Health Insurance Regulations (Amendment) (Cth)

Statutory Rules

1976 No. 202

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 twenty-second day of September, 1976.

John R. Kerr

Governor-General.

By His Excellency’s Command,

Minister of State for Health.

 

Amendments of the Health Insurance Regulations 

1. After regulation 2ab of the Health Insurance Regulations the following regulation is inserted:—

Net operating costs of recognized hospitals in internal Territory.

“ 2aab. (1) For the purposes of paragraph (b) of the definition of ‘ net operating costs ’ in sub-section 3 (1) of the Act, the net operating costs in relation to a recognized hospital in an internal Territory during a period referred to in sub-section 32 (3) of the Act shall be the amount (if any) by which the gross operating costs of the hospital during the period exceed the revenue of the hospital during the period.

“ (2) For the purposes of sub-regulation (1), the gross operating costs of a hospital during a period shall be the aggregate of all payments made by the hospital during the period, other than payments for or in relation to—

(a) the purchase of an interest in land;

(b) the planning and construction of a building (including the cost of preparing the site for the construction of the building);

(c) the planning and construction of extensions of an existing building (including the cost of preparing the site for the extensions of the building);

(d) the purchase and erection of a portable building (including the cost of preparing the site for the erection of the building);

 

* Notified in the Australian Government Gazette on 23 September 1976.

  Statutory Rules 1975, No. 80, as amended by Statutory Rules 1975, Nos. 118, 125 and 135.

12603/76—Recommended retail price 20c 10/12.8.1976

 

(e) the initial provision and installation of plant, equipment, furniture, furnishings, fittings, ancillary services and facilities in a building—

(i) constructed on land referred to in paragraph (a); or

(ii) referred to in paragraph (b) or (d),

or in an extension referred to in paragraph (c);

(f) the planning and execution of a project costing $5,000 or more for the modification of a building or other works or of a part of a building or other works, including the provision and installation of plant, equipment, furniture, furnishings, fittings, ancillary services and facilities in the building or other works so modified;

(g) the planning and execution of a project costing $5,000 or more for the provision or installation in the hospital of fittings, services or facilities other than fittings, services or facilities referred to in paragraph (e) or (f);

(h) the provision or installation in the hospital of an item costing $5,000 or more, being an item comprising plant, equipment, furniture, furnishings or fittings other than plant, equipment, furniture, furnishings or fittings referred to in paragraph (e) or (f);

(i) a loan made by the hospital;

(j) the repayment of a loan made to the hospital;

(k) interest in respect of a loan made to the hospital;

(l) the provision, after 30 June 1975, of services not normally provided by hospitals other than services of a kind provided by the hospital during the whole of the period from and including 1 April 1975 to and including 30 June 1975; or

(m) the establishment and maintenance of a fund or an account to provide for the replacement of depreciated assets.

“ (3) For the purposes of sub-regulation (1), the revenue of a hospital during a period shall be the aggregate of an amount ascertained by multiplying $2 by a number (being the number of days of hospital treatment in the hospital, whether included in the period or not, in respect of which payment was made to the hospital during the period and in respect of which Commonwealth benefit has been paid or is payable under sub-section 46 (1) of the National Health Act 1953) and of all receipts by the hospital during the, period, other than receipts for or in relation to—

(a) the sale of an interest in land;

(b) the sale of abuilding for the purposes of removal;

(c) the sale of anitem, comprising plant, equipment, furniture, furnishings or fittings, where the item—

(i) is sold for $5,000 or more and is not intended to be replaced; or

(ii) is replaced by an item costing $5,000 or more;

(d) a loan made to the hospital;

(e) the repayment of a loan made by the hospital;

(f) interest in respect of a loan made by the hospital;

(g) a donation or legacy to the hospital for a purpose referred to in a paragraph of sub-regulation (2)or for the provision of amenities for patients;

 

(h) fund raising activities conducted on behalf of the hospital for a purpose referred to in a paragraph of sub-regulation (2) or for the provision of amenities for patients;

(i) interest payments on receipts in relation to a donation or legacy referred to in paragraph (g) or to fund raising activities referred to in paragraph (h);

(j) moneys to be held in trust for a patient and interest in respect of moneys so held,

and amounts received by the hospital—

(k) under section 32 of the Act;

(l) under any Act in respect of the maintenance of the hospital;

(m) from the Commonwealth for a purpose referred to in a paragraph of sub-regulation (2); or

(n) otherwise from the Commonwealth by way of grant or benefit in relation to any period before 1 July 1975.

