceded by the words ‘hospital‑substitute treatment’.

(3) For the purposes of subsection 19(6) of the Act, the following particular is prescribed in relation to professional services other than professional services referred to in subregulation (2), namely, a description of the professional service sufficient to identify the item that relates to the service.

(4) For the purposes of subsection 19(6) of the Act, the following particulars are prescribed in relation to professional services rendered by a consultant physician, or a specialist, in the practice of his or her specialty to a patient who was referred to that consultant physician or specialist in the manner prescribed in regulation 29 by a referring practitioner:

  • (a)

    the name of the referring practitioner;

  • (b)

    the address of the place of practice, or the provider number in respect of the place of practice, of the referring practitioner;

  • (c)

    the date on which the patient was referred by the referring practitioner to the consultant physician or specialist;

  • (d)

    the period of validity of the referral applicable under regulation 31.

(5) For the purposes of subsection 19(6) of the Act, if a referral is given under subregulation 30(1) the words, ‘referral within (insert the name of the hospital in which the referral was given)’ are prescribed.

(6) For the purposes of subsection 19(6) of the Act, the following particulars are prescribed in relation to professional services rendered by a consultant physician, or a specialist, in the practice of his or her specialty to a patient who has declared to the consultant physician or specialist that a referral referring the patient to that consultant physician or specialist has been completed by a referring practitioner, the name of the referring practitioner, and that the referral has not been delivered to the consultant physician or specialist due to the referral having been lost, stolen or destroyed:

  • (a)

    the name of the referring practitioner;

  • (b)

    the words ‘lost referral’;

  • (c)

    the address of the place of practice, or the provider number in respect of the place of practice, of the referring practitioner (if either of these are known to the consultant physician or specialist).

(7) For the purposes of subsection 19(6) of the Act, the word ‘emergency’ is prescribed if:

  • (a)

    a referring practitioner; or

  • (b)

    a specialist or consultant physician in the practice of his or her speciality;

decides in an emergency that it is necessary in the patient’s interests for a professional service to be given as soon as practicable.

(8) For the purposes of subsection 19(6) of the Act, the following particular is prescribed in relation to professional services to which an item in items 3 to 10929 (inclusive) of the general medical services table relates, namely, where a practitioner or optometrist was in attendance on a person on more than one occasion on the same day and on each occasion rendered such a professional service on that person, the time at which each such attendance on that day commenced.

(8A)

For subsection 19(6) of the Act, subregulation (8B) applies if a participating midwife or participating nurse practitioner:

  • (a)

    attends a person more than once on the same day; and

  • (b)

    on each occasion provides a professional service to the person.

(8B)

The time each attendance starts is prescribed as a particular for the participating midwife or participating nurse practitioner.

(9) For the purposes of subsection 19(6) of the Act, the following particulars are prescribed in relation to professional services to which an item in the pathology services table relates:

  • (a)

    where the professional service is a pathology service in respect of which the payment of a medicare benefit is not prevented by the operation of subsection 16A(1), (2) or (3) of the Act:

    • (i)

      the name and:

      • (A)

        where the request referred to in subsection 16A(3) of the Act in respect of which the professional service was rendered was made at the place of practice of the practitioner, participating midwife or participating nurse practitioner who determined that the professional service was necessary—the provider number in respect of that place of practice of that practitioner, participating midwife or participating nurse practitioner; or

      • (B)

        where that request was not made at the place of practice of the practitioner, participating midwife or participating nurse practitioner who determined that the professional service was necessary—the provider number in respect of any place of practice of that practitioner, participating midwife or participating nurse practitioner; and

    • (ii)

      the date on which the practitioner, participating midwife or participating nurse practitioner so determined that the service was necessary;

  • (b)

    where the professional service is a pathologist‑determinable service that was determined to be necessary by the approved pathology practitioner by whom, or on whose behalf, the service was performed—the initials ‘s.d.’ or ‘p.d.’;

  • (c)

    where the professional service is a pathology service to which subsection 16A(7) of the Act applies—if the service was rendered in pursuance of a request of the kind referred to in paragraph 16A(7)(b) of the Act—the date on which the request referred to in that subparagraph was made and the surname, and the initials of the Christian or given names, of the medical practitioner who determined that the service was necessary or, where at least one other member of the group of practitioners of which he is a member has the same surname and the same initials as the medical practitioner, the surname, and such of the Christian or given names, of the medical practitioner as distinguish him from each of those other members.

(10)

For subsection 19(6) of the Act, if the professional service rendered is the collection of a specimen and is the initiation of a patient episode, there is to be recorded, for that pathology service, the appropriate collection point identification number as follows:

  • (a)

    for a collection made at an approved collection centre, the approved pathology collection centre identification number assigned by the Chief Executive Medicare to that collection centre;

  • (b)

    for a collection made at a recognised hospital, the recognised hospital collection point identification number assigned by the Chief Executive Medicare to that hospital;

  • (d)

    for a collection made at a location not described in paragraph (a) or (b), the collection point identification number ‘A01’.

(10A)

An identification number mentioned in paragraph (10)(a) (an approved pathology collection centre identification number) is valid only in relation to a collection made at an approved collection centre by the Approved Pathology Authority that is the owner of that collection centre.

(11) For the purposes of subsection 19(6) of the Act, the following particulars are prescribed in relation to professional services to which any of items 12500 to 12533 (inclusive), 15000 to 15600 (inclusive) and 16003 to 16015 (inclusive) of the general medical services table or an item in the diagnostic imaging services table relates:

  • (a)

    if the professional service is provided by a specialist in diagnostic radiology—the name and either the address of the place of practice, or the provider number, of that specialist; or

  • (b)

    if the professional service is provided by a practitioner other than a specialist in diagnostic radiology—the name and either the address of the place of practice, or the provider number in respect of the place of practice, of the practitioner who:

    • (i)

      is claiming, or receiving, payment of fees in respect of the professional service; or

    • (ii)

      is the assignee of the right to the payment of that benefit under an assignment or agreement made in accordance with section 20A of the Act, in relation to the medicare benefit in respect of the professional service, if an assignment of that kind has been made, or an agreement of that kind entered into.

(12)

For subsection 19(6) of the Act, particulars for professional services to which an item in the pathology services table, other than items 73801 to 73811 (inclusive), relates are the name and either the address of the place of practice or the provider number for the place of practice of:

  • (a)

    the approved pathology practitioner by whom, or on whose behalf, the professional service was rendered; or

  • (b)

    if the professional service was rendered completely in an accredited pathology laboratory—any approved pathology practitioner rendering professional services in the accredited pathology laboratory; or

  • (c)

    any approved pathology practitioner rendering professional services in an accredited pathology laboratory that is owned and controlled by an approved pathology authority if:

    • (i)

      a request for the professional service was received by:

      • (A)

        any approved pathology practitioner rendering professional services in the accredited pathology laboratory; or

      • (B)

        the approved pathology authority; and

    • (ii)

      the professional service was rendered partly in the accredited pathology laboratory and partly in another accredited pathology laboratory that are both owned and controlled by the approved pathology authority.

(13)

For subsection 19(6) of the Act, the following particulars are prescribed for professional services other than those mentioned in subregulation (13A):

  • (a)

    the name of the practitioner, optometrist, participating midwife or participating nurse practitioner who provided the professional service;

  • (b)

    a statement that the professional service was provided by that person;

  • (c)

    either:

    • (i)

      the address of the place of practice where the service was provided; or

    • (ii)

      both:

      • (A)

        if the service was provided at a place of practice for which that person has been allocated a provider number—the provider number; and

      • (B)

        in any other case—the provider number allocated to that person for any place where he or she practices.

(13A)

Subregulation (13) does not apply to a professional service to which any of the following items relate:

  • (a)

    an item in the pathology services table other than items 73801 to 73811 (inclusive);

  • (b)

    any of items 12500 to 12533 (inclusive), 15000 to 15600 (inclusive) and 16003 to 16015 (inclusive) of the general medical services table;

  • (c)

    an item in the diagnostic imaging services table.

(14) Subject to subregulations (15) and (16), the following particulars are prescribed for the purposes of subsection 19(6) of the Act in relation to professional services to which an item in the diagnostic imaging services table relates:

  • (a)

    the name and either:

    • (i)

      the address of the place of practice; or

    • (ii)

      the provider number in respect of the place of practice;

 of the person who requested that professional service;

  • (b)

    the date on which that professional service was requested;

  • (c)

    the name and either:

    • (i)

      the address of the place of practice; or

    • (ii)

      the provider number in respect of the place of practice;

 of the practitioner who:

  • (iii)

    is claiming, or receiving, payment of fees in respect of that professional service; or

  • (iv)

    if an assignment has been made, or an agreement entered into, in accordance with section 20A of the Act, in relation to the medicare benefit in respect of that professional service, is the assignee of the right to the payment of that benefit under that assignment or agreement.

(15) If the person referred to in paragraph (14)(a) is a chiropractor, osteopath, physiotherapist or podiatrist, the reference in subparagraph (14)(a)(ii) to a provider number is a reference to a requester number.

(16) For the purposes of subsection 19(6) of the Act, if the practitioner referred to in paragraph (14)(c) is not the practitioner who rendered the professional service referred to in subregulation (14), the following additional particulars are prescribed in relation to that professional service, namely the name and either:

  • (a)

    the address of the place of practice; or

  • (b)

    the provider number in respect of the place of practice;

of the second‑mentioned practitioner, unless those particulars and the date on which the professional service was requested are recorded at the place of practice of the first‑mentioned practitioner.

