Health Insurance Regulations (Amendment) (Cth)

Statutory Rules 1987 No. 1661

 

Health Insurance Regulations2 (Amendment)

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 29 July 1987.

N. M. STEPHEN

Governor-General

By His Excellency’s Command,

Neal Blewett

Minister of State for Community Services and Health

 

Commencement

1. These Regulations shall come into operation on 1 August 1987.

Prescribed particulars for purposes of subsection 19 (6) of the Act

2. Regulation 2ada of the Health Insurance Regulations is amended:

(a) by omitting from paragraph (1a) (b) all words after “rendered”;

(b) by inserting after subregulation (1a) the following subregulations:

“(1ab) For the purposes of subsection 19 (6) of the Act, the following particulars are prescribed in relation to professional services of the kind referred to in paragraph (da) of the definition of ‘basic private table’ or ‘basic table’ in subsection 4 (1) of the National Health Act 1953:

(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) in lieu of the particulars referred to in paragraph (a)—a description of the professional service sufficient to identify the item that relates to the professional service preceded by the word ‘in patient’.

 

(S.R. 190/87)—Cat. No.  15/23.7.1987

 

“(1ac)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 (1ab), namely, a description of the professional service sufficient to identify the item that relates to the service.”;

(c) by omitting from paragraph (3) (a) “to which paragraph 16a (1) (a) of the Act applies—” and substituting “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:”;

(d) by omitting subparagraph (3) (a) (i) and substituting the following subparagraph:

“(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 who determined that the professional service was necessary—the provider number in respect of that place of practice of that practitioner; or

(b) where that request was not made at the place of practice of the practitioner who determined that the professional service was necessary—the provider number in respect of any place of practice of that practitioner; and”;

(e) by omitting from subparagraph (3) (a) (ii) “and”;

(f) by omitting subparagraph (3) (a) (iii);

(g) by omitting subparagraph (3) (b) and substituting the following subparagraph:

“(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.’”;

(h) by omitting from paragraph (3) (c) “paragraph 16 (a) (1) (c)” and substituting “subsection 16a(7)”;

(i) by omitting from paragraph (3) (c) “sub-paragraph 16a(1) (c) (ii)” and substituting “paragraph 16a(7) (b)”;

(j) by omitting from subregulation (4) “a Division (other than Division 9) of the pathology services table or in” and “or approved pathology practitioner”; and

(k) by inserting after subregulation (4) the following subregulation:

“(4a) 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 a Division (other than Division 9) of the pathology services table relates, namely, the name and either the address of the place of practice, or the provider number in respect of the place of practice, of:

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

 

(b) where the professional service was rendered wholly in an accredited pathology laboratory—any approved pathology practitioner by whom, or on whose behalf, professional services may be rendered in that accredited pathology laboratory; or

(c) where the professional service, being a professional service in respect of which a request was made;

(i) to an approved pathology practitioner rendering professional services in an accredited pathology laboratory owned and controlled by a single approved pathology authority; or

(ii) to the approved pathology authority owning and controlling that accredited pathology laboratory;

was rendered partly in that accredited pathology laboratory and partly in another accredited pathology laboratory owned and controlled by the same approved pathology authority—any approved pathology practitioner by whom, or on whose behalf, professional services may be rendered in the first-mentioned accredited pathology laboratory.”.

 

NOTES

1. Notified in the Commonwealth of Australia Gazette on 31 July 1987.

2. Statutory Rules 1975 No. 86 as amended to date. For previous amendments see Note 2 to Statutory Rules 1987 No. 32 and see also Statutory Rules 1987 Nos. 32 and 163.

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