Health Insurance (Variation of Fees and Medical Services) (No. 46) Regulations (Cth)
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
Dated 5 March 1987.
N. M. STEPHEN
Governor-General
By His Excellency's Command,
NEAL BLEWETT
Minister of State for Health
AMENDMENTS OF SCHEDULE TO THE HEALTH INSURANCE (VARIATION OF FEES AND MEDICAL SERVICES) (NO. 44) REGULATIONS
1. Omit rules 3 and 4 of the rules for the interpretation of the table of general medical services, substitute the following rules:
'3. Where an item, other than an item in Part 1, in Division 3 of Part 3 or in Part 4, includes the symbol "(S)", the item shall be taken to relate to the service
specified in the item when rendered by a specialist in the practice of his or her specialty:
(a) to a patient who has been referred to the specialist, where that service is the first service rendered to that patient by the specialist subsequent to his or her receipt of the referral;
(b) to a patient who has been referred to the specialist, where that service constitutes part of a single course of treatment rendered to that patient for the condition identified in the referral, or, if no condition was identified in the referral, for the condition identified by the specialist, and that service is rendered within the period of 12 months (or such lesser period, if any, specified by the medical practitioner who referred the patient) after the day on which the first service rendered pursuant to the referral was rendered;
(c) to a patient who has declared that a written referral was completed by a specified medical practitioner and that that referral has been lost, stolen or destroyed prior to the rendering of the service, where that service is the first service rendered by the specialist pursuant to that referral or where that service constitutes part of a single course of treatment rendered to that patient for the condition identified by the specialist when he or she rendered the first service rendered to that patient subsequent to the making of the declaration and that service is rendered within the period of 12 months after the day on which the first service rendered pursuant to the referral was rendered; or
(d) to a patient who has not been referred to the specialist, where the specialist was, at the time that that service was rendered, of the opinion that it was necessary that that service be rendered as quickly as possible.
'4. Where an item, other than an item in Part 1, in Division 3 of Part 3 or in Part 4, includes the symbol "(G)" the item shall be taken to relate to the service specified in the item when rendered otherwise than by a specialist in the practice of his or her specialty:
(a) to a patient who has been referred to the person rendering the service, where that service is the first service rendered to that patient by the person rendering the service subsequent to the receipt of the referral;
(b) to a patient who has been referred to the person rendering the service, where that service constitutes part of a single course of treatment rendered to that patient for the condition identified in the referral, or, if no condition was identified in the referral, for the condition identified by the person rendering the service, and that service is rendered within the period of 12 months (or such lesser period, if any, specified by the medical practitioner who referred the patient) after the day on which the first service rendered pursuant to the referral was rendered;
(c) to a patient who has declared that a referral was completed by a specified medical practitioner and that that referral has been lost, stolen or destroyed prior to the rendering of the service, where that service is the first service rendered pursuant to that referral or constitutes part of a single course of treatment rendered to that patient for the condition identified by the person rendering the service when he or she rendered the first service rendered to that patient subsequent to the making of the declaration and that service is rendered within the period of 12 months after the day on which the first service rendered pursuant to the referral was rendered; or
(d) to a patient who has not been referred to the person rendering the service, where that person was, at the time that that service was rendered, of the opinion that it was necessary that that service be rendered as quickly as possible.'.
2. Omit from Rule 5 of the rules for the interpretation of the table of general medical services "rule 3 or 4", substitute "rule 3, 4 or 5A"
3. After rule 5 of the rules for the interpretation of the table of general medical services insert the following rule:
'5A. A reference in an item in Part 1 to an attendance by a specialist or consultant physician in the practice of his specialty where the patient is referred to him shall be read as including a reference to an attendance by a specialist or consultant physician in the practice of his or her specialty where:
(a) the patient has declared that a written referral was completed by a medical practitioner in respect of the patient, the name of the medical practitioner who completed that referral, and that that referral has been lost, stolen or destroyed prior to the attendance specified in the item; or
(b) the patient has not been referred to the specialist or consultant physician and the specialist or consultant physician was, at the time of the attendance specified in the item, of the opinion that it was necessary that that service rendered as quickly as possible;
but shall not be read as including a reference to an attendance by a specialist or consultant physician in the practice of his or her specialty where the service rendered forms part of a single course of treatment for which the first service was rendered on a day more than 12 months prior to the day on which that service was rendered, unless a subsequent referral has been made.'.
1. Notified in
the
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