(17) For the purposes of subsection 19(6) of the Act, if professional services to which an item in the diagnostic imaging services table relates are rendered:

  • (a)

    by a consultant physician or a specialist in circumstances specified in subsection 16B(6) of the Act; or

  • (b)

    within an area that is a remote area for the purposes of Division 2 of Part IIB of the Act in circumstances specified in subsection 16B(7) of the Act; or

  • (c)

    as an additional necessary service in circumstances specified in subsection 16B (10) of the Act; or

  • (d)

    in circumstances specified in subsection 16B(11) of the Act;

the following particular is prescribed in relation to those services—the letters ‘SD’, indicating that the services were self‑determined.

(17A)

For subsection 19(6) of the Act, if professional services to which an item in the diagnostic imaging services table relates are rendered in the circumstances mentioned in subsection 16B(10A) of the Act, the letters ‘SS’ (indicating that the services were substituted for a requested service) are a prescribed particular in relation to those services.

(18) For the purposes of subsection 19(6) of the Act, if professional services to which an item in the diagnostic imaging services table relates are rendered in circumstances specified in subsection 16B(8) of the Act, the following particular is prescribed in relation to those services—the word ‘emergency’.

(19) For the purposes of subsection 19(6) of the Act, if professional services to which an item in the diagnostic imaging services table relates are rendered in circumstances specified in subsection 16B(9) of the Act, the following particular is prescribed in relation to those services—the words ‘lost request’.

(20)

For subsection 19(6) of the Act, the following additional particulars are prescribed in relation to professional services to which any of items 23010 to 24136 of the general medical services table relates:

  • (a)

    if the service rendered is administration of anaesthesia (other than administration of anaesthesia performed in association with a service to which item 22900 or 22905 applies):

    • (i)

      the name of each practitioner who performed a procedure for which the anaesthesia was administered; and

    • (ii)

      if item 25025 applies to the service—when the service time began and ended, and the duration of the service time; and

  • (b)

    if the service rendered is perfusion to which item 25050 applies—when the service time began and ended, and the duration of the service time; and

  • (c)

    if the service rendered is assistance in the administration of anaesthesia:

    • (i)

      the name of the principal anaesthetist; and

    • (ii)

      the name of each practitioner who performed a procedure for which the anaesthesia was administered; and

    • (iii)

      if item 25030 applies to the service—when the service time began and ended, and the duration of the service time.

(21)

In subregulation (20):

service time has the meaning given by clause 2.44.4 of the general medical services table.

(22)

For subsection 19(6) of the Act, in relation to professional services consisting of:

  • (a)

    diagnostic imaging services rendered using a diagnostic imaging procedure carried out using diagnostic imaging equipment ordinarily located at registered diagnostic imaging premises or, when not in use, at a registered base for diagnostic imaging equipment; or

  • (b)

    radiation oncology services rendered using radiation oncology equipment ordinarily located at registered radiation oncology premises or, when not in use, at a registered base for radiation oncology equipment;

the location specific practice number for the premises or base is a prescribed particular.

13AAPayment to general practitioner by electronic transmission (Act s 20(5))
  • (1)

    This regulation applies to the payment, by the Chief Executive Medicare on behalf of the Commonwealth, of an amount under subsection 20(3) of the Act to a general practitioner by whom, or on whose behalf, a professional service was rendered.

  • (2)

    For subsection 20(5) of the Act, the amount may be paid by electronic transmission if the claim for medicare benefit for the service:

    • (a)

      is made using any of the following electronic claiming channels:

      • (i)

        Medicare Online;

      • (ii)

        Medicare Easyclaim;

      • (iii)

        ECLIPSE; or

    • (b)

      is made by, or on behalf of, a general practitioner who:

      • (i)

        is enrolled, for the location at which the professional service was rendered, in the scheme known as the ‘90 Day Pay Doctor Cheque Scheme’ administered by the Chief Executive Medicare for the purpose of making payments by electronic transmission of amounts to general practitioners under subsection 20(3) of the Act; and

      • (ii)

        has given the Chief Executive Medicare written permission to give to the Reserve Bank of Australia the following information:

        • (A)

          the name and number of the account into which a payment to the general practitioner under subsection 20(3) of the Act may be made;

        • (B)

          the name and BSB number of the bank at which that account is kept.

  • (3)

    For the purposes of section 20 of the Act:

    general practitioner includes a medical practitioner (other than a specialist or consultant physician) who practises in general practice.

13ABPayment to specialists or consultant physicians by electronic transmission (Act s 20(5))
  • (1)

    This regulation applies to the payment, by the Chief Executive Medicare on behalf of the Commonwealth, of an amount under subsection 20(3) of the Act to a specialist or consultant physician by whom, or on whose behalf, a professional service was rendered.

  • (2)

    For subsection 20(5) of the Act, the amount may be paid by electronic transmission if the claim for medicare benefit for the service is made using any of the following electronic claiming channels:

    • (a)

      Medicare Online;

    • (b)

      Medicare Easyclaim;

    • (c)

      ECLIPSE.

13ACManner of electronic claim (Act s 20(6))

For subsection 20(6) of the Act, the claim must be made using an electronic claiming channel mentioned in subregulation 13AB(2).

13BApplication for approval as billing agent
  • (1)

    For paragraph 20AB(2)(a) of the Act, an application must be in the form approved by the Chief Executive Medicare.

  • (2)

    For paragraph 20AB(2)(b) of the Act, the fee to accompany an application is:

    • (a)

      if the applicant has not previously been approved as a billing agent—$1,000; or

    • (b)

      in any other case—$500.

14Medicare benefit not payable in respect of certain professional services

(1) Unless the Minister otherwise directs, medicare benefits are not payable in respect of professional services rendered in prescribed circumstances.

(2) Each of the following shall be taken to be professional services rendered in prescribed circumstances:

  • (a)

    professional services rendered in relation to the provision of chelation therapy (that is to say, the intravenous administration of ethylenediamine tetra‑acetic acid or any of its salts) otherwise than for the treatment of heavy‑metal poisoning;

  • (b)

    professional services rendered in association with the injection of human chorionic gonadotrophin in the management of obesity;

  • (c)

    professional services rendered in relation to the use of hyperbaric oxygen therapy in the treatment of multiple sclerosis;

  • (e)

    professional services rendered for the purpose of, or in relation to, the removal of tattoos;

  • (ea)

    professional services rendered for the purposes of, or in relation to, the removal from a cadaver of kidneys for transplantation;

  • (f)

    professional services rendered for the purposes of, or in relation to:

    • (i)

      the transplantation of a thoracic or abdominal organ, other than a kidney, or of part of an organ of that kind; or

    • (ii)

      the transplantation of a kidney in conjunction with the transplantation of a thoracic or other abdominal organ, or of a part of an organ of that kind;

 if the services are rendered to a patient of a hospital;

  • (g)

    professional services rendered for the purpose of administering microwave (UHF radiowave) cancer therapy, including the intravenous injection of drugs used immediately before or during the therapy.

14AEligibility requirements for midwives

For the purposes of paragraph 21(1)(b) of the Act, a midwife must be endorsed by the Nursing and Midwifery Board.

16Application for acceptance of undertaking – repayment of fee

For the purposes of section 23DJ of the Act, the fee paid by a person who gives an undertaking under subsection 23DC(1) or 23DF(1) of the Act shall be repaid to the person, where the undertaking is not accepted, by forwarding an amount equal to the amount of the fee to the person at the address specified in the application for the Minister’s acceptance of the undertaking or at such other address as the person specifies by notice in writing to the Minister.

16ARecords of pathology services to be kept by approved pathology authorities

(1) For the purposes of subsection 23DKA(1) of the Act, an approved pathology authority must prepare and maintain, in accordance with subregulations (2) and (3), records of the pathology services rendered in an accredited pathology laboratory of which the authority is the proprietor.

(2) For each service rendered, the record in relation to the service must include a copy of a report of the service.

(3) The records must be kept in a manner that enables information to be retrieved from the records on the basis of:

  • (a)

    the name of the person to whom the service was rendered; and

  • (b)

    the date on which the service was rendered.

17Application for approval of premises – prescribed fees

For the purposes of paragraph 23DN(1)(b) of the Act, the prescribed fee in relation to an application for the approval of premises as an accredited pathology laboratory is:

  • (a)

    where the premises are accredited as a pathology laboratory under the Pathology Laboratories Accreditation Act, 1981 of the State of New South Wales or are an accredited pathology service under the Pathology Services Accreditation Act 1984 of the State of Victoria—$50; or

  • (b)

    in any other case—$200.

18Application for approval of premises – repayment of fees

For the purposes of subsection 23DN(8) of the Act, the fee paid by a person who makes an application under subsection 23DN(1) of the Act shall be repaid to the person, where the application is not granted, by forwarding an amount equal to the amount of the fee to the person at the address specified in the application or at such other address as the person specifies by notice in writing to the Minister.