“ (4) For the purposes of this regulation, a donation, legacy or payment to, or a payment by, the person who, or organization that, conducts a hospital shall be deemed to be a donation, legacy or payment to, or a payment by, that hospital.”.

2. Regulations 2a, 2b and 2c of the Health Insurance Regulations are repealed and the following regulations substituted:—

Form of agreement assigning right to payment of medical benefit.

“ 2a. For the purposes of sub-section 20 (3) of the Act, the prescribed form, in accordance with which an agreement for the assignment of a right to payment of medical benefit may be entered into, is Form 1a in Schedule 1.

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

“ 2b. For the purposes of section 22 of the Act, the prescribed form, in accordance with which a claim for medical benefit by the person who incurred the medical expenses shall be made, is Form 1b in Schedule 1.

Claim form—claim by person to whom right to payment of medical benefit has been assigned.

“ 2c. For the purposes of section 22 of the Act, the prescribed form, in accordance with which a claim for medical benefit by a person to whom the right to payment of medical benefit has been assigned under an agreement referred to in sub-section 20 (3) of the Act shall be made, is Form 1c in Schedule 1.”.

3. Regulations 3 and 4 of the Health Insurance Regulations are repealed and the following regulations substituted:—

Application form–application for approval as hospital.

“ 3. For the purposes of sub-section 24 (1) of the Act, the prescribed form, in accordance with which an application under that sub-section by the proprietor of premises for the approval of the premises as a hospital shall be made, is Form 1 in Schedule 1.

Form of certificate of approval of premises as hospital.

“ 4. A certificate of approval of premises as a hospital, being a certificate issued under section 25 of the Act, shall be in accordance with Form 2 in Schedule 1.”.

Application form—application by organization for approval to provide care and treatment.

4. Regulation 5 of the Health Insurance Regulations is amended by omitting sub-regulation (1) and substituting the following sub-regulation:—

“ (1) For the purposes of sub-section 34 (2) of the Act, the prescribed form, in accordance with which an application under that sub-section by an organization shall be made, is Form 3 in Schedule 1.”.

 

Claim form—claim for daily bed payment.

5. Regulation 6 of the Health Insurance Regulations is amended by omitting sub-regulation (1) and substituting the following sub-regulation:—

“ (1) For the purposes of section 35 of the Act, the prescribed form, in accordance with which a claim for payment to a private hospital of a daily bed payment under section 33 of the Act shall be made, is Form 4 in Schedule 1.”.

Claim form—claim for supplementary daily bed payment.

6.Regulation 7 of the Health Insurance Regulations is amended by omitting sub-regulation (1) and substituting the following sub-regulation:—

“ (1) For the purposes of section 35 of the Act, the prescribed form, in accordance with which a claim for the payment to an organization of a supplementary daily bed payment under sub-section 34 (4) of the Act shall be made, is Form 5 in Schedule 1.”.

7. After regulation 7 of the Health Insurance Regulations the following regulation is inserted:—

Form of warrant for authorized person to enter premises.

“ 7a. For the purposes of sub-section 37 (3) of the Act, the prescribed form, in accordance with which a Magistrate may grant a warrant authorizing an authorized person to enter premises for the purpose of exercising the functions of an authorized person under section 37 of the Act, is Form 5a in Schedule 1.”.

Application form—application for approval as an organization under Part IV of the Act.

