Health Insurance Regulations (Amendment) (Cth)

   

Statutory Rules

1976 No. 214

REGULATIONS UNDER THE HEALTH INSURANCE ACT 1973.*

I, THE GOVERNOR-GENERAL of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, hereby make the following Regulations under the Health Insurance Act 1973.

Dated this thirtieth day of September, 1976.

JOHN R. KERR

Governor-General.

By His Excellency’s Command,

RALPH J. HUNT

Minister of State for Health.

________

 

Amendments of the Health insurance Regulations 

Commencement.

1. These Regulations shall come into operation on 1 October 1976.

Claim form—claim by person who has incurred medical expenses.

2. Regulation 2b of the Health Insurance Regulations is amended by adding at the end thereof the following sub-regulation:—

“ (2) In Form 1b in Schedule 1, ‘ practitioner ’ includes a participating optometrist.”.

Schedule 1.

3.Schedule 1 to the Health Insurance Regulations is amended by omitting Forms 1a, 1b and 1c and substituting the following forms:—

________________________________________________________________________________

• Notified in the Australian Government Gazette on 30 September 1976.

  Statutory Rules 1975, No. 80, as amended by Statutory Rules 1975, Nos. 118, 125 and 135 (commenced 3 July 1975; disallowed 4 September 1975); and 1976, No. 202.

ASSIGNMENT FORM Form 1A  Regulation 2a

(SUB-SECTION 20 (3) HEALTH INSURANCE ACT 1973)

PATIENT’S NAME_			CHRISTIAN OR GIVEN NAMES
						m   f
MEDIBANK NUMBER			PATIENT’S DATE OF BIRTH			(COMPLETE IF MEDIBANK NUMBER NOT QUOTED)				SEX
			DAY	MONTH	YEAR
DATE OF SERVICE			DESCRIPTION OF SERVICE			ITEM No.	AMOUNT OF BENEFIT	AMOUNT PAYABLE BY ASSIGNOR
Day	Month	Year
PATIENT’S ADDRESS

ASSIGNOR TO COMPLETE

I assign to ...................................................................................................my right to payment of medical benefits for the above-mentioned

professional services

   (specify number of services)

I declare that—

• (a)

  I do not contribute to both a basic medical benefits table and a basic hospital benefits table with a registered benefits organization

other than Medibank; and

• (b)

  the patient in respect of whom the service was provided is an Australian resident or is a person to whom the Health Insurance Act

1973 applies by virtue of an approval under section 6 of that Act.

Signature of Assignor or Agent........................................................................................................Date.................. / ................./.....................

____________________________________________________________________________________________________________

ASSIGNEE TO COMPLETE

I accept this assignment and the amounts specified above as being payable by the assignor for the above-mentioned professional services in

full payment of all amounts due to me in respect of those services. The services were rendered by me or on my behalf.

SignatureofAssigneeorAgent...........................................................................................................Date................../................./........................

Form 1b  Regulation 2b

     

MEDICAL CLAIM FORM
(SECTION 22 HEALTH INSURANCE ACT 1973)
CLAIMANT DETAILS			PLEASE PRINT
SURNAME.......................................................................................................................................................................................................
CHRISTIAN or GIVEN NAMES.......................................................................................................................................................................................................
CLAIMANT’S ADDRESS.......................................................................................................................................................................................................
POSTCODE
PATIENT DETAILS					SERVICE DETAILS
FIRST CHRISTIAN OR GIVEN NAME	SEX M or F	MONTH OF BIRTH		MEDIBANK NUMBER	DATE OF SERVICE			NAME OF PRACTITIONER Surname and Initials
					Day	Month	Year

 

Form 1B—continued

PLEASE SUPPLY THESE DETAILS IF YOU HAVE A MEDIBANK MEMBERSHIP BOOK

BOOK NUMBER  TABLE

COMPLETE THE FOLLOWING FOR ANY PATIENT WHOSE MEDIBANK NUMBER IS NOT SHOWN ABOVE. COMPLETION OF A MEMBERSHIP APPLICATION MAY BE REQUIRED._
PATIENT’S SURNAME	CHRISTIAN OR GIVEN NAMES	DATE OF BIRTH
		Day	Month	Year

Do you contribute to a registered hospital benefits organization other than Medibank?  Yes No  

Were any of the above-mentioned services provided in a hospital?  Yes No 

If “Yes”: Name of hospital................................................................................................... Name of patient....................................................................................................................................................