18ABranded Pathology Request Form
  • (1)

    For subsection 23DP(3) of the Act, a pathology request form that is a branded pathology request form must include one of the following statements:

    • (a)

      ‘Your doctor has recommended that you use [insert name of pathology provider]. You are free to choose your own pathology provider. However, if your doctor has specified a particular pathologist on clinical grounds, a Medicare rebate will only be payable if that pathologist performs the service. You should discuss this with your doctor.’;

    • (b)

      ‘Your treating practitioner has recommended that you use [insert name of pathology provider]. You are free to choose your own pathology provider. However, if your treating practitioner has specified a particular pathologist on clinical grounds, a Medicare rebate will only be payable if that pathologist performs the service. You should discuss this with your treating practitioner.’.

  • (2)

    In this regulation:

    branded pathology request form means a pathology request form that:

    • (a)

      if the form is provided by an approved pathology authority—includes:

      • (i)

        the registered name or trading name of the approved pathology authority; and

      • (ii)

        the location of one or more specimen collection centres; and

    • (b)

      if the form is provided by an approved pathology practitioner—includes:

      • (i)

        the registered name or trading name of an approved pathology authority that employs or engages the approved pathology practitioner; and

      • (ii)

        the location of one or more specimen collection centres.

19Information that must be included in requests for diagnostic imaging services

(1) For the purposes of subsection 23DQ(1) of the Act, the following information must be included in a subsection 16B(1) request:

  • (a)

    the name and either:

    • (i)

      the address of the place of practice; or

    • (ii)

      the provider number in respect of the place of practice;

 of the requesting practitioner;

  • (b)

    the date of the request;

  • (c)

    a description of the diagnostic imaging service;

  • (d)

    if all of the following circumstances apply—a statement that informs the patient that the request may be taken to a diagnostic imaging provider of the patient’s choice:

    • (i)

      the request is made on a document for use by requesting practitioners in making subsection 16B(1) requests; and

    • (ii)

      the document is supplied, or made available to, a requesting practitioner by a diagnostic imaging provider on or after 1 August 2012; and

    • (iii)

      the document contains relevant information about the diagnostic imaging provider at the time the document is supplied or made available.

(2) For the purposes of subregulation (1), a description of the diagnostic imaging service must provide, in terms that are generally understood throughout the medical profession, sufficient information to identify the item of the diagnostic imaging services table that relates to the service but it need not specify the item number.

(3)

In this regulation:

diagnostic imaging provider means a person who:

  • (a)

    renders diagnostic imaging services; or

  • (b)

    carries on the business of rendering diagnostic imaging services; or

  • (c)

    employs, or engages under a contract of service, a person mentioned in paragraph (a) or (b).

relevant information means:

  • (a)

    the registered name or trading name of the diagnostic imaging provider; and

  • (b)

    one or more locations of the diagnostic imaging provider if diagnostic imaging services are rendered at the location.

20Records of diagnostic imaging services that must be kept by providing medical practitioners

(1) For the purposes of subsection 23DS(1) of the Act, a medical practitioner who provides diagnostic imaging services (in this regulation called the providing practitioner) must prepare and maintain records of those services.

(2) For each service rendered, the providing practitioner’s records must include:

  • (a)

    a copy of the report by the providing practitioner; and

  • (b)

    if the service is rendered in circumstances specified in subsection 16B(8) of the Act, sufficient information to indicate the nature of the emergency; and

  • (c)

    if the service is rendered in circumstances specified in subsection 16B(9) of the Act, words indicating:

    • (i)

      that the person to whom the service was rendered, or a person acting on that person’s behalf, asserted that a medical practitioner, a dental practitioner, a chiropractor, an osteopath, a physiotherapist, a podiatrist, a participating midwife or a participating nurse practitioner (in this regulation called the requesting practitioner) had requested that the service be rendered but that the request had been lost; and

    • (ii)

      that the providing practitioner, or an employee or agent of the providing practitioner, had sought and received from the requesting practitioner, or from an employee or agent of the requesting practitioner, confirmation that the request had been made; and

    • (iii)

      the date and manner of that confirmation; and

  • (d)

    if the service is rendered in the circumstances mentioned in subsection 16B(10A) of the Act:

    • (i)

      words indicating that the providing practitioner has consulted with the requesting practitioner and the date of that consultation; or

    • (ii)

      if the providing practitioner has not consulted with the requesting practitioner, sufficient information to demonstrate that he or she has taken all reasonable steps to do so.

(2A)

If an ultrasound service is performed by a registered sonographer under the supervision, or at the direction, of the providing practitioner, the report mentioned in paragraph (2)(a) must include the name of the registered sonographer who performed the service.

(3) The providing practitioner’s records must be kept in a manner that enables retrieval of information on the basis of:

  • (a)

    the name of the person to whom the service was rendered; and

  • (b)

    the date on which the service was rendered.

(4)

In this regulation:

registered sonographer means a person whose name is entered on the Register of Sonographers kept by the Chief Executive Medicare.

20ADiagnostic imaging – information to be included in application for registration

For paragraph 23DZP(1)(d) of the Act, the other information to be included in an application for registration of diagnostic imaging premises or a base for mobile diagnostic imaging equipment is:

  • (a)

    the nature of the practice; and

  • (b)

    details of the diagnostic imaging equipment ordinarily located at the premises or base, including:

    • (i)

      if the equipment is a type of equipment, prescribed in regulation 20C—the type of equipment, the age and quantity of equipment of that type; and

    • (iii)

      the functionality of the equipment; and

    • (iv)

      if the equipment has a serial number or other identifying number—that number; and

  • (c)

    if the premises are, or the base is, accredited under a diagnostic imaging accreditation scheme—the information mentioned in subregulation 20B(2).

Example for paragraph (a): The practice might be a base for mobile equipment, a specialist diagnostic imaging practice (either on a stand‑alone practice site or co‑located with a primary care practice or group), a primary care practice, a sports medicine clinic or a public hospital.

20BDiagnostic imaging – information to be included on register
  • (1)

    For subparagraph 23DZQ(1)(b)(iv) of the Act, the other information to be included on the register is the information included in the application for registration.

  • (2)

    For subsections 23DZZIAB(1) and (2) of the Act, the following information is to be included on the register:

    • (a)

      the name of the approved accreditor;

    • (b)

      the commencement date for the accreditation;

    • (c)

      the diagnostic imaging procedures for which the premises are, or base is, accredited or not accredited;

    • (d)

      the expiry date for the accreditation.

20CPrimary information – types of diagnostic imaging equipment
  • (1)

    For subsection 23DZR(2) of the Act, diagnostic imaging equipment is prescribed if:

    • (a)

      the equipment is used in carrying out a diagnostic imaging procedure used in rendering a service that is described in an item of the type mentioned in columns 2 and 3 of an item of the following table; and

    • (b)

      the conditions (if any) mentioned in column 4 of that item of the following table are met.

Diagnostic imaging equipment

Item

Column 1

Diagnostic imaging equipment

Column 2

The item is …

Column 3

in the following provision of the diagnostic imaging services table:

Column 4

Conditions

1

Ultrasound equipment non‑musculoskeletal K‑type

a (K) item

Group I1 (other than Subgroup 6)

The equipment is 10 years old or less

2

Ultrasound equipment non‑musculoskeletal K‑type upgraded

a (K) item

Group I1 (other than Subgroup 6)

The equipment:

(b) is more than 10 years old and no more than 15 years old; and

(c) was upgraded on or before it was 10 years old

3

Ultrasound equipment non‑musculoskeletal NK‑type

an (NK) item

Group I1 (other than Subgroup 6)

The equipment:

(a) is more than 10 years old and has not been upgraded; or

(b) was upgraded on or before it was 10 years old and is more than 15 years old

4

Ultrasound equipment musculoskeletal K‑type

a (K) item

Subgroup 6 of Group I1

The equipment is 10 years old or less

5

Ultrasound equipment musculoskeletal K‑type upgraded

a (K) item

Subgroup 6 of Group I1

The equipment:

(b) is more than 10 years old and no more than 15 years old; and

(c) was upgraded on or before it was 10 years old

6

Ultrasound equipment musculoskeletal NK‑type

an (NK) item

Subgroup 6 of Group I1

The equipment:

(a) is more than 10 years old and has not been upgraded; or

(b) was upgraded on or before it was 10 years old and is more than 15 years old

6A

Computed tomography equipment K‑type

a (K) item

Group I2

The equipment is 10 years old or less

7

Computed tomography equipment K‑type upgraded

a (K) item

Group I2

The equipment:

(a) is more than 10 years old and no more than 15 years old; and

(b) was upgraded on or before it was 10 years old or before 1 January 2016

8

Computed tomography equipment NK‑type

an (NK) item

Group I2

The equipment:

(a) is more than 10 years old and has not been upgraded; or

(b) was upgraded on or before it was 10 years old or before 1 January 2016, and is more than 15 years old

9

Magnetic resonance imaging equipment K‑type

a (K) item

Group I5

The equipment is 10 years old or less

10

Magnetic resonance imaging equipment K‑type upgraded

a (K) item

Group I5

The equipment:

(a) is more than 10 years old and no more than 20 years old; and

(b) was upgraded on or before it was 10 years old

11

Magnetic resonance imaging equipment NK‑type

an (NK) item

Group I5

The equipment:

(a) is more than 10 years old and has not been upgraded; or

(b) was upgraded on or before it was 10 years old and is more than 20 years old

12

Nuclear medicine imaging equipment for positron emission tomography

any of items 61523 to 61647

Group I4

13

Nuclear medicine imaging equipment K‑type

a (K) item

Group I4 (other than items 61523 to 61647)

The equipment is 10 years old or less

14

Nuclear medicine imaging equipment K‑type upgraded

a (K) item

Group I4 (other than items 61523 to 61647)