8. Regulation 8 of the Health Insurance Regulations is amended by omitting sub-regulation (1) and substituting the following sub-regulation:—

“ (1) For the purposes of sub-section 40 (1) of the Act, the prescribed form, in accordance with which an application under that sub-section by an organization for approval as an organization under Part IV of the Act shall be made, is Form 6 in Schedule 1.”.

Application form—application for approval of health service.

9. Regulation 9 of the Health Insurance Regulations is amended by omitting sub-regulation (1) and substituting the following sub-regulation:—

“ (1) For the purposes of sub-section 41 (1) of the Act, the prescribed form, in accordance with which an application under that sub-section by an organization for approval of a health service shall be made, is Form 7 in Schedule 1.”.

10. After regulation 9 of the Health Insurance Regulations the following regulation is inserted:—

Allowances for witnesses at hearing before Medical Services Committee of Inquiry or Optometrical Services Committee of Inquiry.

“ 9a. The prescribed allowances for expenses that shall be paid under section 100 of the Act, or that section in its application in relation to an Optometrical Services Committee of Inquiry by virtue of section 106d of the Act, to a person appearing as a witness at a hearing in respect of his attendance before a Medical Services Committee of Inquiry or an Optometrical Services Committee of Inquiry, as the case requires, shall be the allowances ascertained in accordance with Schedule 2.”.

Schedule.

11. The Schedule to the Health Insurance Regulations is amended—

(a) by omitting all words before the words—

“ ASSIGNMENT FORM ”,

and substituting the words—

“ SCHEDULE 1

FORM 1a ”; and

(b) by inserting after Form 5 the following form:—

 

“Form 5a Regulation 7a

HEALTH INSURANCE ACT

Search Warrant Under Sub-section 37 (3)

To: [full name], an authorized person within the meaning of section 37 of the Health Insurance Act 1973.

WHEREAS, on an application under sub-section 37 (2) of that Act in relation to premises at , I, [full name], a Magistrate within the meaning of that expression in section 37 of that Act, am satisfied, by information on oath [or affirmation]—

(a) that there is reasonable ground for believing that there are on those premises books [or documents or papers or as the case may be] relating to the occupation of approved beds within the meaning of that Act in premises at , being premises approved as a hospital under section 24 of that Act; and

(b) that the issue of a warrant is reasonably required for the purposes of that Act;

YOU ARE HEREBY AUTHORIZED, with such assistance as you think necessary, to enter the premises at  , during the hours of  [or at any time], if necessary by force, for the purpose of exercising the functions of an authorized person under section 37 of that Act, namely, to search for, inspect, take extracts from, or make copies of, any books [or documents or papers or as the case may be] relating to the occupation of approved beds in that hospital.

AND for so doing, this shall be your sufficient warrant.

Dated this day of , 19 .

Magistrate”.

Schedule 2.

12. After the Schedule to the Health Insurance Regulations the following Schedule is added:—

SCHEDULE 2 Regulation 9a

WITNESSES’ ALLOWANCES FOR TRAVELLING AND OTHER EXPENSES

1. A witness appearing, because of his professional, scientific or other special skill or knowledge, before a Committee shall be paid an allowance of not less than $45, or more than $225, for each day on which he so appears.

2. A witness, other than a witness referred to in Item 1, appearing before a Committee shall be paid—

(a) if he is remunerated by wages, salary or fees—

(i) an allowance equal to the amount of wages, salary or fees lost by him by reason of his so appealing; or

(ii) an allowance of $50 for each day on which he so appears,

whichever is the less; or

(b) if he is not so remunerated—an allowance of $25 for each day on which he so appears.

3. A witness appearing before a Committee to give expert evidence shall be paid, in addition to any other allowance payable to him under Item 1 or 2, a reasonable amount for qualifying to give that evidence.

4. A witness appearing before a Committee to give evidence shall be paid a reasonable amount—

(a) in respect of his conveyance to and from the place at which he so attends; and

(b) if he is required to be absent overnight from his usual place of residence, for meals and accommodation.

5. In this Schedule, “Committee” means a Medical Services Committee of Inquiry or an Optometrical Services Committee of Inquiry.

 

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