Period in hospital: From  / / to / / Was the patient a private patient? Yes No 

I claim the medical benefits payable in respect of the professional services specified in the attached accounts. Where a receipt is not attached in respect of a professional service, the account has not been paid and I request a cheque payable to the practitioner in respect of that service.

I declare that—

(a) I have incurred the expenses in respect of which this claim is made;

(b) the patient in respect of whom the claim is made is an Australian resident or is a person to whom the Health Insurance Act 1973 applies by virtue of an approval under section 6 of that Act;

(c) I do not contribute to both a basic medical benefits table and a basic hospital benefits table with a registered benefits organization other than Medibank; and

(d) to the best of my knowledge and belief, all the professional services in respect of which this claim is made are services in respect of which medical benefits are payable. (See “Excluded Services”)

    

CLAIMANT’S SIGNATURE........................................................................................................................... DATE.............../................/.........

 

Form 1b—continued

EXCLUDED SERVICES

Under the provisions of the Health Insurance Act 1973 a medical benefit is not payable in respect of a professional service—

(a) that was a medical examination for the purposes of life insurance, a superannuation or provident account scheme or admission to membership of a friendly society;

(b) that was rendered by, or on behalf of, or under an arrangement with the Commonwealth, a State, a local governing body or an authority established by a law of the Commonwealth, a law of a State or a law of an internal Territory (unless the Minister otherwise directs);

(c) if the medical expenses in respect of that service were incurred by the employer of the person to whom the professional service was rendered or the person to whom the professional service was rendered was employed in an industrial undertaking and the service was rendered to him for purposes connected with the operation of that undertaking (unless the Minister otherwise directs);

(d) that was rendered in the course of the carrying out of a mass immunization;

(e) if the service was rendered on the premises of an organization approved for the purposes of the payment of a health program grant;

(f) that was provided to a patient in a private hospital occupying a bed in respect of which the hospital receives a supplementary daily bed payment (unless the Minister otherwise directs);

(g) if the medical expenses in respect of that service have been paid, or are payable, to a recognized hospital;

(h) except with the approval of the Commission, where the service is the administration of an anaesthetic by a practitioner in connexion with another professional service rendered by that practitioner; or

(i) that consists of assistance at an operation rendered by the anaesthetist or a practitioner assisting the anaesthetist.

Form 1c Regulation 2c

CLAIM FOR ASSIGNED MEDICAL BENEFITS

(SECTION 22 HEALTH INSURANCE ACT 1973)

FIRST ASSIGNMENT

CLAIMANT’SNAME................................................................................................................................................... FORMNUMBER................................................................................................................................................................................

CLAIMANT’SADDRESS..................................................................................................................................................... LASTNUMBER................................................................................................................................................................................

NUMBER OF

ASSIGNMENT FORMS

AMOUNT CLAIMED $

I hereby claim in respect of the professional services specified in the attached assignment forms the amounts specified in those forms in the column headed “AMOUNT OF BENEFIT”.

I declare that none of the amounts claimed is in respect of a professional service—

(a) that was rendered in a recognized hospital to a patient who was not a private patient:

(b) that was rendered in the carrying out of a mass immunization:

(c) that was a medical examination for the purposes of life insurance, a superannuation or provident account scheme or admission to membership of a friendly society; or

(d) in respect of which, to the best of my knowledge and belief, a medical benefit is otherwise not payable under the Health Insurance Act 1973.

I further declare that no other payments have been sought from the assignors other than those specified in the columns headed “AMOUNT PAYABLE BY ASSIGNOR” on the attached assignment forms.

      

CLAIMANT'S SIGNATURE....................................................................................................................... DATE................../................./.........