The equipment:

(a) is more than 10 years old and no more than 15 years old; and

(b) was upgraded on or before it was 10 years old

15

Nuclear medicine imaging equipment NK‑type

an (NK) item

Group I4

The equipment:

(a) is more than 10 years old and has not been upgraded; or

(b) was upgraded on or before it was 10 years old and is more than 15 years old

16

Diagnostic radiology equipment for mammography K‑type

a (K) item

Subgroup 10 of Group I3

The equipment is 10 years old or less

17

Diagnostic radiology equipment for mammography K‑type upgraded

a (K) item

Subgroup 10 of Group I3

The equipment:

(a) is more than 10 years old and no more than 15 years old; and

(b) was upgraded on or before it was 10 years old

18

Diagnostic radiology equipment for mammography NK‑type

an (NK) item

Subgroup 10 of Group I3

The equipment:

(a) is more than 10 years old and has not been upgraded; or

(b) was upgraded on or before it was 10 years old and is more than 15 years old

18A

Diagnostic radiology equipment for angiography K‑type

a (K) item

Subgroup 13 of Group I3

The equipment is 10 years old or less

19

Diagnostic radiology equipment for angiography K‑type upgraded

a (K) item

Subgroup 13 of Group I3

The equipment:

(a) is more than 10 years old and no more than 15 years old; and

(b) was upgraded on or before it was 10 years old or before 1 January 2016

20

Diagnostic radiology equipment for angiography NK‑type

an (NK) item

Subgroup 13 of Group I3

The equipment:

(a) is more than 10 years old and has not been upgraded; or

(b) was upgraded on or before it was 10 years old or before 1 January 2016, and is more than 15 years old

21

Diagnostic radiology equipment for fluoroscopic examination K‑type

a (K) item

Subgroup 15 or 17 of Group I3

The equipment is 15 years old or less

22

Diagnostic radiology equipment for fluoroscopic examination K‑type upgraded

a (K) item

Subgroup 15 or 17 of Group I3

The equipment:

(a) is more than 15 years old and no more than 20 years old; and

(b) was upgraded on or before it was 15 years old

23

Diagnostic radiology equipment for fluoroscopic examination NK‑type

an (NK) item

Subgroup 15 or 17 of Group I3

The equipment:

(a) is more than 15 years old and has not been upgraded; or

(b) was upgraded on or before it was 15 years old and is more than 20 years old

24

Diagnostic radiology equipment for orthopantomography K‑type

item 57960, 57963, 57966 or 57969

Subgroup 3 of Group I3

The equipment is 15 years old or less

25

Diagnostic radiology equipment for orthopantomography K‑type upgraded

item 57960, 57963, 57966 or 57969

Subgroup 3 of Group I3

The equipment:

(a) is more than 15 years old and no more than 20 years old; and

(b) was upgraded on or before it was 15 years old

26

Diagnostic radiology equipment for orthopantomography NK‑type

an (NK) item

Subgroup 3 of Group I3

The equipment:

(a) is more than 15 years old and has not been upgraded; or

(b) was upgraded on or before it was 15 years old and is more than 20 years old

27

Diagnostic radiology equipment X‑ray K‑type

a (K) item

Subgroups 1 to 9 (other than items 57960, 57963, 57966 and 57969), 11, 12 and 14 of Group I3

The equipment is 15 years old or less

28

Diagnostic radiology equipment X‑ray K‑type upgraded

a (K) item

Subgroups 1 to 9 (other than items 57960, 57963, 57966 and 57969), 11, 12 and 14 of Group I3

The equipment:

(a) is more than 15 years old and no more than 20 years old; and

(b) was upgraded on or before it was 15 years old

29

Diagnostic radiology equipment X‑ray NK‑type

an (NK) item

Subgroups 1 to 9 (other than items 57959, 57962, 57965 and 57968), 11, 12 and 14 of Group I3

The equipment:

(a) is more than 15 years old and has not been upgraded; or

(b) was upgraded on or before it was 15 years old and is more than 20 years old

  • (2)

    Clause 1.2.2 of the diagnostic imaging services table (age of equipment) applies, for this regulation, in the same way as that clause applies for the diagnostic imaging services table.

20CAMethod for determining substantial difference from market value
  • (1)

    For subsection 23DZZIF(9) of the Act, the method mentioned in subregulation (2) is prescribed for working out whether the amount of a payment or of consideration for property, goods or services is substantially different from the market value of the property, goods or services.

  • (2)

    The amount of the payment or consideration is substantially different from the market value, determined in accordance with regulation 20CB, if the difference between the market value and the payment or consideration is more than 20% of the market value.

20CBMethod for determining market value
  • (1)

    For subsection 23DZZIF(9) of the Act, the market value of property, goods or services is the amount that a willing purchaser would have had to pay, at the time mentioned in subregulation (2), to a vendor who was willing, but not anxious, to sell.

  • (2)

    The time is:

    • (a)

      for an offence of asking for a benefit that is not a permitted benefit—when the person asked for the benefit; or

    • (b)

      for an offence of accepting a benefit that is not a permitted benefit—when the person accepted the benefit; or

    • (c)

      for an offence of offering a benefit that is not a permitted benefit—when the person offered the benefit; or

    • (d)

      for an offence of providing a benefit that is not a permitted benefit—when the person provided the benefit.

20DRadiation oncology – information to be included in application for registration

For paragraph 23DZZO(1)(d) of the Act, the other information to be included in an application for registration of radiation oncology premises or a base for radiation oncology equipment is:

  • (a)

    the nature of the practice; and

  • (b)

    details of the radiation oncology equipment ordinarily located at the premises or base, including:

    • (i)

      the quantity of equipment of each type mentioned in regulation 20F; and

    • (ii)

      the functionality of the equipment; and

    • (iii)

      if the equipment has a serial number or other identifying number—that number.

Examples for paragraph (a): The practice might be a base for mobile equipment, a specialist radiation oncology practice (either on a stand‑alone practice site or co‑located with a primary care practice or group), a primary care practice, a sports medicine clinic or a public hospital.

20ERadiation oncology – information to be included on register

 For subparagraph 23DZZP(1)(b)(iv) of the Act, the other information to be included on the register is the information included in the application for registration.

20FPrimary information – types of radiation oncology equipment

For subsection 23DZZQ(2) of the Act, the following types of radiation oncology equipment are prescribed:

  • (a)

    megavoltage equipment—that is, equipment used in the rendering of a radiation oncology service described in subgroup 3 of Group T2 in the general medical services table;

  • (b)

    planning equipment—that is, equipment used in the rendering of a radiation oncology service described in subgroup 5 of Group T2 in the general medical services table;

  • (c)

    brachytherapy equipment—that is, equipment used in the rendering of a radiation oncology service described in subgroup 4 of Group T2 in the general medical services table.

21Application form – application for approval as an organisation under Part IV of the Act

(1) For the purposes of subsection 40(1) of the Act, the prescribed form, in accordance with which an application under that subsection by an organization for approval as an organization under Part IV of the Act shall be made, is Form 1 in Schedule 1.

(2) An application under subsection 40(1) of the Act by an organization shall be signed by a person, being one of the persons responsible for the management of the organization, authorized in writing by the organization to sign that application.

Intensive Care

Medical Oncology

Neurology

Nuclear Medicine

Paediatric Medicine

Renal Medicine

Rheumatology

Thoracic Medicine

203A

The Royal Australasian College of Physicians,

Australasian Faculty of Occupational Medicine

Note: This organisation is now called by the name mentioned in column 2 of item 103.

Occupational Medicine

Fellowship of the Australasian Faculty of Occupational Medicine

(FAFOM)

Note: This qualification has not been awarded since 7 May 2007.

204

Royal Australasian College of Surgeons, Faculty of Anaesthetists

Anaesthesia Intensive Care

Fellowship of the Faculty of Anaesthetists, Royal Australasian College of Surgeons (FFARACS)

Note: This qualification has not been awarded since 7 February 1992.

205

The Royal Australasian College of Radiologists

Note: This organisation is now called by the name specified in column 2 of item 109.

Diagnostic Radiology

Nuclear Medicine

Radiation Oncology

Fellowship of the Royal Australasian College of Radiologists (FRACR)

Note: This qualification has not been awarded since 26 October 1998.

206

The Royal Australian College of Obstetricians and Gynaecologists

Note: This organisation is now called by the name specified in column 2 of item 111.

Obstetrics and Gynaecology

Gynaecological Oncology

Maternal‑fetal Medicine

Obstetrics and Gynaecological Ultrasound

Reproductive Endocrinology and Infertility

Urogynaecology

Fellowship of the Royal Australian College of Obstetricians and Gynaecologists (FRACOG)

Note: This qualification has not been awarded since 22 October 1998.

207

The Royal Australian College of Ophthalmologists

Note: This organisation is now called by the name specified in column 2 of item 112.

Ophthalmology

Fellowship of the Royal Australian College of Ophthalmologists (FRACO)

Note: This qualification has not been awarded since 20 December 2000.

208

Australian and New Zealand College of Anaesthetists and Royal Australasian College of Physicians, Joint Faculty of Intensive Care Medicine

Note: This organisation is now called by the name mentioned in column 2 of item 115.

Intensive Care Medicine

Fellowship of the Joint Faculty of Intensive Care Medicine (FJFICM)

Note: This qualification has not been awarded since 1 January 2010.

Schedule 5Matters specified for Register of Approved Placements

(regulations 6E and 6EA)

Part 1Specified bodies and qualifications

Item

Body

Qualification

1

Australasian Chapter of Addiction Medicine

FAChAM

2

Australasian Chapter of Palliative Medicine

FAChPM

3

Australasian Chapter of Sexual Health Medicine

FAChSHM

4

Australasian College for Emergency Medicine

FACEM

5

Australasian College of Dermatologists

FACD

6

Australasian College of Sports Physicians

FACSP

7

Australasian Faculty of Occupational and Environmental Medicine

FAFOEM

8

Australasian Faculty of Public Health Medicine

FAFPHM

9

Australasian Faculty of Rehabilitation Medicine

FAFRM

10

Australian and New Zealand College of Anaesthetists

FANZCA

11

College of Intensive Care Medicine of Australia and New Zealand

FCICM

12

Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists

FFPMANZCA

13

Royal Australasian College of Physicians

FRACP

14

Royal Australasian College of Surgeons

FRACS

15

Royal Australian and New Zealand College of Obstetricians and Gynaecologists

FRANZCOG

16

Royal Australian and New Zealand College of Ophthalmologists

FRANZCO

17

Royal Australian and New Zealand College of Psychiatrists

FRANZCP

18

Royal Australian and New Zealand College of Radiologists

FRANZCR

19

Royal College of Pathologists of Australasia

FRCPA

Part 2Specified bodies and programs

Item

Body

Program

1

Health Department

Approved Medical Deputising Services Program

2

Health Department

Approved Private Emergency Department Program

3

Health Department

Rural Locum Relief Program

4

Health Department

Special Approved Placements Program

5

Health Department

Temporary Resident Other Medical Practitioners Program

6

Health Department

Australian General Practice Training Program

8

General Practice Workforce Inc—

trading as Health Recruitment Plus

Rural Locum Relief Program

9

Health Workforce Queensland Ltd (ACN 065 574 996)

Rural Locum Relief Program

10

Northern Territory Medicare Local Ltd (ACN 158 970 480)

Rural Locum Relief Program

11

NSW Rural Doctors Network Ltd (ACN 081 388 810)

Rural Locum Relief Program

12

Queensland Department of Health

Queensland Country Relieving Doctors Program

14

Remote Vocational Training Scheme Ltd (ACN 122 891 838)

Remote Vocational Training Scheme

15

Rural Doctors Workforce Agency Incorporated

Rural Locum Relief Program

16

Rural Workforce Agency, Victoria Limited (ACN 081 163 519)

Rural Locum Relief Program

17

Western Australian Centre for Remote and Rural Medicine Ltd (ACN 123 188 367)

Rural Locum Relief Program

18

Australian College of Rural and Remote Medicine

Independent Pathway

Part 3Participatory eligibility programs1Specific Workforce Shortage Program
  • (1)

    This item relates to:

    • (a)

      the Specific Workforce Shortage Program established by the Minister for the placement of medical practitioners in locations otherwise underprovided with medical practitioners qualified to provide services in demand; and

    • (b)

      the associated registration of medical practitioners, under section 3GA of the Act, in the Register of Approved Placements.

  • (2)

    A medical practitioner who is an applicant under subsection 3GA(5) of the Act is eligible for registration if he or she:

    • (a)

      is awaiting:

      • (i)

        recognition, by the appropriate Australian medical college, of an acquired overseas specialist qualification; or

      • (ii)

        if he or she is an overseas trained doctor or former overseas medical student, within the meaning of section 19AB of the Act, who has an exemption under subsection 19AB(3) of the Act—recognition, by the Royal Australian College of General Practitioners, of his or her post‑graduate general practice qualifications; and

    • (b)

      because of the circumstance mentioned in paragraph (a), has been accepted for participation in the Program to provide professional services.

Schedule 6Services for which medicare benefit is 100% of Schedule fee

(regulation 6EF)

  1Items of the general medical services table

 For the purposes of paragraph 6EF(a), a service described in an item of the general medical services table mentioned in column 2 of the following table is prescribed.

Items of the general medical services table

Item

Column 1

Group

Column 2

Items of the general medical services table

1

A1

3, 4, 20, 23, 24, 35, 36, 37, 43, 44, 47, 51

2

A2

52, 53, 54, 57, 58, 59, 60, 65, 92, 93, 95, 96,

3

A5

160, 161, 162, 163, 164

4

A6

170, 171, 172

5

A7

173, 193, 195, 197, 199

6

A11

585, 588, 591, 594, 599, 600

7

A14

701, 703, 705, 707, 715

8

A15

721, 723, 729, 731, 732, 735, 739, 743, 747, 750, 758

9

A17

900, 903

10

A18

2497, 2501, 2503, 2504, 2506, 2507, 2509, 2517, 2518, 2521, 2522, 2525, 2526, 2546, 2547, 2552, 2553, 2558, 2559

11

A19

2598, 2600, 2603, 2606, 2610, 2613, 2616, 2620, 2622, 2624, 2631, 2633, 2635, 2664, 2666, 2668, 2673, 2675, 2677

12

A20

2700, 2701, 2712, 2713, 2715, 2717, 2721, 2723, 2725, 2727

13

A22

5000, 5003, 5010, 5020, 5023, 5028, 5040, 5043, 5049, 5060, 5063, 5067

14

A23

5200, 5203, 5207, 5208, 5220, 5223, 5227, 5228, 5260, 5263, 5265, 5267

15

A27

4001

15A

A29

139

15B

A30

2100, 2122, 2125, 2126, 2137, 2138, 2143, 2147, 2179, 2195, 2199, 2200

16

M12

10983, 10984, 10986, 10987, 10988, 10989, 10997

2Items of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018

 For the purposes of paragraph 6EF(a), a service specified in an item of a Schedule (within the meaning of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018) mentioned in column 2 of the following table is prescribed.

 

Items of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018

Item

Column 1

Subgroup

Column 2

Items of the Health Insurance (Section 3C General Medical Services – Other Medical Practitioner) Determination 2018

1

Subgroup 2 of Group A7

179, 181, 183, 185, 187, 188, 189, 191, 202, 203, 206, 212

2

Subgroup 3 of Group A7

214, 215, 218, 219, 220

3

Subgroup 4 of Group A7

221, 222, 223

4

Subgroup 5 of Group A7

224, 225, 226, 227, 228

5

Subgroup 6 of Group A7

229, 230, 231, 232, 233, 235, 236, 237, 238, 239, 240, 243, 244

6

Subgroup 7 of Group A7

245, 249

7

Subgroup 8 of Group A7

251, 252, 253, 254, 255, 256, 257, 259, 260, 261, 262, 263, 264, 265, 266, 268, 269, 270, 271

8

Subgroup 9 of Group A7

272, 276, 277, 279, 281, 282, 283, 285, 286, 287

9

Subgroup 10 of Group A7

733, 737, 741, 745, 761, 763, 766, 769, 772, 776, 788, 789

10

Subgroup 11 of Group A7

792

11

Subgroup 12 of Group A7

812, 827, 829, 867, 868, 869, 873, 876, 881, 885, 891, 892

Endnotes

Endnote 1About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Editorial changes

The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.

If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

Endnote 2Abbreviation key

ad = added or inserted

o = order(s)

am = amended

Ord = Ordinance

amdt = amendment

orig = original

c = clause(s)

par = paragraph(s)/subparagraph(s)

C[x] = Compilation No. x

 /sub‑subparagraph(s)

Ch = Chapter(s)

pres = present

def = definition(s)

prev = previous

Dict = Dictionary

(prev…) = previously

disallowed = disallowed by Parliament

Pt = Part(s)

Div = Division(s)

r = regulation(s)/rule(s)

ed = editorial change

reloc = relocated

exp = expires/expired or ceases/ceased to have

renum = renumbered

 effect

rep = repealed

F = Federal Register of Legislation

rs = repealed and substituted

gaz = gazette

s = section(s)/subsection(s)

LA = Legislation Act 2003

Sch = Schedule(s)

LIA = Legislative Instruments Act 2003

Sdiv = Subdivision(s)

(md) = misdescribed amendment can be given

SLI = Select Legislative Instrument

 effect

SR = Statutory Rules

(md not incorp) = misdescribed amendment

Sub‑Ch = Sub‑Chapter(s)

 cannot be given effect

SubPt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

 commenced or to be commenced

Endnote 3Legislation history

Number and year

FRLI registration or gazettal

Commencement

Application, saving and transitional provisions

1975 No. 80

16 May 1975

16 May 1975

1975 No. 118

13 June 1975

13 June 1975

1975 No. 125

27 June 1975

1 July 1975

1975 No. 135

3 July 1975

3 July 1975

Note: disallowed by the Senate on 4 Sept 1975

1976 No. 202

23 Sept 1976

23 Sept 1976

1976 No. 214

30 Sept 1976

1 Oct 1976

1976 No. 215

30 Sept 1976

30 Sept 1976

1977 No. 26

15 Mar 1977

r. 2(2): 1 Apr 1977

Remainder: 15 Mar 1977

1977 No. 44

15 Apr 1977

15 Apr 1977

1978 No. 95

29 June 1978

1 July 1978

1978 No.177

26 Sept 1978

26 Sept 1978

1979 No. 230

31 Oct 1979

31 Oct 1979

1981 No. 198

17 July 1981

25 June 1981

1981 No. 317

4 Nov 1981

1 Sept 1981

1982 No. 157

30 June 1982

1 July 1982

1982 No. 251

1 Oct 1982

1 Oct 1982

1982 No. 287

29 Oct 1982

r. 1: 1 Nov 1982

Remainder: 29 Oct 1982

1983 No. 106

22 July 1983

22 July 1983

1983 No. 231

28 Oct 1983

1 Nov 1983

1983 No. 253

31 Oct 1983

1 Feb 1984

1983 No. 255

31 Oct 1983

31 Oct 1983

1984 No. 5

26 Jan 1984

1 Mar 1984

1984 No. 162

25 July 1984

1 Mar 1984

1985 No. 36

4 Apr 1985

4 Apr 1985

1985 No. 50

29 Apr 1985

29 Apr 1985

1985 No. 95

7 June 1985

7 June 1985

1985 No. 205

29 Aug 1985

29 Aug 1985

1985 No. 290

7 Nov 1985

7 Nov 1985

Note: disallowance by the Senate on 10 Apr 1986

1986 No. 19

21 Feb 1986

22 Feb 1986

1986 No. 20

21 Feb 1986

22

 Feb 1986

1986 No. 87

9 May 1986

9 May 1986

1986 No. 326

6 Nov 1986

6 Nov 1986

1987 No. 32

6 Mar 1987

7 Mar 1987

1987 No. 163

29 July 1987

1 Aug 1987

1987 No. 166

31 July 1987

1 Aug 1987

1988 No. 314

2 Dec 1988

r. 2: 1 Aug 1987

r. 3: 1 Aug 1988

Remainder: 2 Dec 1988

1989 No. 6

31 Jan 1989

31 Jan 1989

1989 No. 54

14 Apr 1989

14 Apr 1989

1989 No. 117

21 June 1989

21 June 1989

1989 No. 293

31 Oct 1989

31 Oct 1989

1990 No. 25

13 Feb 1990

13 Feb 1990

1991 No. 82

30 Apr 1991

1 May 1991

1991 No. 314

16 Oct 1991

1 Nov 1991

1991 No. 365

27 Nov 1991

1 Dec 1991

1991 No. 441

19 Dec 1991

1 Feb 1992

1992 No. 42

28 Feb 1992

r. 6.2: 1 Apr 1992

Remainder: 1 Mar 1992

1992 No. 111

28 Apr 1992

rr. 4‑6: 1 May 1992

Remainder: 28 Apr 1992

1992 No. 239

29 July 1992

1 May 1992 (r 1.1)

1992 No. 335

27 Oct 1992

1 Nov 1992

1992 No. 431

24 Dec 1992

24 Dec 1992

1993 No. 106

3 June 1993

3 June 1993

1993 No. 130

17 June 1993

17 June 1993

1993 No. 154

29 June 1993

1 July 1993

1994 No. 20

18 Feb 1994

1 Mar 1994

1994 No. 27

25 Feb 1994

25 Feb 1994

1994 No. 111

29 Apr 1994

1 May 1994

1994 No. 137

23 May 1994

23 May 1994

1994 No. 138

23 May 1994

1 July 1994

r. 5

1994 No. 328

23 Sept 1994

23 Sept 1994

1994 No. 413

13 Dec 1994

13 Dec 1994

1995 No. 9

3 Feb 1995

3 Feb 1995

1995 No. 25

28 Feb 1995

28 Feb 1995

1995 No. 287

10 Oct 1995

10 Oct 1995

1995 No. 300

26 Oct 1995

1 Nov 1995

1995 No. 409

19 Dec 1995

1 Jan 1996 (r. 1)

1996 No. 231

30 Oct 1996

1 Nov 1996

1996 No. 234

30 Oct 1996

1 Nov 1996

1996 No. 235

30 Oct 1996

1 Nov 1996

1996 No. 335

24 Dec 1996

24 Dec 1996

1996 No. 336

24 Dec 1996

1 Jan 1997

1997 No. 61

26 Mar 1997

26 Mar 1997

1997 No. 287

8 Oct 1997

8 Oct 1997

1997 No. 300

31 Oct 1997

1 Nov 1997

1997 No. 319

17 Nov 1997

17 Nov 1997

1997 No. 395

24 Dec 1997

1 Jan 1998

1998 No. 44

25 Mar 1998

1 Feb 1998

1998 No. 125

9 June 1998

1 July 1998

1998 No. 138

25 June 1998

1 July 1998

1998 No. 204

1 July 1998

1 July 1998

1998 No. 220

7 July 1998

7 July 1998

1998 No. 253

6 Aug 1998

6 Aug 1998

1998 No. 268

26 Aug 1998

1 Sept 1998

1998 No. 370

22 Dec 1998

22 Dec 1998

1998 No. 371

22 Dec 1998

22 Dec 1998

1998 No. 372

22 Dec 1998

1 Jan 1999

1999 No. 48

24 Mar 1999

24 Mar 1999

1999 No. 88

4 June 1999

4 June 1999

1999 No. 157

28 July 1999

28 July 1999

1999 No. 176

1 Sept 1999

1 Sept 1999

1999 No. 254

27 Oct 1999

1 Nov 1999

1999 No. 343

22 Dec 1999

1 Jan 2000

1999 No. 344

22 Dec 1999

1 Feb 2000

2000 No. 146

28 June 2000

28 June 2000

2000 No. 290

1 Nov 2000

1 Nov 2000

2001 No. 272

5 Oct 2001

5 Oct 2001

2001 No. 273

5 Oct 2001

5 Oct 2001

2001 No. 274

5 Oct 2001

1 Nov 2001

2001 No. 275

5 Oct 2001

1 Nov 2001

2001 No. 290

1 Dec 2001

1 Dec 2001

2001 No. 342

21 Dec 2001

21 Dec 2001

2002 No. 246

24 Oct 2002

rr. 1–3 and Schedule 1: 1 Nov 2001

Remainder: 1 Nov 2002

2002 No. 261

6 Nov 2002

Sch 2: 1 Sept 1999 (r 2(b))

Remainder: 1 Mar 1999 (r 2(a))

2003 No. 87

16 May 2003

16 May 2003

r. 4

2003 No. 254

16 Oct 2003

1 Nov 2003

2003 No. 356

23 Dec 2003

23 Dec 2003

2003 No. 357

23 Dec 2003

23 Dec 2003

2004 No. 46

30 Mar 2004

30 Mar 2004

2004 No. 75

30 Apr 2004

30 Apr 2004

2004 No. 110

3 June 2004

3 June 2004

2004 No. 125

18 June 2004

18 June 2004

2004 No. 180

1 July 2004

1 July 2004

2004 No. 181

1 July 2004

1 July 2004

2004 No. 305

29 Oct 2004

1 Nov 2004

2004 No. 306

29 Oct 2004

1 Nov 2004

2004 No. 324

25 Nov 2004

25 Nov 2004

2004 No. 383

23 Dec 2004

1 Jan 2005

2005 No. 9

14 Feb 2005 (F2005L00169)

r. 1, 2, 3(1) and Schedule 1: 30 Apr 1997

r. 3(2) and Schedule 2: 31 May 1997

r. 4(1) and Schedule 3: 23 Oct 1998

r. 4(2) and Schedule 4: 27 Oct 1998

r. 4(3) and Schedule 5: 21 Dec 2000

r. 4(4) and Schedule 6: 22 Feb 2002

Remainder: 14 Feb 2005

2005 No. 64

27 Apr 2005 (F2005L00938)

1 May 2005

2005 No. 128

21 June 2005 (F2005L01451)

1 July 2005

2005 No. 207

19 Sept 2005 (F2005L02673)

1 Oct 2005 (r. 2)

2005 No. 236

27 Oct 2005 (F2005L03104)

28 Oct 2005

2005 No. 237

27 Oct 2005 (F2005L03124)

1 Nov 2005

2005 No. 286

2 Dec 2005 (F2005L03869)

1 Jan 2006

2006 No. 69

31 Mar 2006 (F2006L00966)

1 Apr 2006

2006 No. 84

28 Apr 2006 (F2006L01209)

1 May 2006

2006 No. 269

20 Oct 2006 (F2006L03311)

1 Nov 2006

2007 No. 55

30 Mar 2007 (F2007L00582)

1 Apr 2007

2007 No. 56

30 Mar 2007 (F2007L00802)

1 Apr 2007 (r. 2)

2007 No. 98

27 Apr 2007 (F2007L00992)

1 May 2007

2007 No. 187

29 June 2007 (F2007L01519)

1 July 2007

2007 No. 311

28 Sept 2007 (F2007L02262)

29 Sept 2007

2007 No. 337

8 Oct 2007 (F2007L03759)

1 Nov 2007

2008 No. 110

20 June 2008 (F2008L01330)

1 July 2008

2008 No. 209

17 Oct 2008 (F2008L03448)

1 Nov 2008 (r. 2 and F2008L03447)

2009 No. 136

25 June 2009 (F2009L02306)

1 July 2009

2009 No. 225

10 Sept 2009 (F2009L02262)

11 Sept 2009

2009 No. 270

13 Oct 2009 (F2009L03138)

1 Nov 2009 (r. 2)

2009 No. 306

13 Nov 2009 (F2009L03987)

1 Jan 2010

2009 No. 368

15 Dec 2009 (F2009L04019)

1 Jan 2010

2009 No. 369

15 Dec 2009 (F2009L04017)

1 July 2010

2010 No. 230

21 July 2010 (F2010L01978)

rr. 1–3 and Schedule 1: 22 July 2010

Schedule 2: 1 Nov 2010

2010 No. 260

27 Oct 2010 (F2010L02796)

rr. 1–3 and Schedule 1: 1 May 2010

r. 4 and Schedule 2: 1 Nov 2010

r. 4

2010 No. 261

27 Oct 2010 (F2010L02770)

1 Nov 2010

2010 No. 262

28 Oct 2010 (F2010L02797)

1 Nov 2010

2011 No. 27

15 Mar 2011 (F2011L00426)

1 Jan 2010

2011 No. 98

20 June 2011 (F2011L01083)

1 July 2011

2011 No. 120

30 June 2011 (F2011L01364)

1 July 2011

2011 No. 183

24 Oct 2011 (F2011L02113)

25 Oct 2011

2011 No. 184

25 Oct 2011 (F2011L02119)

rr. 1–3 and Schedule 1: 1 Nov 2011

Schedule 2: 1 Jan 2012

2012 No. 57

20 Apr 2012 (F2012L00906)

1 May 2012

2012 No. 138

30 June 2012 (F2012L01477)

1 July 2012

2012 No. 165

13 July 2012 (F2012L01547)

1 Aug 2012

2012 No. 293

7 Dec 2012 (F2012L02368)

8 Dec 2012

2012 No. 294

10 Dec 2012 (F2012L02372)

27 Dec 2012

186, 2013

25 July 2013 (F2013L01432)

1 Sept 2013

250, 2013

26 Nov 2013 (F2013L01982)

Sch 1: 27 Nov 2013

28, 2014

17 Mar 2014 (F2014L00280)

Sch 1 (items 3–5): 18 Mar 2014

148, 2014

17 Oct 2014 (F2014L01362)

Sch 3 (items 1–3): 1 Nov 2014 (s 2 item 4)

Sch 3 (items 39–50): 1 Jan 2015 (s 2 item 5)

149, 2014

17 Oct 2014 (F2014L01360)

Sch 1 (items 28–33): 1 Jan 2015 (s 2 item 3)

195, 2014

16 Dec 2014 (F2014L01715)

Sch 1 (items 21, 22): 17 Dec 2014 (s 2 item 3)

236, 2015

14 Dec 2015 (F2015L01965)

Sch 1: 1 Jan 2016 (s 2(1) item 1)

Name

Registration

Commencement

Application, saving and transitional provisions

Health Insurance Legislation Amendment (2016 Measures No. 2) Regulation 2016

14 Oct 2016 (F2016L01616)

Sch 1 (items 44, 45): 1 Nov 2016 (s 2(1) item 2)

Sch 1 (items 46–48) 1 Jan 2017 (s 2(1) item 3)

Health Insurance Legislation Amendment (2017 Measures No. 2) Regulations 2017

12 Oct 2017 (F2017L01343)

Sch 1 (item 26): 1 Nov 2017 (s 2(1) item 1)

Health Insurance Legislation Amendment (2017 Measures No. 3) Regulations 2017

3 Nov 2017 (F2017L01429)

Sch 1 (item 29): 1 Dec 2017 (s 2(1) item 1)

Health Insurance Legislation Amendment (After Hours Services) Regulations 2018

30 Jan 2018 (F2018L00062)

Sch 1 (item 15): 1 Mar 2018 (s 2(1) item 1)

Health Insurance Legislation Amendment (2018 Measures No. 1) Regulations 2018

24 Apr 2018 (F2018L00514)

Sch 1 (items 22, 23): 1 May 2018 (s 2(1) item 1)

Health Insurance Legislation Amendment (2018 Measures No. 2) Regulations 2018

13 June 2018 (F2018L00768)

Sch 1 (items 59–62), Sch 2: 1 July 2018 (s 2(1) items 2–4)

Endnote 4Amendment history

Provision affected

How affected

Part 1

Part 1 heading..............................

ad F2016L01616

r 1...............................................

rs 1998 No 268

r. 2..............................................

rs. 1983 No. 253

am. 1989 No. 54; 1991 No. 82

rs. 1991 No. 365

am. 1991 No. 441; 1992 Nos. 42 and 111; 1996 Nos. 235 and 335; 2001 No. 290; 2003 No. 87; 2005 No. 207; 2007 No. 55; 2010 No. 230; 2011 No. 120; No 250, 2013; No 28, 2014; No 149, 2014

Note to r. 2...................................

ad. 2007 No. 56

rs. 2010 No. 230

r. 2A............................................

ad. 2007 No. 55

r. 2B............................................

ad. 2010 No. 230

r. 2C............................................

ad. 2010 No. 230

am No 186, 2013

r. 2D............................................

ad. 2010 No. 230

r. 2E............................................

ad. 2010 No. 230

r 2EA..........................................

ad No 186, 2013

r. 2F............................................

ad. 2010 No. 230

r. 2G............................................

ad. 2010 No. 230

r. 2H............................................

ad. 2010 No. 230

r. 3..............................................

ad. 1975 No. 125

am. 1991 No. 365; 1999 No. 157

rs No 28, 2014

r. 3A............................................

ad. 2004 No. 125

am. 2004 No. 305; 2005 No. 286; 2006 No. 69

rs. 2006 No. 269

am. 2010 No. 230; 2011 No. 98

r. 4..............................................

ad. 1986 No. 20

rs. 2005 No. 9

r. 5..............................................

ad. 1986 No. 20

r. 6..............................................

ad. 1986 No. 20

r. 6A............................................

ad. 1996 No. 335

r. 6B............................................

ad. 1996 No. 335

am. 2005 No. 207; 2011 No. 120

r. 6C............................................

ad. 1996 No. 335

am. 2005 No. 207; 2011 No. 120

r. 6D............................................

ad. 1996 No. 335

am. 2005 No. 207; 2011 No. 120

r. 6DA.........................................

ad. 2007 No. 55

am. 2011 No. 120

r. 6DB.........................................

ad. 2007 No. 55

r. 6DC.........................................

ad. 2007 No. 55

am. 2011 No. 120

Heading to r. 6E............................

rs. 1999 No. 344

r. 6E............................................

ad. 1996 No. 335

am. 1998, No. 44; 1999 No. 344

r. 6EA..........................................

ad. 1999 No. 344

am. 2001 No. 272

r. 6EB..........................................

ad. 1999 No. 344

am. 2005 No. 207; 2011 No. 120

r. 6EF..........................................

ad. 2004 No. 383

rs. 2009 No. 270

am. 2010 No. 260; 2012 No. 57; No 250, 2013; F2018L00768

r. 6F............................................

ad. 1996 No. 335

am. 2005 No. 207; 2011 No. 120

r. 6G............................................

ad. 1996 No. 335

r. 7..............................................

ad. 1989 No. 293

rep. 2001 No. 273

r. 8..............................................

ad. 1988 No. 314

am. 1988 No. 314

rep. 1994 No. 111

r. 9..............................................

ad. 1975 No. 125

r. 9A............................................

ad. 1994 No. 413

rs. 2010 No. 230

am. 2012 No. 165

r. 10............................................

ad. 1991 No. 82

rs. 1991 No. 365

am. 1992 Nos. 111 and 239

rs. 1993 No. 130

am. 1993 No. 154; 1994 No. 111; 1996 No. 231; 1997 No. 300; 1998 No. 268; 1999 Nos. 157, 176 and 343; 2000 No. 290; 2002 Nos. 246 and 261; 2003 No. 254; 2004 No. 306; No 250, 2013; No 148, 2014; No 195, 2014

r 11.............................................

ad No 82, 1991

rs No 365, 1991

am No 42, 1992; No 111, 1992; No 239, 1992; No 231, 1996; No 87, 2003; No 337, 2007; No 306, 2009

rs No 250, 2013; F2017L01343

r 11A...........................................

ad No 261, 2010

am F2017L01429

r. 11B..........................................

ad. 2010 No. 261

am. 2011 No. 184

rs No 250, 2013

r. 12............................................

ad. 1991 No. 82

rs. 1991 No. 365

am. 1992 Nos. 111 and 239; 1996 No. 231; 1999 No. 157

rs No 250, 2013

r. 12A..........................................

ad. 1996 No. 336

am. 1997 No. 395; 1998 No. 372; 1999 No. 343

r. 12AA.......................................

ad. 2008 No. 110

rep. 2009 No. 369

r. 12B..........................................

ad. 2003 No. 87

r. 13............................................

ad. 1983 No. 255

am. 1986 No. 19; 1987 Nos. 32 and 166; 1991 Nos. 82, 365 and 441; 1992 Nos. 42 and 431; 1995 Nos. 9, 287 and 409; 1996 Nos. 231 and 234; 1998 No. 371; 1999 No. 157; 2001 Nos. 274 and 290; 2003 No. 87; 2004 No. 46; 2005 No. 207; 2007 No. 56; 2010 Nos. 230 and 260; 2011 No. 120; 2012 No. 165; F2018L00768

r. 13AA.......................................

ad. 2001 No. 272

am. 2005 No. 207; 2008 No. 209; 2011 No. 120

r. 13AB........................................

ad. 2008 No. 209

am. 2011 No. 120

r. 13AC........................................

ad. 2008 No. 209

r. 13A..........................................

ad. 1998 No. 204

am. 2005 No. 207

rep. 2007 No. 56

r. 13B..........................................

ad. 1998 No. 204

am. 2004 No. 110; 2005 No. 207; 2011 No. 120

r. 14............................................

ad. 1985 No. 36

am. 1985 No. 205; 1986 No. 87; 1989 No. 117; 1990 No. 25; 1991 No. 314; 1992 Nos. 111 and 335; 1994 No. 20; 1995 No. 9; 2005 No. 236; 2006 No. 84

r. 14A..........................................

ad. 2010 No. 230

rs F2016L01616

r. 15............................................

ad. 1975 No. 125

am. 1976 No. 215

rep F2016L01616

r. 16............................................

ad. 1986 No. 326

r. 16A..........................................

ad. 1994 No. 328

r. 17............................................

ad. 1986 No. 326

r. 18............................................

ad. 1986 No. 326

r. 18A..........................................

ad. 2012 No. 165

r. 19............................................

ad. 1991 No. 82

am. 1996 Nos. 231 and 234; 2007 No. 56; 2012 No. 165

r. 20............................................

ad. 1992 No. 42

am. 2001 No. 275; 2003 No. 87; 2005 No. 207; 2010 No. 230; 2011 No. 120

r. 20A..........................................

ad. 2003 No. 87

am. 2008 No. 110; 2011 No. 183

r. 20B..........................................

ad. 2003 No. 87

am. 2008 No. 110

r. 20C..........................................

ad. 2003 No. 87

am. 2011 No. 183

rs No 250, 2013

am No 148, 2014; F2018L00514; F2018L00768

r. 20CA........................................

ad. 2009 No. 225

r. 20CB........................................

ad. 2009 No. 225

r. 20D..........................................

ad. 2003 No. 87

r. 20E..........................................

ad. 2003 No. 87

r. 20F...........................................

ad. 2003 No. 87

r. 21............................................

ad. 1975 No. 118

am. 1976 No. 202

r. 22............................................

ad. 1975 No. 118

am. 1976 No. 202

r. 22A..........................................

ad. 1997 No. 287

rep No 236, 2015

r. 23............................................

ad. 1977 No. 44

rep. 1982 No. 251

ad. 1986 No. 20

r. 23A..........................................

ad. 1993 No. 106

r. 23B..........................................

ad. 1993 No. 106

am. 1994 No. 27

r. 23C..........................................

ad. 1993 No. 106

r. 23D..........................................

ad. 1993 No. 106

r. 23E..........................................

ad. 1993 No. 106

am. 1994 No. 27

r. 23F...........................................

ad. 1993 No. 106

am. 1994 No. 27

r. 23G..........................................

ad. 1993 No. 106

am. 1994 No. 27

r. 24............................................

ad. 1976 No. 202

rs. 1989 No. 54

am. 1994 No. 138

r. 25............................................

ad. 1986 No. 20

r. 25A..........................................

ad. 1998 No. 220

am. 2010 No. 230

r. 26............................................

ad. 1986 No. 20

r. 27............................................

ad. 1979 No. 230

am. 1983 No. 106; 1985 Nos. 50, 95 and 290

rs. 1992 No. 111

am. 1996 No. 235; 2001 No. 342; 2005 No. 207; 2011 No. 120; No 149, 2014

r. 28............................................

ad. 1992 No. 111

rs. 2005 No. 207; 2011 No. 120

Heading to r. 29............................

rs. 2012 No. 294

r. 29............................................

ad. 1975 No. 125

am. 1976 No. 215; 1978 No. 95; 1987 No. 32

rs. 1991 No. 365

am. 1996 No. 235; 2010 No. 230; 2012 No. 294

r. 30............................................

ad. 1975 No. 125

am. 1978 No. 177

rep. 1982 No. 251

ad. 1991 No. 365

am. 1995 Nos. 9 and 300

Heading to r. 31............................

rs. 2012 No. 294

r. 31............................................

ad. 1975 No. 125

am. 1976 No. 215

rep. 1982 No. 251

ad. 1991 No. 365

am. 1995 Nos. 9 and 300; 1996 No. 235; 1999 No. 157; 2010 No. 261; 2012 No. 294

Part 2

Part 2...........................................

ad F2016L01616

r 32.............................................

ad No 149, 2014

rep 30 June 2015 (r 32(3))

ad F2016L01616

Schedule 1A.................................

ad. 1996 No. 335

am. 1997 Nos. 61 and 319

rep. 1998 No. 44

Schedule......................................

am. 1975 No. 118

Schedule 1

Heading to Schedule 1...................

ad. 1976 No. 202

Schedule 1...................................

am. 1976 Nos. 202, 214 and 215; 1982 No. 251; 1992 No. 111

Form 1.........................................

ad. 1975 No. 118

am. 1976 No. 215

Form 2.........................................

ad. 1975 No. 118

am. 1976 No. 215

Schedule 1A.................................

ad. 1997 No. 287

rs. 1998 No. 253; 2004 No. 324

rep No 236, 2015

Schedule 2

Schedule 2...................................

ad. 1976 No. 202

am. 1989 No. 54; 1994 No. 138

Schedule 3

Schedule 3...................................

ad. 1979 No. 230

rs. 1992 No. 111

am. 1995 No. 25; 1996 No. 235; 2004 No. 180; 2005 No. 207; 2011 No. 120

Schedule 4

Schedule 4...................................

ad. 1986 No. 20

am. 1992 No. 111

rs. 1994 No. 137

am. 1998 No. 125; 1999 Nos. 157 and 254; 2005 No. 9

rs. 2005 No. 9

am. 2006 No. 69; 2007 No. 311; 2009 No. 368; 2010 No. 262

Schedule 5

Heading to Schedule 5...................

rs. 1999 No. 344

Schedule 5...................................

ad. 1998 No. 44

am. 1998 Nos. 138 and 370; 1999 Nos. 48 and 344; 2000 No. 146; 2001 Nos. 272 and 342; 2003 Nos. 356 and 357; 2004 Nos. 75 and 181; 2007 Nos. 98 and 311; 2009 No. 368; 2010 No. 262; 2012 No 138, 2014; No 149, 2014; No 293, 2014; F2016L01616

Schedule 6

Schedule 6...................................

ad. 2004 No. 383

am. 2005 Nos. 64, 128 and 237; 2006 Nos. 84 and 269; 2007 No. 187; 2009 No. 136

rs. 2010 No. 260

am. 2011 Nos. 27, 98 and 184; F2018L00062; F2018L00768

Endnote 5Miscellaneous

Repeal table

The amendment history of the repealed provisions of the Health Insurance Regulations 1975 up to and including the Health Insurance Regulations (Amendment)(1992 No. 111) appears in the table below.

 

Provision affected

How affected

r. 2AA.........................................

ad. 1975 No. 125

rep. 1982 No. 251

r. 2AAB.......................................

ad. 1976 No. 202

am. 1977 No. 26

rep. 1982 No. 251

r. 2AC.........................................

ad. 1975 No. 125

am. 1987 No. 163

rep. 1989 No. 6

ad. 1991 No. 365

rep. 1992 No. 42

r. 2ADAA....................................

ad. 1984 No. 5

rep. 1992 No. 111

r. 2AE..........................................

ad. 1982 No. 287

rep. 1992 No. 111

r. 2A............................................

ad. 1975 No. 118

rs. 1976 No. 202

rep. 1982 No. 251

r. 2B............................................

ad. 1975 No. 118

rs. 1976 No. 202

am. 1976 No. 214

rep. 1982 No. 251

r. 2C............................................

ad. 1975 No. 118

rs. 1976 No. 202

rep. 1982 No. 251

r. 2CD.........................................

ad. 1991 No. 82

rep. 1992 No. 42

rr. 3, 4..........................................

rs. 1976 No. 202

rep. 1992 No. 111

r. 4A............................................

ad. 1981 No. 198

rep. 1992 No. 111

r. 5..............................................

ad. 1975 No. 118

am. 1976 No. 202

rep. 1982 No. 251

rr. 6, 7..........................................

ad. 1975 No. 118

am. 1976 No. 202; 1982 No. 251

rep. 1992 No. 111

r. 7A............................................

ad. 1976 No. 202

rep. 1992 No. 111

Heading to Schedule.....................

rep. 1976 No. 202

Schedule 4...................................

ad. 1981 No. 198

am. 1981 No. 317; 1982 No. 157; 1983 No. 231; 1984 No. 5

rep. 1992 No. 111

Schedule 5...................................

ad. 1984 No. 5

rs. 1984 No. 162

rep. 1992 No. 111

Renumbering table

The renumbering of provisions of the Health Insurance Regulations 1975, made by the Health Insurance Regulations (Amendment) (1992 No. 111) appears in the table below.

Old

number

New

number

Regulation

Regulation

1

1

2

2

2AB

3

2ABA

4

2ABB

5

2ABC

6

2ABD

7

2ACA

8

2AD

9

2ADAAA

10

2ADAAB

11

2ADAAC

12

2ADA

13

2ADB

14

2CA

15

2CB

16

2CC

17

2CD

18

2CE

19

2CF

20

8

21

9

22

9AA

23

9A

24

9AB

25

9AC

26

9B

27

9C

28

10

29

11

30

12

31

Schedule 1

Schedule 1

Form 6

Form 1

Form 7

Form 2

Schedule 2

Schedule 2

Schedule 3

Schedule 3

Schedule 6

Schedule 4

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